Medicare and Home Health Care

Many people don’t know that Medicare can pay for Home Health Care. In this Home Health Study by Medicare they discuss the requirements for Medicare benefits for Home Health Care and some of the trends in the program since it’s inception.

To qualify for the Medicare home health benefit, the social security act requires a Medicare beneficiary to be:

  • Confined to the home
  • Under the care of a physician
  • Receiving services under a plan of care established, certified, and periodically reviewed by a physician
  • Be in need of skilled nursing care (other than solely venipuncture) on an intermittent basis
  • Or physical therapy
  • Or speech-language pathology
  • Or have a continuing need for occupational therapy

The Medicare home health benefit covers the following:

  • Part-time or intermittent skilled nursing services
  • Part-time or intermittent home health aide services
  • Physical therapy speech-language pathology, occupational therapy
  • Medical social services
  • Medical supplies
  • Durable medical equipment with a 20 percent coinsurance

With 2008, over 10 percent from Home health patients had an analysis of diabetes, followed as a result of essential hypertension (7. 0 percent), heart failure (6. 7 percent), and additionally chronic skin ulcer (4. 3 percent). The profile of beneficiaries’ specific diagnoses has changed significantly since the beginning of the program with particularly large growth with the diagnosis of diabetes along with essential hypertension. Depending over the needs of the persistent, there can be differences inside average number of visits per patient, length from visit, number of Home health disciplines linked to Home care, number with alternative services provided, and involvement in the referring physician with that patient’s care plan and discharge.

Overall, physicians generally have reduced involvement in developing the routine of care – with the exception during major milestones, including re-certifications and before discharge – as well as a larger number of disciplines tended to be involved in providing care meant for longer episodes.