The Goals of Home Health

Home health is a covered service under the Part A Medicare benefit.  As such, providers have been given a set of quality guidelines by the Department of Health and Human Services and the Centers for Medicare and Medicaid Services (CMS). These goals must be an integral part of the delivery of services as they provide intermittent, medically necessary skilled nursing care under the direction of a physician, and  are as follows:

Effectiveness: This means providing care and achieving outcomes that are supported by scientific evidence, such as clinical measurements of improvement in a patient’s condition or measurable progress toward client goals.

Efficiency: This involves making sure that the level of care provided is reasonable and cost effective.

Equity: This relates to providing the same quality of care to those who may differ in personal characteristics other than their clinical condition or preferences for care.

Patient Centeredness: This means putting the patient’s needs first, while striving to meet their preferences for care.  It also means providing education about the patient’s condition and treatment, and rendering support for the patient.

Safety: Health care providers are required to do whatever they can to avoid any actual or potential bodily harm to the client.

Timeliness: The goal is to provide the needed care while minimizing any delays in the delivery of care.

These goals help Louisiana home health agencies like Medistar ensure that their clients receive the best care available in the comfort of their own homes in a professional,  effective and efficient manner.

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Home Health Care and Illness among the Elderly

As people age, chronic illness often becomes a part of daily life.  If caregivers are not available or are unwilling or unable to provide adequate medical care at home, people who suffer from chronic conditions often end up having their medical needs met in a hospital or nursing home setting.  These are expensive options and do not provide the same quality of life as can be achieved when the requisite care can be provided at home.  Home health care can help the elderly cope with chronic illnesses in the comfort of their homes.

The majority of illnesses suffered by the elderly typically fall into three categories: nonfatal chronic illnesses; serious, eventually fatal chronic conditions; and frailty.  Nonfatal chronic illnesses include common ailments such as arthritis, and hearing and vision problems.  These conditions can certainly impact the quality of life and amount of extra care that elderly need, but these conditions are rarely fatal.  Serious chronic conditions that eventually become fatal include cancers, organ system failures (such as heart, liver, kidney, and respiratory systems), dementia, and strokes.  These conditions require different levels of care at different times during the duration of the illnesses.  Frailty is described as the fragility of multiple body systems as the patient’s resources diminish.  This is different than, for example, congestive heart failure in a person whose other organ systems are still functioning well.

For chronic and other illnesses the elderly commonly face, Medistar has the resources to provide skilled home health care that can help them maintain a higher quality of life in their own homes.  An important component of Medistar’s services is the education and coaching of the patient and caregiver on the treatment and management of chronic and other illness.  These medical services are covered by Medicare and provide a cost-effective alternative for coping with illnesses while helping the elderly maintain as much independence as they can for as long as possible.

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What Types of Services do Home Health Agencies Provide?

Home health agencies are dedicated to providing quality medical care in the comfort and convenience of the patient’s home.  The types of services they provide varies some from one agency to the next, but most Medicare-certified home health agencies  provide the following types of services.

Skilled Nursing:  Nursing services are often the main type of service provided by home health agencies.  These services are provided by both registered nurses (RNs) and licensed practical nurses (LPNs).  They can perform a variety of tasks, including post-acute care, observation and assessment, medication administration and management, wound care, and pain management, as well as educating caregivers and patients regarding disease management.  Skilled nurses often provide management of specific conditions, such as congestive heart failure and diabetes.

Therapy Services: When nursing care is not enough, most agencies also offer therapy services such as physical, occupational and speech/language therapy.  Physical therapists focus on strengthening the lower body in order to improve endurance and mobility and are oftentimes critical to post surgery recovery.  Occupational therapists focus primarily on strengthening the upper body and helping patients learn to safely complete tasks of daily living, such as showering, eating and dressing.  Speech therapists help patients regain abilities following a stroke and also help patients who have difficulties swallowing as a result of a medical event.

Other Services: There are a variety of other services that are commonly offered.  Some of these include clinical dietitian services, visually impaired services, respiratory therapy services, medical social services, and home care assistants.

Medistar provides all of these services to meet all of the individual needs of each patient they serve.  If you have questions about any of our services, don’t hesitate to contact us for more information.

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Home Health and Its Implication On National Savings

Did you know that a 3 percent reduction in the national rate of avoidable hospitalizations just among Medicare home health patients would reduce the cost to Medicare by more than $2.7 billion dollars annually? Did you know that effective utilization of this valuable service would allow more than 110,000 patients to remain in their home each year? Studies have shown both of these statements to be true. The projected cost of the national expenditures for health care in 2017 is projected to be $4.3 trillion dollars.

What Research has Shown

  • A study by Duke University has shown that patients with heart disease who received care from home health professionals after their discharge reported to have a better quality of life than those who did not receive visits.
  • A National Institute of Health-funded study showed that heart-failure patients who received specialized care at home had a much lower rate of hospital readmissions resulting in an approximate 38 percent savings to Medicare.
  • A Rand Corporation study has shown that patients who have undergone hip and knee replacements were much less likely to end up in expensive rehabilitation institutions when discharged directly home, with in-home rehabilitative services. This results in a cost savings between $3,500 –$8,000 per episode over the cost of treatment in an inpatient rehab facility.
  • A recent study by Avalere Health LLC showed that Medicare Part A spending on home health users was $2.81 billion less than it would have been if they had received other post-acute care services. Furthermore, this study showed that patients with the chronic conditions, Diabetes, COPD and CHF, who received home health services, were less likely to be rehospitalized than those receiving other post-acute care services.
  • The jury is no longer out. There are mounting studies and research proving that effective utilization of home health care results in significant cost savings. As the country struggles with health care reform, the Medicare system, and the national debt ceiling, there must be an eye opening moment of realization that significant reductions in healthcare spending per person must be realized. The most cost effective care after a surgery or for those with chronic conditions is home health care provided by Medistar and other agencies. The average cost of nursing home care in the U.S. is around $160 per day and the average hospital stay costs $1,993 per day. Home health care costs Medicare $37 per day for a standard 60-day episode of care. With Medicare hospital insurance projected to exceed income and be exhausted by 2019, we must all do what we can to ensure that Medicare will be around for generations to come. It has been shown that effective utilization of home health and its effectiveness in reducing rehospitalizations could help to extend the life of Medicare.
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Why Patients Prefer Home Health

Did you know that, according to a survey of 1,000 American adults conducted by Harris Interactive, 82 percent of the respondents stated a preference for home health care over institutional care?  Although strong across all age groups, gender, and income segments, this was especially true among Americans age 55 and older.  More than 91 percent stated home health care to be their preference.  Public Opinion Research conducted a poll for Genworth Financial that showed 75 percent of the respondents in their poll would prefer to receive home health care, and many believed that Medicare or their private insurance would help to foot the bill.

What are they saying? – More and more seniors are saying that they want to live out their retirement years in the comforts of their own home.  Approximately half of those surveyed expect to remain in their home even if they need ongoing medical care.  Many of these educated baby boomers have expressed a preference for a paid caregiver as their source of care over their own adult children.  The degree of preference is staggering especially in those polled in the 55 to 65 category, who expressed this preference more than eight to one.

What does this mean? – As professionals, service providers, and consumers we all have a duty to provide the highest level of health care in the most cost-effective manner possible.  It has been clearly proved that not only are agencies such as Medistar doing all that they can do to ensure that  home health remains the most cost-effective healthcare option available , they are providing the high quality of care that is preferred by the aging patients.  Why, then, are we not utilizing these services more frequently for post-acute care and for chronic conditions when clearly they are the best choice?

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Home Health Effectiveness

The creation of Accountable Care Organizations (ACOs) is about much more than cost reduction.  Their creation emphasizes patient centered care, which is individualized for the patient’s specific needs.  To be cost-effective the ACOs must embrace and utilize  healthcare providers with programs for chronic illnesses and providers of post acute care such as home health agencies.  But the responsibility of the ACOs does not stop there.  They must then evaluate the service delivery of all healthcare providers in the continuum of care to ensure that they are working well together to accomplish the mission of service delivery with quality outcomes.

How to evaluate the effectiveness of home health care? – When evaluating the effectiveness of home health care you must first determine the desired outcome.  The first thing that comes to mind during this budgetary season is cost savings, but the truth of the matter is, with effective performance, cost savings will naturally fall into place.  Many components can be used to measure the effectiveness of this service.

One of the first components of an effective evaluation needs to be the reported quality of life.  This can be measured as reported by the patient or as evidenced by their affect or attitude.  An improved quality of life will lead to less depression, greater mental clarity and less incidence of other mental health issues often experienced by our aging population.

Another important  component is the reduction in rehospitalizations or required non-emergency care.  Through the provision of home health care services, studies have shown a huge reduction in the number of patients having to be rehospitalized in the 30-90 days following the initial hospitalization.  In fact, a recent study by Avalere Health, a healthcare advisory services firm, found that patients receiving home health services were less likely to be rehospitalized than patients who received other post-acute care services, such as skilled nursing facilities, inpatient rehabilitation facilities, hospices and long-term acute care hospitals.  The significance of patient or caregiver education and compliance, a key element of home health services, cannot be underestimated.  Teaching people to effectively monitor their chronic illnesses will lead to better medication compliance and a reduction in the need for emergency care.  Engaging and coordinating the patient’s participation in their care will promote independent living and lessen their dependence on medical care.  Is the best measure of home health effectiveness the patient’s ability to move more quickly towards independency in the comfort of their home, the reduction in rehospitalization rates or better medication management?  Whichever measure you use, we know that home health care, like that provided by Medistar, works!

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Technology and Home Health

Are you a technophobe? Do you keep up with the latest and greatest advancements in technology?  Are you amazed by what technology can now do?  Even if you are not the most computer savvy person in the world, technology has invaded your life.  It is impossible to escape no matter how hard you try.  If you do not believe this just go to the cell phone store and tell them that you want a regular phone.  Whether it is fortunate or unfortunate, many of us carry gadgets that bring the world to our fingertips, so why should health care be any different?

Home health plays a vital role – As the nation moves to create and develop effective Accountable Care Organizations, the implementation of health information technology will create the innovation that is needed for effective and efficient health care services. No one is in a better position to be the catalyst of this technology than are the post acute care providers, home health care agencies, such as Medistar.

Home health technology – There is a lot of technology on the market that is important in reducing medical errors and support clinical services.  Some of these are:

  • Point of Care Devices – Home health professionals can utilize these while providing all aspects of care.  These devices will allow for better interactions between the patient’s location and the physicians.  These devices give the clinicians additional informational resources that may be needed to provide the best care and treatment, including personalized clinical pathways or physician protocols.  Clinicians can record their observations and notes in “real time” directly into the electronic medical record, which is then available for the doctor to see.
  • Digital Cameras – Offer the ability for the wound to be seen at various stages of healing.  The ability to upload pictures gives the physician and other clinicians the ability to see the status of the wound the wound healing process without having to bring the patient in for an office or clinic visit.
  • Telemonitoring – These devices can be useful in the monitoring and treatment of certain diagnoses, such as diabetes or congestive heart failure.  The use of telemonitoring can help to reduce or eliminate the need for hospitalizations of this nature.
  • Cell Phones – Give the physicians the ability to access the home health provider to provide more information or additional support for an immediate response to a patient’s needs.
  • Physician Portals – Gives the physicians direct access to home health agencies, allowing them to more easily monitor the care of their patients and issue orders in a more efficient manner.  Promotes a faster dissemination of real-time patient and medical information, including medication management, a top reason for unplanned rehospitalization.
  • E-minders – Gives the home health provider the ability to remind patients of their upcoming appointments, to take their medications, check their blood sugars, etc.

The uses of technology in home health are limitless.  The effective utilization of these tools creates a win-win situation for all that are involved.  Medistar has been a leader in the use of cutting-edge technology for years.  Benefit from what technology has to offer your health care.

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Home Health Patient Satisfaction

Are you at the crossroads of having to make crucial medical decisions for patients or loved ones, choices that will impact where they spend the last years of their life?  Are you considering relocating them to some type of higher level of care just to get the services and resources that you feel are required?  This may not be  necessary as there are quality home health care services that can provide care right where they want to be, in the comforts of their own home.  These highly skilled services that are provided by home health care providers, such as Medistar, afford millions of older, chronically sick and disabled people to be taken care of in their own homes.

Patient Satisfaction – Exactly how satisfied are patients with quality home health care services?  One word sums it up and that word is “Extremely!”  Home health care offers seniors independence at a time that they are becoming more and more dependent.  It empowers them to continue to live their lives and be surrounded by familiar people, places and things that they hold near and dear to their hearts.  It gives them confidence that their total care is being monitored, thereby reducing the number of non-emergency trips to the hospital.  Studies have shown that patients who receive home health care while recovering in their own homes recuperate faster and have a lower risk for infection.  Being able to maintain the patient at home creates less stress and hardship on the family caretakers as well.

If you have to make a decision about providing quality care for a patient, you need to first consider the benefits that home health care from a quality provider like Medistar can help provide.

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Who Pays For Home Health?

With the invention of Accountable Care Organizations, Americans will be looking at a more cost-effective, patient-centered service delivery.  This will be designed to be more individually focused and will offer more services outside the traditional model of care.  They will see more and more services available in the privacy of their own homes through quality home health care services.  Although more cost-effective, this is an expense that most seniors cannot afford. So the question becomes, who pays for home health?

Who pays for home health? – Physician-authorized home health care is paid for by Medicare, Medicare Advantage, Medicaid, , the VA, most commercial insurance companies, or directly by the patients and their families through private pay.  There may be just one payer or a coordination of payments that come from multiple sources.  A patient may have a primary insurer, secondary insurer and other payer resources.  Making up more than 40 percent of all home health expenditures, Medicare is the largest payer of home health care including hospice.

Home Health is Affordable – Home health has proved to be the least expensive medical care that can be provided.  Sixty days of home health is the cost equivalent of less than one day in the hospital, and 15 times cheaper than a skilled nursing facility.  While the cost of inpatient hospital services and services received in skilled nursing facilities have risen at rates that exceeded between 40 percent – 70 percent over the past ten years, the cost of home health care only increased by approximately 2 percent.  This affordable, cost-effective service offers the patient the additional ability to recuperate in the comfort of their own home, while still receiving the high quality of care that is needed.

When medically possible, quality home health care with agencies such as Medistar Home Health, is the way to go,no matter what your payment source.  Ask them today.

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Care Plan Oversight

Care plan oversight encourages physicians to be more intimately involved in their patient’s care but can also increase the profits made by their practice.

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