Study Shows Home Health Services Are Being Underutilized


Sharek Law Firm LLC

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Sep 18, 2023


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.

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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.

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Sharek Law Firm LLC

Elder Law 105 Maple Dr, Warrendale, Pennsylvania, 15086

At Sharek Law Firm we dont 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 youve ever been before, and make all the best choices for the people you love.I cherish the opportunity to help secure what you love. I look forward to learning your story, hearing what matters to you, and helping you to discover what's actually needed to keep your loved ones out of court and out of conflict when something happens to you (or them). We specialize in creating wills and trusts to achieve your goals, whether you're located in Pittsburgh or outside of Western PA, we are here to help all Pennsylvania residents.Our law firm was built with your needs of in mind. We understand you are BUSY, and you value ease, convenience, and efficiency. You want to know youve made the best decisions to protect your family and assets, and that your plan will work when your loved ones need it most. We also help make sure your adult children are properly prepared to care for you and what you leave behind.Weve developed unique systems to give you the same access to legal planning 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. Contact us to get started today!