Home healthcare has long been a safe and effective alternative to care in an institutional setting. Medicare reforms are overdue to provide viable, extended care services at home for patients who otherwise have only one option: Medicare’s Skilled Nursing Facility benefit. The COVID-19 pandemic has vividly shown the limitations and risks of skilled nursing facilities (SNFs), and extended care at home beyond the pandemic makes sense. There is a better way to care for seriously ill Medicare beneficiaries after hospital discharge.
To address these limitations, home health leaders support a cost-effective and patient preferred home-based extended care program – Choose Home – to supplement the existing Medicare Home Health benefit that better supports patients who choose to recover at home following a hospitalization.
The Choose Home Care Act is designed to serve those who are clinically appropriate for healthcare in their own home but need more services than available under the existing Medicare Home Health benefit.
The Choose Home option would:
- Allow nursing home eligible patients to have the option to receive health care at home following a hospitalization.
- Allow patients to receive all care services provided under the Medicare Home Health benefit.
- Allow patients to receive expanded home health benefit services AND transportation, meals, home modifications, remote patient monitoring, telehealth services, and personal care services for 30 days.
- Not include cost sharing.
- Combine payments for the home health amount and fixed add-on for expanded services.
- Cap add-on payments for expanded services at 80% of the SNF 30-day payment amount, assuring significant Medicare savings under Choose Home.
Estimates suggest the Choose Home program could generate Medicare savings of $121-222 million per year (4.4-8.6% savings of SNF 1st PAC payments), with $2.6-4.8 billion in savings over 10 years. In simulations, Choose Home episodes tend to generate savings when substituting for SNF care as payment rates are not reflective of facility costs.
A recent public opinion poll, conducted by Morning Consult on behalf of the Partnership, underscores the popularity of home health and the importance of passing the Choose Home Care Act of 2021. Of the poll respondents:
- 86% of adults, including 94% of Medicare beneficiaries, expressed support for the Choose Home Care Act.
- 83% of Republicans and 92% of Democrats showing support for the legislation.
- Four in five adults (81%) say it is important for Congress to pass the Choose Home Care Act.
- 97% of Medicare beneficiaries and 96% caretakers for an adult over age 65 say it is important to them personally to have the ability to choose the setting in which they or a loved one recover post-hospitalization.