I once had a patient say to me “please don’t send me to the poor house.” Why? It was my job to inform the eighty-year-old hospitalized man that he could not return to his home. His next stay would be at a nursing home. Ok, so this was the last century, and I was a naive 21-year-old graduate student in my first medical social work internship. He cried. He pleaded. He felt helpless, abandoned, and demoralized. I still see his face and hear his voice in my memory.
The Poor House
I recalled this story in a blog post during the height of the pandemic. In the twenty-first century, we don’t refer to nursing homes as “the poor house” instead we all watched in horror as body bags and refrigerated trailers were the backdrops for reporters outside the nursing homes. The virus was spreading rapidly from staff to patients and back because these facilities lacked the personal protective equipment needed to stop the carnage. In nursing homes and assisted living facilities, families got locked out and residents were confined to their rooms. Isolated. Helplessness. Demoralized.
But wait! Turns out there’s a bunch of Baby Boomers in Congress who are staring down the retirement then frail elderly stages of life. They have put together a new way to deliver high-quality, lower-cost long-term care without entering a nursing home. Could this be the year when the wishes of senior adults and their families finally get coverage for long-term care services at home?
Choose Home Care Act
The proposed legislation is the Choose Home Care Act of 2021 (S. 2562/H.R. 5514) that reduces the cost of nursing home care by enabling Medicare recipients to “Choose Home” for their post-acute care needs. Think about it, today’s remote patient monitoring, health records, and telehealth services provide a level of care at home that has never been possible. Family members and caregivers will need adequate training and a well-coordinated care plan using home health nursing and therapies to keep the healing on track. Best of all, such an approach will likely limit the potential for infections and deadly viruses.
Choose Home Option
- Patient meets SNF benefit eligibility
- The patient resides at home
- Receive traditional HH benefit services AND for 30-days – an expanded package of services including transportation, meals, home modifications, remote patient monitoring, telehealth services, and personal care services
- No cost-sharing
- Payment combines home health amount and fixed add-on for expanded services
- Add-on payments for expanded services are capped at 80% of the SNF 30-day payment amount, assuring savings under Choose Home of about $4,623 per patient.
I believe this legislation can be a game-changer when it comes to senior adult care. Next week I will outline the economic benefits of this approach.
