Survey of Medical Literature Show Homecare Is Cost-Effective Setting for Medicare, Medicaid

Main Category: Caregivers / Homecare
Also Included In: COPD
Article Date: 24 Jun 2005 - 11:00 PDT

email to a friend   printer friendly   opinions  

A recent survey of medical and healthcare literature documents that homecare is the more cost-effective setting for healthcare. Studies published in the Journal of the American Geriatrics Society, Health Care Financing Review, and other journals illustrate the value of homecare.

Earlier this month, hundreds of delegates from the American Association for Homecare called on Congress to consider these studies and support policy that emphasizes greater use of homecare. U.S. Department of Health and Human Services Secretary Michael Leavitt recently called home-based care "radically more efficient" for Medicaid. The Association believes the same principal applies to Medicare.

"Homecare is not only cost-effective and clinically effective, but it's preferred by patients and their families," said Kay Cox, President and CEO of the American Association for Homecare. "Homecare is a key piece of the answer to the nation's healthcare challenge."

Summaries of several studies are below. More research summaries and details are available at http://www.aahomecare.org.

Homecare Reduces Costs by 37 Percent for Heart Failure Patients

The May 2004 Journal of the American Geriatrics Society reports that homecare directed by Advanced Practice Nurses (APNs) reduced total costs of care for patients suffering from heart failure and comorbid conditions, attributable to fewer and later hospitalizations and fewer deaths. ("Transitional Care of Older Adults Hospitalized with Heart Failure: A Randomized Controlled Trial," Journal of the American Geriatrics Society, May 2004.)

Cost of Home Intravenous Antibiotic Treatment Much Lower than Hospital and SNF Settings

This 1998 study in Clinical Infectious Diseases quantifies cost savings of a home intravenous antibiotic program in a Medicare managed care plan. The average cost per day of home therapy was $122, compared to $798 in the hospital and $541 in a skilled nursing facility (SNF) setting. (Dalovisio, J., et al, "Financial Impact of a Home Intravenous Antibiotic Program on a Medicare Managed Care Program," Clinical Infectious Diseases, 2000.)

One Year of Long-Term Oxygen Therapy at Home Costs Less than One Day in Hospital

Oxygen can be provided to a chronic obstructive pulmonary disease (COPD) patient who lives at home for one year at less than the average Medicare cost for one day in the hospital, which is $3,606 (Annual Statistical Supplement, 2004, Social Security Bulletin). Direct medical costs for COPD in the U.S. total $18 billion per year, nearly 9% of Medicare expenditures. (Dunne PJ. "The demographics and economics of long-term oxygen therapy." Respiratory Care. 45:223-228, 2000.)

Review of Medicaid Homecare in Seven States Shows Reduced Costs

A 2002 study published in Health Care Financing Review describes the characteristics of Medicaid home and community-based (HCB) programs in seven states. In Washington, the state imposed strict fiscal caps, keeping spending to 40 percent of the cost of nursing home care on a per capita basis. In 1999 in Alabama, spending per enrollee in HCB services was $6,612 compared to a per capita cost in nursing homes of $22,771. (Wiener, J., et al, "Home and Community-Based Services in Seven States," Health Care Financing Review, Spring 2002.)

Homecare Saves 65 Percent in Post-Acute Care

A 1999 study reported in the Journal of the American Medical Association reported savings of about 65 percent in a randomized-controlled trial of post-acute home-based management by advanced practice nurses. (Naylor, MD, et al, "Comprehensive discharge planning and home follow-up of hospitalized elders," JAMA 281:613-620, 1999.)

The American Association for Homecare is the only national association that represents every line of service in the homecare community, including home health and home medical equipment providers, respiratory and infusion therapy, telemedicine, rehab and assistive technology, and hospice. With more than 3,000 member locations, AAHomecare advances quality healthcare services where patients prefer them - at home.

Michael Reinemer, VP, Communications
American Association for Homecare
625 Slaters Lane, Suite 200
Alexandria, VA 22314-1171 703-535-1881
http://www.aahomecare.org

• Additional
• References
• Citations