For Home Health Providers to Support Hospitals, More Federal Barriers Need to Be Lifted

Home health providers are positioning themselves as the answer to lessening the burden on U.S. hospitals during the COVID-19 pandemic, but the federal government will need to continue cutting through the red tape for providers to be effective.

The past four weeks have elicited concerns about hospital over-capacity issues, as the number of confirmed coronavirus cases continues to surge.

“Hospitals are under tremendous pressure right now,” Joanne Cunningham, executive director of Partnership for Quality Home Healthcare (PQHH), told Home Health Care News. “They are experiencing and will continue to experience increased strain. One of the solutions policymakers have focused on is bolstering hospital capacity, but it’s also important to think about how home health … can be a safety valve for the hospital sector.”


Increasing the use of home health care during the COVID-19 means that discharged patients can continue receiving care in the home — leaving room in the hospital for more critical patients.

On the flip side, home health providers are also able to care for confirmed COVID-19 patients whose symptoms are manageable at home, according to a joint report from PQHH and the National Association for Home Care & Hospice (NAHC).

“The home health care sector is committed to caring for patients safely and effectively,” David Causby, president and CEO of Kindred at Home, said in the report. “Increasing health care at home is part of the solution to reduce the burden on our nation’s hospitals in this time of crisis.”


Causby is also a member of NAHC’s board of directors.

In recent weeks, the Centers for Medicare & Medicaid Services (CMS) has waived a number of regulatory barriers, but more needs to be done in order to enable the home health industry to properly provide support for hospitals, according to Cunningham.

“We are urging [CMS] to continue to lift regulatory burdens,” she said. “Today, we have a model that favors a face-to-face interaction with a patient.”

One of the ways CMS can help expand the use of home health care at this time is by lifting the restrictions surrounding telehealth reimbursement.

The use of telehealth would not only help to further prevent the spread of coronavirus but could help preserve personal protective equipment (PPE).

“Many home health agencies, right now, are struggling to obtain PPE,” Cunningham said. “They are lower on the priority list and they are attempting to use all of their efforts to channel resources.”

Today, a telehealth home health visit does not count as an in-person visit and can’t be reimbursed through CMS.

Due to new flexibilities announced this week, telehealth services can be used in conjunction with in-person visits more broadly.

Telehealth services may also receive a contracted rate when included in a physician’s plan of care.

“There could be much greater use of telehealth for home health clinicians,” Cunningham said. “Home health can do telehealth, but they aren’t getting paid. We would like to see all government payers, as well as private payers, recognize that telecommunication-based caregiving modalities … are important parts of the care delivery system — especially right now.”

Aside from more leniency around telehealth, temporary elimination of physician signature requirements is necessary, according to Cunningham.

“It’s always a challenge to obtain signed physician documentation, and right now it’s almost impossible because a lot of physician offices are not fully functional,” she said. “One of the things we asked for is a temporary waving of that regulation. It’s just not practical.

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