SNF-at-Home Concept Earning ‘Very Positive Feedback’ in Congress, Among Special Interest Groups

An innovative care concept designed to keep patients at home and out of skilled nursing facilities (SNFs) is reportedly gaining ground in Congress and among special interest groups.

The concept — known as “Choose Home” — is a type of SNF-at-home model that leverages both medical and non-medical home care services for certain patients.

LHC Group Inc. (Nasdaq: LHCG) Chairman and CEO Keith Myers provided an update on Choose Home on Wednesday, after first floating the concept during a Feb. 26 earnings call.


“We have begun to socialize Choose Home legislation for the first time,” Myers said during a morning presentation at Oppenheimer’s annual health care conference. “This important legislation will provide a time-limited, cost-effective benefit, which would include Medicare-certified skilled home health services and personal care services for patients in the home.”

Myers revealed that the Choose Home concept would be for select patients who meet SNF requirements but who could safely recover at home with the right layers of medical and non-medical support. Telehealth and remote patient monitoring technologies would likewise play a role in the emerging model.

From a reimbursement perspective, Choose Home would create a new payment pathway around a 30-day episode of care. In theory, it could potentially lead to new Medicare access for non-medical home care agencies, which have historically operated mostly in the Medicaid and private-pay arenas.


In some ways, Choose Home is actually similar to existing efforts developed by state Medicaid programs, Myers noted, specifically calling out Ohio’s PASSPORT program. PASSPORT is an acronym for “Pre-Admission Screening System Providing Options and Resources Today.”

The Ohio Medicaid PASSPORT waiver program allows seniors who require a nursing facility-level of care to remain living at home — or the home of a family member — while receiving care.

The program coordinates a long list of benefits and services, including adult day, home maintenance, home-delivered meals and more. Professionals going into the home can include social workers, home care attendants and others.

A key condition of the Ohio program: Cost of care provided at home cannot exceed 60% of the cost for that same care if it were provided in a nursing home.

LHC Group piloted a similar SNF-at-home program years ago with Ochsner Health in Louisiana, Myers previously explained.

Choose Home advocacy is still in the very early stages, but efforts to advance the concept have been going well overall. That will likely remain the case as the spotlight continues to shine on home-based care amid the ongoing public health emergency. 

“[We’re] receiving very positive feedback from Congress, as well as other interest groups such as AARP,” Myers said. “We anticipate that this legislation will be filed with Congress for consideration in 2021.”

In addition to individual companies like LHC Group, Choose Home is also supported by the National Association for Home Care & Hospice (NAHC) and the Partnership for Quality Home Healthcare (PQHH), according to Myers.

“We are going to see favorable policies and regulations coming out of Washington, D.C., for home health, I believe,” he added. “We continue to work closely with the administration and Congress.”

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