Coronavirus Pandemic and Medicare Home Healthcare

Coronavirus highlights the weaknesses in our healthcare system for the most vulnerable populations. 

Covid-19 has a funny way of exposing weakness and patting us on the back for the things we do well. We’ve seen both of these trends in healthcare during the pandemic as some services are used more than others. One such service is home healthcare. 

With widespread stay at home orders and necessary isolation of vulnerable populations, people are in greater need of alternative care solutions. Medicare beneficiaries qualify for home healthcare if prescribed after being discharged from the hospital for at-home post-acute care. Medicare beneficiaries are also eligible if individuals have long-term care needs that keep them restricted to staying at home. 

Home healthcare includes the services of visiting nurses, skilled nurses such as speech therapy of social services. Patients and healthcare proxies are responsible for selecting the best care options that are covered by their insurance. 

However, Medicare home healthcare does not offer the unlimited coverage that many needed before the Pandemic, nevermind during the Pandemic. There are limits on the quantity of hours someone can receive home healthcare services that happen to be less hours than a working week. Often this forces people who are in need of these essential services to split their costs between Medicare and Medicaid, ultimately leading to a poor quality of care. 

Now the population of people using home healthcare services for post-acute care  are not insignificant, as it accounts for about ⅓ of Medicare spending. (healthpayerintelligence.com) “The large amount of federal funding directed to this benefit underscores the importance of efforts to ensure Medicare home health is both sustainable and cost-effective for the long term,” the researchers argued. - Healthpayer Intelligence 

CMS and some states have created cost management measures such as reimbursement and bundled payments to reduce costs to patients. The CARES Act altered home health services to make it more flexible. Despite these efforts, telehealth is still not covered. Luckily in 2021, many insurance companies are looking at expanding their coverage of a new Covid-19 world. 

Researchers investigating home healthcare services see this an evolving story that we will only understand as the Pandemic decreases. In the meantime, advocates are putting pressure on policy  makers to increase access to care for seniors , mandate cost reduction for essential services, and increase pay for home healthcare workers while mandating insurance companies cover a wider range of home healthcare services.