Study Shows Home Health Services Are Being Underutilized

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Entrusted Legacy Law

For more information about the author, click to view their website: Sharek Law LLC

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Sep 18, 2023

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Pennsylvania - Greater Pittsburgh Area

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Health Affairs estimates that 4 million older adults can only leave their homes with assistance, making accessing care challenging.

The Centers for Disease Control and Prevention reports that 1.3 million Americans receive care in nursing homes. According to A Place for Mom, more than 810,000 reside in assisted living.

Home health care presents an alternative to nursing homes and assisted living, providing care for homebound people. Those who receive home health care can remain in their residences, reducing expenses, preserving autonomy, and maintaining community ties.

Although Medicare funds some home health care services, a recent study has found that Medicare beneficiaries are underutilizing the program’s home health care options. Many older adults do not receive the home-based clinical care or home-based long-term services and supports that could benefit them.

Medicare Coverage of Home Health Services

Medicare Parts A and B cover certain home health services. Homebound individuals can receive part-time or intermittent skilled services. Part A covers home health care for people following a hospital stay or a stay in a skilled nursing facility. Part B provides home health care for homebound adults who need skilled nursing care.

A Medicare beneficiary is considered homebound in the following situations:

  • Because of an illness or injury, they have trouble leaving their home without help, such as a cane, wheelchair, walker, or crutches, special transportation, or another person’s assistance.

  • Their physician recommends staying at home.

  • Leaving their residence takes a major effort.

The program covers medically necessary part-time or intermittent skilled nursing care and health assistance, durable medical equipment, and medical supplies for use at home.

Medicaid also covers long-term services and supports (LTSS), which include medical and personal care services that aid with activities of daily living (ADLs). These are the kinds of services an assisted living facility typically provides.

Use of Home-Based Clinical Care and Long-Term Services and Supports Among Homebound Older Adults

A 2023 study published in the Journal of American Medical Directors Association looked into home-based clinical care and home-based LTSS among homebound older Medicare beneficiaries. The researchers examined the Medicare claims of 974 beneficiaries to shed light on their use of in-home services.

The study found that while homebound individuals used these services, no group received high levels of all care types.

Homebound individuals more commonly utilized LTSS services than home-based clinical care.

  • Approximately 30 percent of participants received some home-based clinical care.

  • About 80 percent of the sample received home-based LTSS.

The researchers identified three levels of home clinical care and LTSS usage among older adults:

  • Low Care and Services (46.6 percent). The largest group of participants received little home-based care. These individuals tended to be younger with fewer chronic conditions and functional impairments.

  • Home Health Only with LTSS (44.5 percent). While this group used some home health services, such as assistance with ADLs, they received little home-based clinical care.

  • High Clinical with LTSS (8.9 percent). Only a few participants had extensive home-based clinical care. In addition to tending to be older, they were more likely to have dementia and live alone.

In finding that only roughly 9 percent of participants receive high levels of clinical care and LTSS, the study points to a gap between those who could benefit from these services and the care provided. Although in-home care and support could meet the needs of older adults, many homebound older adults do not take full advantage of the services available.

Learn More About Your Options

If you or your loved one need help with medicare care of activities of daily living at home, contact Sharek Law Office at 412-347-1731 or click here to schedule a complimentary 15-Minute call to learn more about your options.

 

This article is a service of Sharek Law Office, LLC. We don’t just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than you’ve ever been before and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

Study Shows Home Health Services Are Being Underutilized

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Entrusted Legacy Law

Elder Law 100 Pinewood Lane Suite #303, Warrendale, Pennsylvania, 15086

Our Firm Prepares You for Life What makes our firm different is that we were built with the needs of growing families in mind. We understand you are BUSY, you are growing, you are planning for a life of prosperity and you value ease, convenience and efficiency. You are raising children, and caring for elderly parents, while also working hard to build your own nest egg for a lifetime of support. You want to know youve made the best decisions for your family and that your plan will work when your loved ones need it most. You want to make sure your minor children would be raised by the people you choose, and never by anyone you wouldnt want, and that your teens and adult children are properly prepared to care for you and what you leave behind.  You want to feel confident that youve made the right choices, and handled everything so that you arent leaving behind a mess, when something happens. That is our focus as well. Weve developed unique systems to give you the same access to a Personal Family Lawyer as was previously only available to the super-wealthy, so you can have the guidance you need to build and maintain a life of prosperity and wealth. And, to keep your family out of court and out of conflict, which is the greatest risk to the people you love and all you have created, even if youve already worked with a traditional lawyer or created documents online. Our Team Is Here for You We encourage communication with our clients. In fact, weve thrown out the time clocks so you never have to be afraid to call with a quick question. Everything we do is billed on a flat-fee basis, agreed to in advance, so there are never any surprises. We have a whole team to serve you. When you call our office to ask your quick question, you wont have to wait hours or days for a phone call back. Youll get your question answered, right away. And, if you need to schedule a more in-depth legal or strategic call with your Personal Family Lawyer, a call will be scheduled when you're both available and ready for the call so we can make the very best use of your time and not waste your time by leaving voicemail after voicemail back and forth. And, we ensure the most important details of your planning are followed through on and your plan continues to work throughout your lifetime. We have a funding coordinator to ensure your assets are owned the right way throughout your lifetime and none of your assets will end up going through a long, expensive court process or being lost to the state because they were missed after your death. Weve created unique membership programs to keep your plan up to date year in and year out as well as give you access to our Trusted Team of Legal Experts for guidance on ANY legal or financial matter. One day you will need a lawyer. I dont know why and I dont know when, but when you do, you will be grateful you can call on us and well be here to advise you or get you out of a jam. We Help You Transfer Your Life and Legacy Lastly, we believe your financial wealth is only a small part of your overall Life and Legacy Planning which is made up of your far more valuable and most often lost upon incapacity or death intellectual, spiritual and human assets. These assets are what make you who you are, and sum up whats most important to you. And, a survey of inheritors has revealed that what they care about even more than inheriting your money, is inheriting these intangible assets.   Most estate plans only focus on the transfer of your financial wealth to the next generation. Most people have such great intentions of passing on the intangible, but very few ever get around to it. Its just not a priority, until its too late. How much do you know about your grandparents values? Their most prized personal possessions? How they felt about you? What they had learned during their lifetime? If you are like most people, you know very little. Thats why we build the capture and passage of these most valuable assets into every estate plan we create. Not only will we help you pass on your money, but also your values, your insights, your stories and your experience the truly valuable assets your loved ones care about the most.  Weve developed a tool that allows us to capture and pass on your whole family wealth, including your Intellectual, Spiritual and Human assets.  I cant go into all of the details here, but well definitely talk about it when you come in for your Life and Legacy Planning Session.

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