Medicare beneficiaries must have the option to recover safely at home

While our nation has recently faced unprecedented challenges in the delivery of health care, we have also been offered significant opportunities for positive change — including reforming post-acute care options for American seniors in order to transition them safely home after hospitalization.

For decades, Medicare’s Home Health Benefit has enabled health care delivery in a patient-preferred setting for post-acute and rehabilitative care. Yet, despite increased demand from patients, the capacity for older Americans and their families to select home-based care following a serious hospitalization has been limited.

The time has come for Congress to enable greater patient choice so that American families can choose to safely transition Medicare beneficiaries to the home setting for post-acute recovery. Doing so requires embracing policies that modernize the existing Medicare Home Health Benefit.

Just as rapid adoption of services like telehealth has helped millions of Americans receive care safely at home, the nation’s home health providers are asking Congress to advance an enhanced home health program called Choose Home — to enable more patients to leave the hospital and recover safely at home with a mix of skilled nursing, therapy, primary care, personal care, continuous remote monitoring, meals, home adaptations, and transportation services.

Under an enhanced home health benefit, many Medicare beneficiaries who live at home and meet Medicare Skilled Nursing Facility (SNF) eligibility requirements would have the option to receive extended home-based care services. Eligibility for these home health and home-based services would be carefully controlled by the use of an assessment tool that includes consideration of an individuals’ place of care preferences, functionality, medical conditions, recovery goals, and family caregiver concerns.

The bipartisan Choose Home Care Act of 2021 (S.2562/H.R. 5541), introduced by Sens. Debbie Stabenow (D-Mich.) and Todd Young (R-Ind.) in the Senate and Representatives Henry Cuellar (D-Texas) and James Comer (R-Ky.) in the House, would increase access to health services at home by giving eligible Medicare beneficiaries the option to choose home-based extended care as an alternative to SNF care after being discharged from the hospital. The bill would not only promote a safer recovery with increased patient and family satisfaction — it will also produce significant cost savings to the Medicare program and taxpayers. This is a win-win for both patients who prefer to remain in their homes and for the health care system as a whole.

Public opinion data also show 86 percent of adults, including 94 percent of Medicare beneficiaries, support the Choose Home Care Act. The data also demonstrates wide bipartisan support for the bill, with 83 percent of Republicans and 92 percent of Democrats expressing support for Choose Home.

All across our society, Americans are looking for enhanced and innovative new ways to access health care, particularly for older, sicker, more at-risk individuals. It is a logical extension of those efforts to keep seniors in their own homes where they want to be, rather than in institutional health care settings. Home-based extended care services under Choose Home can do that while also saving precious health care dollars. That might be one of the handful of positive outcomes emerging from the learnings of the pandemic over the past year. 

Home health professionals from across the country are meeting with lawmakers in Congress this week to urge support for the bipartisan Choose Home Care Act. We hope Congress will listen, act quickly and pass this bill to enable more American seniors to choose home for their care.

Joanne Cunningham is Executive Director of the Partnership for Quality Home Healthcare.  William  Dombi, Esq. is President of the National Association for Home Care & Hospice.