Almost half of Medicare beneficiaries utilizing home health care services have five or more chronic conditions. This is also true when looking at Medicare Advantage (MA) beneficiaries, according to data from the Research Institute for Home Care (RIHC).
RIHC recently released its 2022 Home Care Chartbook, a detailed overview of the home health landscape that includes data on demographics and organizational trends.
“As in previous years, home health continues to serve an older, sicker and poorer patient population,” Jennifer Schiller, executive director at RIHC, told Home Health Care News.
RIHC found that 45% of all Medicare home health users have five or more chronic conditions, 17.3% have four chronic conditions, 13.8% have three chronic conditions and 23.9% have between zero and two chronic conditions.
As far as MA home health users, 49.4% have five or more chronic conditions, 19.5% have four chronic conditions, 13.5% have three chronic conditions and 17.5% have between zero and two chronic conditions.
The report also offered detailed information about the clinical conditions of individuals being discharged from the hospital to home health care. In 2021, the top three Medicare severity diagnosis related groups for these people were: sepsis; respiratory infections and inflammations; and major hip and knee joint replacement.
It also found that there’s been a dip in home health beneficiary episodes when it came to major hip and knee replacement.
“The decline in hip and knee replacement or reattachment of lower extremity without major complication or comorbidity Part A episodes predate PDGM and COVID-19, but you really see it in that year-over-year data,” Schiller said.
Indeed, in 2017, there were 235,362 beneficiaries discharged from the hospital to home health care with major hip and knee replacement. In 2021, that number dropped to 68,748.
“It’s just a change in what type of patient is going into home health,” Schiller said. “It really speaks to the huge benefit of home health, which is that it can serve a really wide and vast range of different patients.”
Another noteworthy finding is the jump in the number of beneficiaries discharged from hospital to home health with respiratory infections and inflammations. This saw a significant increase, jumping to 80,334 in 2021, compared to 39,281 in 2020.
The report also examined initial patient destinations following an inpatient hospital stay for Medicare beneficiaries. It found that, in 2021, home health care was the destination for 14.5% of these individuals, which isn’t much of a change from 14.6% in 2020.
Additionally, the report provided information regarding the number of Medicare-certified, free-standing home health agencies.
Overall, there were 9,378 agencies in 2020, compared to 9,893 in 2019, and 10,852 in 2014.
Ultimately, the chartbook’s findings should mostly line up with what providers are seeing and experiencing for themselves.
“I think providers have a really good idea of what’s going on,” she said. “The chartbook is beneficial because it helps reinforce a lot of what the providers know. They’re serving the patients, they’re on the ground. They know what they’re seeing.”
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