Home Health Patient Demographics Continue to Shift

Individual and clinical characteristics of home health patients continue to shift, reflective of both America’s aging population and providers’ ability to handle more acute cases.

That’s according to the latest Home Health Chartbook, an annual overview of the home health landscape put together by the Alliance for Home Health Quality and Innovation and Avalere Health.

In addition to highlighting the industry’s ever-changing patient population, the Chartbook also details the economic contribution of home health providers on the U.S. economy.

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Compared to the overall Medicare population, home health patients tend to be older and slightly more economically vulnerable, the Chartbook suggests. Home health patients additionally tend to reside in rural areas and live alone at slightly higher rates than the broader universe of all Medicare beneficiaries.

“The Chartbook helps to conceptualize the home health landscape via data and charts that roughly sketches home health care in the United States,” Jennifer Schiller, executive director of the Alliance for Home Health Quality and Innovation, told Home Health Care News in an email. “We continue to see the value of home health care to patients and the health care system, writ large.”

When it comes to the health status of patients, home health users are far more likely to suffer from several chronic conditions.

Nearly half of the home health patient population suffers from five or more chronic conditions, with another 19% suffering from four chronic conditions, according to the Chartbook. In comparison, just 22.4% of the overall Medicare population suffers from five or more chronic conditions.

The apparent imbalance is partly attributable to the rising population of dual-eligible beneficiaries in home health care, Schiller noted.

“We continue to see a small but fairly steady increase in dual eligibles receiving home health care,” she said. “Dual-eligible home health users tend to have more chronic conditions and need assistance with more activities of daily living (ADLs) than home health users as a whole.”

On top of needing more assistance with ADLs and their chronic conditions, home health patients also often need more support for a severe mental illness, such as depression, bipolar disorder or schizophrenia.

More than one-third of the home health patient population suffers from a severe mental illness, the Chartbook shows. But just 28.9% of the overall Medicare population suffers from such an illness.

Apart from basic demographic information, the Chartbook also highlights the most common diagnosis-related groups for beneficiaries discharged from the hospital to home health providers under Medicare Part A.

In order, the most common diagnoses of patients referred from the hospital to home health are: septicemia or severe sepsis; major hip and knee joint replacement; heart failure; hip and femur procedures; and pneumonia.

In 2019, 6.93% of all home health claims were coded for Type 2 diabetes, with another 6.47% coded for orthopedic aftercare.

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