Despite the ongoing public health emergency, hard data on how COVID-19 is affecting the U.S. home health industry is still lacking.
That’s according to a new analysis from The Commonwealth Fund.
As opposed to other industries, the Medicare-certified home health subsector’s struggle with COVID-19 has not received much attention. The worry is that a lack of understanding could affect beneficiaries, providers and policies for years to come.
In order to conduct its analysis, The Commonwealth Fund examined the current home health landscape, interviewed agencies and reviewed the recent policy changes within the industry. The Commonwealth Fund is a foundation that does research on health care issues.
“The impact of COVID-19 on Medicare home health services is not fully understood,” its analysis states. “More research is needed on how COVID-19 affects home health use, particularly for populations experiencing disparities in accessing care.”
One of the other main, overarching themes from the Commonwealth Fund analysis is that the definition of “home health,” at least under Medicare, needs to be expanded.
Without that expansion, multiple providers need to come into the equation to help the patient, which often complicates things.
“Medicare beneficiaries who require skilled care and help with activities of daily living need to secure and coordinate two providers under two payment systems: Medicare and either Medicaid or private pay,” the analysis reads. “These beneficiaries may be at risk for poor outcomes because of lack of coordination between providers. Home health aide shift changes alone, for example, are associated with increased likelihood of hospital readmission within 30 days of initial discharge.”
At the very least, provider care coordination — both internally and externally — needs to be improved in order to see more positive outcomes.
In regard to COVID-19, home health beneficiaries are among the most vulnerable due to older age and the prevalence of chronic conditions.
Now, patients are generally seeking care less due to fear of COVID-19 exposure, which could lead to worse outcomes in the end. A June survey from Home Health Care News found that 90% of home health agencies had lower revenue since the beginning of the pandemic, with nearly two-thirds experiencing at least a 20% decline.
Agencies are also spending considerably more than usual on purchases like personal protective equipment (PPE) and other COVID-19 related resources.
Until the true impact of COVID-19 is known, providers need sufficient aid and assistance from the federal government in order to take care of their patients.
“Home health is well positioned to offer services to individuals in their own homes, which is an increasingly important care option during the pandemic,” the analysis notes. “However, the current design of the Medicare home health benefit is not sufficient to meet the needs of post-acute beneficiaries.”