Despite COVID-19 Resurgence, Home Health Agencies Likely to Avoid Another Sudden Admissions Drop

Despite the resurgence of the coronavirus in the U.S., home health providers might not have to worry about another sudden drop in admissions.

When the coronavirus first began its rapid spread across the country, jumping from a long-term care facility in Washington to the New York metropolitan area in a matter of days, many hospitals and health systems began suspending non-essential services. Citing the need to preserve key medical supplies, the U.S. Centers for Medicare & Medicaid Services (CMS) voiced its support for such actions in a March 18 announcement.

“The reality is clear and the stakes are high: we need to preserve personal protective equipment for those on the front lines of this fight,” CMS Administrator Seema Verma said.

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As a result of the health care system pressing pause on hip and knee replacements along with other elective procedures, home health admissions plummeted.

Compared to relative highs in February and March, home health admissions dropped by about 17% following the initial national COVID-19 surge, according to data shared by Homecare Homebase at last month’s Medicare Advantage for Home Care Virtual Summit. Hospice admissions also saw a roughly 17% dip.

“We’ve seen some fairly interesting data come in over the last couple of months regarding COVID-19,” Neal Reizer, senior vice president of product management for Homecare Homebase, said during the summit. “There was a very steep decline when the public health emergency was declared, in terms of admits.”

After the early fallout, home health admissions largely stabilized by late May and early June. The return to normalcy coincided with clear progress in the U.S. flattening the COVID-19 curve — so much progress, in fact, that every state initiated various levels of economic reopenings.

On its end, CMS released guidelines for the resumption of elective procedures and non-essential services in late April. The American Hospital Association (AH) and its members — many of whom were losing millions of dollars per day due to the postponing of non-essential services — welcomed the guidance.

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“This CMS guidance is clearly focused on addressing important health care needs for non-COVID patients, with decisions being made by providers in collaboration with local and state public health leaders,” AHA said in a statement.

But the grasp the U.S. had on the coronavirus has proven to be short-lived.

Currently, the COVID-19 emergency is intensifying in the southern and western portions of the country, with Alabama, Iowa, Missouri, Montana and Wiconsin all hitting single-day highs for new cases this week. In Florida, state officials reported an additional 8,935 new cases of COVID-19 on Thursday, making it the world’s new epicenter.

With those and other statistics in mind, Dr. Anthony Fauci — the nation’s top infectious-disease expert — suggested that some states should consider shutting back down.

“I think any state that is having a serious problem … should seriously look at shutting down,” Fauci said Wednesday. “It’s not for me to say, because each state is different.”

While hospitals and health systems are preparing for COVID-19 surges, there are, so far, no sweeping plans to again suspend elective surgeries, Kaiser Health News reported Thursday. Similarly, CMS isn’t encouraging the health care system to slow down on non-essential services.

“What we now realize is that shutting down the entire health care system in anticipation of a surge is not the best option,” Carmela Coyle, president of the California Hospital Association, told Kaiser Health News. “It will bankrupt the health care delivery system.”

Joshua Adler, executive vice president for physician services at UCSF Health, echoed similar sentiments, noting that most hospitals are better prepared for COVID-19 surges based on their experiences in spring.

“We were all things COVID when it was just starting,” Adler told Kaiser Health News. “We didn’t know what we were facing.”

Although the health care system is in better shape now compared to in the spring when it comes to keeping its elective-surgeries engine on, some states are opting for more aggressive action.

For example, on Thursday — just hours after Kaiser Health News published its story — Texas Gov. Greg Abbott issued a formal proclamation suspending elective surgeries in hospitals in all counties located within 11 Trauma Services Areas (TSAs).

“The State of Texas continues to implement strategies to help ensure ample supply of hospital beds for COVID-19 patients,” Abbott announced. “By expanding this directive to include the counties within these 11 TSAs, we are freeing up more resources to address upticks in COVID-19 related cases. The State of Texas will continue to do everything we can to mitigate the spread of this virus and support our hospitals and health care professionals as they care for their fellow Texans.”

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