Medical Literature Shows Homecare is Cost-Effective in Medicare, Medicaid - USA

Main Category: Caregivers / Homecare
Article Date: 21 Aug 2005 - 23:00 PDT

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A recent survey of medical literature shows the cost-effectiveness of homecare. Studies from the Journal of the American Medical Association, the New England Journal of Medicine, and other sources support the value of homecare.

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, 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.)

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

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