As the need for home health care grows alongside population aging, the need for a qualified workforce to serve older adults is increasing as well. Over one million home health aides serve America’s home care patients, a number projected to hit nearly 1.4 million by 2018.
And it’s not only paid caregivers who are shouldering the burden. Today approximately 65.7 million individuals currently describe themselves as family or friend caregivers. This method of care delivery costs an annual $85.7 billion. While Medicare, Medicaid, and private insurance cover a portion of the costs for a number of these individuals, many pay for these costly in-home services completely out of pocket.
Even for those who can afford in-home care or qualify to receive home health benefits, many challenges remain to the reception of quality care:
- The Lack of a Continuum of Care – While it is estimated that 60% of people 65 and older need some type of long-term care, a full 90% of older adults live in their own homes and therefore spend most of their time away from inpatient settings or providers. New solutions are needed that bring affordable, continuous care to these populations when they are in their homes and away from their providers, so that they can follow best practices and plans of care in preserving their health as well as obtaining and using health care services.
- Preventable Events – Studies have shown that 64% of home health care recipients experience medication errors; similarly, falls cause 2.2 million injuries annually in adults over 65—over 18,000 of which are fatal—costing approximately $19 billion a year. The majority of these and other preventable events occur due to failure to attend to significant changes in health status, across clinical (e.g., weight, pulse, blood pressure), behavioral (e.g., shortness of breath, swelling, chest pain), and medication adherence metrics. It is estimated that improper care coordination costs an avoidable $25-$45 billion a year.
- Hospitalizations – Unattended problems can lead to hospitalizations and readmissions, both of which are highly prevalent in the home health care patient community, signifying the failure of current monitoring practices. A study of home health care patients found that nearly 13% of participants had engaged in one or more emergent care services in the past 60 days, over 87% of which were hospital emergency room visits. Further, over one-fifth of participants reported one or more overnight hospital stays since they had begun receiving home health care services. Thirty-four percent of hospitalized Medicare beneficiaries are readmitted within 90 days, and 56% within one year. Thirteen percent of these readmissions are considered preventable, costing Medicare alone an annual $25 billion. Because of this, CMS has begun to penalize hospitals for failing to reduce preventable readmissions—in 2012, those penalties were nearly $300 million, a figure expected to triple over the following two years.
In your opinion, what other challenges do you think home health care is up against?