Choose Home Case Study: A Better Option for Patients and Caregivers

Home healthcare is an essential care option for patients recovering from a hospital stay and in need of continued treatment for an acute or chronic health problem. Unfortunately, many patients do not have the option to recover at home. Instead, many Medicare beneficiaries must receive care in a skilled nursing facility following hospitalization due to limited care options under Medicare’s current payment structure.

With the pandemic amplifying existing limitations and challenges of care in institutional settings, it is time to modernize the Medicare home healthcare program and create more choice for seniors who need post-acute care, following a hospitalization. Fortunately, Congress has recognized the need to address this gap by introducing the Choose Home Care Act of 2021 (S. 2562/H.R. 5514), which would create an alternative to skilled nursing home care for Medicare beneficiaries seeking to recover at home following a hospitalization.

To better understand how the Choose Home option might help seniors, consider the case of an 85-year-old patient who was admitted to the hospital after suffering a stroke:

Prior to admission, the patient was completely independent, with the ability to walk, drive, and manage all their health care and personal needs. Following a stroke, the patient needed to use a walker, undergo speech therapy, receive a special modified “Mechanical Soft” diet, and receive 24-hour supervision. The Care Management Team recommended “Facility Based Services,” but the patient and their caregiver initially refused, and the patient was adamant to return home.

The current Medicare home health benefit offers limited support and does not afford nursing home eligible patients with daily clinical services and other extended care supports that would allow this type of patient to be discharged to home. Without this type of clinical services and supports, the caregiver made the difficult decision for the patient to transfer to a skilled nursing facility prior to returning home.

The Choose Home legislation is designed to offer Medicare beneficiaries greater choice in their post-acute care decisions. This patient, as an alternative to skilled nursing facility care, could receive home based daily skilled nursing care, as well as physical, occupational, and speech therapy to help recover from their stroke. In addition, Choose Home would cover clinically appropriate meals, home adaptive equipment, and up to 360 hours of personal care. Choose Home also covers respite care and caregiver support, education, and training which would alleviate the patient’s caregiver from becoming overwhelmed.

The expanded coverage for home healthcare also adds value toward improving patient satisfaction, potentially patient outcomes, and quality of life.

With America’s senior population rapidly growing, it will be critical for Congress to pass the Choose Home Care Act so that our healthcare system can better meet Medicare beneficiaries’ unique needs. Click here to urge your lawmakers to support this important legislation.