Home Is Where the Health Care Is: New Study Shows Increase in Number of Homebound Older Adults While CMS Expands Home Health Reimbursement Model
JAMA Internal Medicine recently published an article finding that the number of homebound adults aged 70 or older more than doubled during the last decade. In 2011, approximately 5% of adults aged 70 or older were homebound compared with 13% in the same age group in 2020. The authors indicate the steep incline in 2020 was likely due to social distancing restrictions and other health precautions taken over the course of the COVID-19 pandemic. But the high number of homebound adults aged 70 and older will likely continue throughout 2021 and have potential lasting effects on the overall health of the individuals and their health care delivery.
While telehealth has become a staple in the lives of many post-pandemic (as discussed in a prior blog post), it may not be reaching this vulnerable population. The JAMA article indicated that, of the survey respondents, 27.8% did not have a cell phone, 50.8% did not have a computer, and more than 50% did not email, text or go online in the last month. This means those in this population that need assistance with health care services may need to rely on in-person home care.
Fortunately, since we last wrote about the home health care industry on this blog, the Centers for Medicare and Medicaid Services (CMS) proposed an expansion of Home Health Value-Based Purchasing (HHVBP) by approximately $310 million, which would take effect in 2022. CMS’s Innovation Center first implemented the HHVBP Model in January of 2016, aiming to improve quality outcomes with financial incentives. CMS’s commitment to expand the HHVBP Model is likely due to the Model’s success. In the Model’s Fourth Annual Evaluation Report prepared by Arbor Research Collaborative for Health, CMS reported moderate improvements in almost every quality measurement category, and found an annual reduction in total Medicare spending of $151 million. The bulk of the savings came from reducing the number of inpatient and skilled nursing facility admissions.
Continued increases in the number of homebound adults aged 70 or older, increased investment in home health care programs that improve quality and reduce health care spending, and additional findings that in-home care can improve patient mental health and reduce hospital readmission rates will continue to foster growth of the home health care industry.