Nearly all Americans want to age in place, but policies and payment mechanisms often get in the way of seniors getting the care they need at home. Between burdensome regulations and limitations on payments for certain types of care, there are a number of policy changes that would better enable seniors to receive care at home.
Leaders across the care spectrum agree that policy updates are necessary for aging Americans to receive necessary care.
“The current care delivery models, infrastructure and reimbursement systems will need to evolve if we want patients to benefit from access to affordable and high-quality health care,” said Tom DeRosa, CEO and director of senior housing real estate investment trust (REIT) Welltower Inc., speaking at the 2016 d.health Executive Summit in New York City. Welltower (NYSE: HCN) is a major real estate owner of senior housing care facilities across the country.
While the home health care industry has seen an onslaught of new regulations over the past few years, not all of these are helpful to expanding care to more Americans at home. Here are the top regulatory recommendations that would better enable home care, according to a white paper from d.health that summarizes major takeaways from the summit:
1. Renovate the regulatory system
Executives agreed that instead of piecing together different regulations, legislative changes could be more focused on getting rid of outdated systems and even standardizing licensing requirements across state lines. Current regulatory changes are making the home health space more complex and even adding costs.
“The gradual accumulation of disparate regulations adds complexity and cost while deterring agile development to meet changing needs,” according to the white paper.
Modern systems will help simplify procedures for all, executives said, including patients, providers, payers and vendors.
2. Reform health care payments
As the health system shifts from fee-for-service reimbursements to value-based purchasing, new metrics and technology need to keep up, experts argue. In addition to paying for home health care services, Medicare should expand to cover telemedicine as more Americans receive health care at home.
“Telemedicine reimbursement (by Medicare). I cannot think of anything more important,” Tom Daschle, a former Senator from South Dakota, founder and CEO of The Daschle Group and a member of the 2016 d.health Advisory Board, said at the summit. “[It is] the most important catalyst by far to bring about home care for individuals with chronic conditions. …[It] has extraordinary potential for transforming home health care and chronic illness management.”
Currently, Medicare fee-for-service does not cover telemedicine, though some private insurers are expanding coverage in this space, according to d.health.
3. Foster interoperability
Currently, between care settings, interoperability is virtually nonexistent. Greater access to medical records, along with telemedicine could encourage more timely care and implementation of payments and penalties. Free-flowing information will likely result in higher quality care. Encouraging wider use of electronic medical records (EMRs) could also boost interoperability, experts said.
4. Tackle the social determinants of health
Access to high quality care is often blocked by social determinants, such as a person’s ability to transport themselves to a physician’s office or have good quality food available to them. These factors can influence the cost of care as well. Supporting access to these other factors of health can improve patient outcomes and reduce overall health care costs.
“The new administration should look to support improvements in such factors, whether by guidance calling on health plans to get Medicaid patients on food assistance or accelerated implementation of rural high-speed Internet access to facilitate connected living and telehealth,” the paper urges.
5. Encourage planning and engagement
Overall, Americans will be better off to age if they are well prepared for their retirement needs. Not only should Americans have better retirement plans in terms of their finances, but family members and other informal caregivers who help provide care at home could be better engaged and informed with better policies.