From technological advances to new pieces of legislation, home health care is an ever-changing field. Though 2018 has only just begun, there are already several key changes on the horizon for the home health care industry that have the potential to affect employment, payment, and standard procedure for home health care providers. These three forthcoming developments not only represent changes to home health care but also new opportunities for the providers.
Governmental Payer Options
At the moment, according to Home Health Care News, one in three Medicare patients are enrolled in Medicare Advantage (MA) plans, and this number is expected to grow in the next ten years. Fred Bentley, vice president of the policy and financial consulting firm Avalere Health, says, “The MA growth—that is significant when you think about how the Medicare population will be exploding by that time.”
While MA and other payer options do represent a large opportunity for providers to partner and adjust their business models, at this time MA options are not paying home health care providers a higher reimbursement as fee-for-service, and this can be a challenge for providers.
An estimated one in four home health care workers are immigrants, and with potential changes to U.S. immigration policies on the horizon (DACA repeal in particular), the home health care workforce could see significant changes in the coming years. This is not only referring to illegal immigrants; the Trump administration’s proposals to limit family reunification (or chain migration) could limit the pipeline for the home health care workforce.
Because three-quarters of home health care workers currently in the workforce were born in the United States, some wish to increase this percentage and are pushing for higher wages and better working conditions for home health care workers. It is estimated that at least one million additional workers will be necessary to meet the needs of the aging population over the next decade.
Payment Model Reform and Alternative Models
The Bipartisan Budget Act of 2018 includes multiple provisions to reform home health care. One of which is a 30-day payment model to replace the current 60-day payment period by 2020, though the 60-day episode of care will likely stay intact. In addition, the proposed model will eliminate therapy caps and introduce a new case-mix reform, with payments being more linked to value. Under this system, providers will be expected to collect and report a higher volume of data, which will in turn be reflected in future payments.
Home health care providers’ upstream models (primarily health systems and hospitals) are also expected to venture forth into alternative payment models this year, and with payments being based on value and health care results, the home health care partners will also see an increase in value. The Department of Health and Human Services’ (HHS) current administration has confirmed its intention to continue to move towards value-based care.
About Caitlin Morgan
Caitlin Morgan is a premier wholesaler providing insurance products for the home healthcare sector, which includes companies that provide healthcare services in patients’ private residences, assisted living or independent living facilities. For more information call us at (317) 575-4440.