Give American Seniors the Option to Choose Home After a Hospital Discharge

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Healthcare needs to adapt so Medicare beneficiaries can select the care setting that’s most appropriate for their health, safety and quality of life when they require care after a hospitalization.

It’s true that old habits and old routines die hard — and for decades our nation’s complex healthcare system has, in some areas, been slow to change with the times. But the past year battling the COVID-19 pandemic has shown us how quickly — and how fundamentally — we can adjust and improve care when we need to.

In a remarkably short period of time, we’ve dramatically expanded safe and convenient telehealth; we’ve witnessed rapid development and deployment of life-saving vaccines; and we can now reliably test for a potentially deadly virus at home, whereas the same testing, even in a doctor’s office, was incredibly hard to come by a little more than a year ago.

It’s clear that transforming care is possible and healthcare can, indeed, flex to meet the needs of the population. It’s time that we do so for the nation’s Medicare beneficiaries when needing care after a hospitalization — adapting post-acute care delivery to ensure older Americans and their families can select the care setting that’s most appropriate for their health, safety and quality of life.

With the support of federal lawmakers, leading home health advocates are working to ensure those changes happen soon. In fact, new bipartisan legislation introduced by Senators Debbie Stabenow (D-MI) and Todd Young (R-IN) and Representatives Henry Cuellar (D-TX) and James Comer (R-KY) — and endorsed by AARP — is designed to provide Medicare beneficiaries with expanded options for their recovery care following surgery, illness or injury.

For years, Medicare beneficiaries have overwhelmingly preferred home-based care over nursing homes, but policy restrictions have prevented many seniors from accessing it. Many patients who go to skilled nursing facilities (SNFs) after hospitalization have similar levels of disease and impairment to those who receive care at home. The main difference in these patients is that individuals ultimately admitted to SNFs often don’t have access to the kind of supplemental health care support they’ll need.

The Choose Home Care Act (S.2562/H.R. 5514) offers an opportunity to change that by enabling eligible Medicare patients to receive extended care services as an add-on to the existing Medicare Home Health benefit — for 30 days post-discharge from a hospital. In real-world terms, it’s a law that seeks to help more seniors recover in the comfort and dignity of their homes — by offering expanded home health services like skilled nursing, therapy, primary care, personal care, continuous remote patient monitoring, meals, home adaptations, and non-emergent transportation.

Providing for comprehensive care services will help more seniors remain independent in the community and has the potential to deliver cost savings to the Medicare program. One expert analysis anticipates that the Choose Home model would generate as much as $247 million in savings annually in avoided skilled nursing facility stays.

A recent public opinion poll, conducted by Morning Consult, underscores the popularity of home health and the importance of passing the Choose Home Care Act. Of the poll respondents, 86 percent of adults, including 94 percent of Medicare beneficiaries, expressed support for the legislation.

Not to be overlooked, the enhanced home health options outlined in the Choose Home Care Act are designed to improve patient and family satisfaction and increase their care options. These choices and flexibilities are especially important during the ongoing COVID-19 pandemic.

There has never been a better time for our lawmakers in Washington, D.C., to enable the delivery of more care in the home. The Choose Home approach offers bold new post-acute options, addresses gaps in care for seniors, and positions Medicare to avoid unnecessary institutional spending. This is an incredible opportunity for our nation, with an aging population, to embrace new approaches to healthcare.

Steven Landers, MD, MPH, is the president and CEO of the Visiting Nurse Association Health Group, Inc.

Craig Mandeville is founder and CEO of Forcura.