Non-Medical Home Care Could Save At Least $4B in Medicare Costs

Non-medical home care benefits that address the social determinants of health of older adults could curb Medicare spending.

That’s according to findings from a recent study published in the Annals of Internal Medicine, which suggests more than $4 billion in Medicare costs are due to the lack of non-medical support for older adults, specifically those with disabilities.

Conducted by researchers at the Johns Hopkins Bloomberg School of Public Health, the study examined data from the school’s 2015 National Health and Aging Trends Study.

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Roughly 60 million people were enrolled in Medicare by the end of 2018, with expenditures reaching more than $700 billion. Additionally, about 15 million Medicare beneficiaries have disabilities.

For the study, researchers looked at older adults who reported having trouble with household activities, such as meal preparation, laundry, paying bills, mobility and self-care, such as bathing, dressing and eating.

Overall, they found that more than one in five seniors with a disability reported negative outcomes due to lack of support with household activities, mobility and self-care management.

For example, about 27% of disabled older adults were unable to go outside, 22% were unable to move around their homes and 22% had trouble tracking their prescribed medication reported making errors.

Additionally, Medicare spending for disabled older adults who reported negative outcomes was higher than for older adults with disabilities who did not experience negative outcomes.

“The data allow us to see on a granular level how many people …don’t receive the help they need to perform daily activities,” Jennifer Wolff, the study’s lead author and director of the Roger C. Lipitz Center for Integrated Health in the Department of Health Policy and Management said in a press release. “We are able to link that number to a public payer like Medicare and see how much extra the public is paying for services to older adults due to lack of adequate support with basic daily activities.”

In some ways, the study’s findings are in line with the Centers for Medicare and Medicaid Services’ (CMS) recent moves to broaden the Medicare Advantage program, creating room for home care providers to offer non-medical benefits and become partners in MA contracts.

“The findings generally support … the importance of non-medical needs and meeting those needs in terms of having the ability to offset spending on acute-care and other types of medical services,” Wolff told Home Health Care News.

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