Following a hospital stay, discharged patients often require some level of extended short-term care. According to a 2021 poll conducted by Morning Consult on behalf of the Partnership for Quality Home Healthcare (PQHH), home is the post-acute setting of choice in which to receive extended care for 94% of Medicare beneficiaries.

The Choose Home Care Act, if passed, aims to make home care a viable and accessible option for those seniors who would prefer to recover at home after a hospitalization. While there is much support for this legislation, many home health agencies (HHAs) have work to do to be prepared to offer adequate post-acute care.

Understanding the Choose Home Care Act

Medicare beneficiaries requiring post-acute care have had little choice in regard to where they could recover. This limitation, accentuated by the global pandemic, spurred the development of the Choose Home Care Act. Choose Home is bipartisan legislation designed to expand the current Medicare home health benefit so that seniors who require continued health care services after hospitalization can receive those services at home, if it is their preference, rather than in a skilled nursing facility.

Currently, Medicare recipients can only receive part-time, intermittent nursing services at home. If enacted, Choose Home will allow hospitals to refer eligible patients to qualified HHAs that can provide post-acute care on a regular, daily basis with expanded services that include:

• Skilled nursing care
• Physical therapy
• Occupational therapy
• Clinically-appropriate meals
• Non-emergency transportation
• Medical supplies
• Personal care services

After a hospital discharge, Medicare beneficiaries will receive an add-on benefit that covers the extended services for 30 days in addition to the traditional 60-day home health benefit.

Choose Home will provide seniors who are currently limited to recovering in an institutional setting with the option to recover safely at home. This has the potential to both increase patient satisfaction and decrease the risk of exposure to infectious diseases. Additionally, Choose Home could result in significant cost savings to the Medicare program. According to an analysis performed by Dobson DaVanzo & Associates, Choose Home could generate up to $247 million in annual Medicare savings.

The Choose Home Care Act was introduced in both the Senate and the House earlier this year. While the bill is still awaiting passage amid current congressional bottlenecks, overwhelming support by home health providers and patient advocates, as well as wide bipartisan support, should help facilitate its enactment.

Considerations for Home Health Agencies

Under the new Choose Home regulations, Medicare beneficiaries would have to meet skilled nursing facility (SNF) eligibility requirements, including the three-day hospital inpatient stay, in order to receive the add-on home health benefit. Eligibility would be determined by an assessment tool and based on factors such as patient and family caregiver preferences, medical condition, acuity level and recovery goals.

HHAs will also have to qualify in order to offer the Choose Home benefit to eligible patients. You will have new certification requirements, including the ability to provide care on a 24-hour basis and to provide training and supervision to care providers, in order to qualify to provide home-based extended care services. Once qualified, your home health agency can benefit from additional Medicare payments and from access to a large population of patients you were previously unable to serve—if you are equipped to adequately serve them.

Prior to passage of the Choose Home Care Act, there are a number of factors you will want to consider, including:

• At a time when the staffing shortage is already at a critical level, will you have the staff you need to meet the increased demand? Offering the Choose Home benefit will require the appropriate number of staff to manage patient care, including licensed nurses, therapists and home health aides. It will also require back-office support to ensure care coordination, education and training and to review and update the Outcome and Assessment Information Set (OASIS).
• Now is the time to ensure that you have the necessary contracts in place in order to offer expanded services. For example, you will need contracts in place with Durable Medical Equipment (DME) companies to provide necessary home adaptive equipment, with pharmacies to provide medications and with food service companies to provide clinically-appropriate meals.
• The Choose Home benefit provides a number of services that you may not have offered in the past. You may need to acquire access to transportation services as well as technology that will facilitate remote patient monitoring.
• If you will be able to provide some services but not all, you may be able to enter into an arrangement with another home health services or senior living partner. Now is the time to reach out to other high-quality service providers to form potential partnerships.

How Can Richter Help?

Passage of the Choose Home Care Act may have substantial growth potential for your home health agency, if you have prepared sufficiently.

Richter can offer guidance and support to agencies wishing to provide extended services in the future. We can assist with training on best practices, implementing effective policies and procedures, evaluating your systems and other home health challenges you may have. Call Richter’s home health consultants at 866-806-0799 or request a free consultation.