The “Choose Home Care Bill” is positioned to change home health billing. This is because it’s the latest in legislation that supports the trend of moving as much care as possible into the home—overlapping with concepts like “aging in place” and “hospital at home” initiatives that have taken on new meaning in a global pandemic. At the same time, general aging trends have contributed to the importance of the bill. The silver tsunami, the progression of Baby Boomers into their senior years as Americans, has drawn new attention to the prospects of in-home care.
So, if you’ve been considering working with home health billing companies, you’ll want to learn exactly what it’s about.
What Is The Choose Home Care Act?
According to Moving Health Home, the “Choose Home Care Act” allows Medicare beneficiaries who are recovering from hospitalization the option of receiving post-hospital services in their homes. This is an alternative to receiving them in an institutional setting, such as a skilled nursing facility (SNF) or other similar setting. It is designed to apply to those who qualify and for who it would be clinically appropriate to receive care outside an institution, but who are also in a position where they need more care than is offered under existing Medicare home health benefits .
Introduced in July, 2021, the act has generated a lot of excitement in the world of senior care in particular. It essentially creates an add-on payment for home health providers that are caring for patients eligible for nursing home-level care. If it does pass, it will support in-home providers that offer services such as non-emergency transportation, meals, remote patient monitoring, and other things that target activities of daily living (ADLs), as well as social determinants of health for 30 days after a hospital visit .
The bill has been endorsed by AARP and has received the support of multiple home-based care advocates. This isn’t surprising, since many home health providers are already well positioned to deliver this kind of all-inclusive care if the rules and regulations of home health billing make it a smart move.
What Are The Benefits Of The Choose Home Bill?
This act clearly offers benefits for patients, but a deeper look reveals positives across the board.
Modernizing Medicare Post-Acute Care
A trend home health billing companies are staying on top of, this legislation takes a step to modernize post-acute benefits through its new, alternative post-acute benefit that supports home-based recovery. In addition to the services mentioned above, it would cover home adaptations and therapy services.
Enhancing Cost Savings
This is where the question of home health billing becomes most interesting. The Choose Home Bill offers the opportunity to reduce spending for Medicare through a value-based, cost-effective alternative. It does this while improving clinical outcomes. Independent health economics firm Dobson Davanzo estimates that legislation will save Medicare $144 to $247 million per year, with savings reaching $1.6 to $2.8 billion over a decade. This is an opportunity for organizations like yours to realize this savings through smart billing strategy.
Improving Patient Choice and Flexibility
The act goes a long way to respect and support patient and caregiver preference since it gives patients another option in receiving care at home across a greater area of the care continuum.
Choose Home can also contribute to equity by shifting the power dynamic between historically disenfranchised populations and health professionals and providers. This is possible because the institutional aspects of the healthcare system are largely removed, shifting care into the home and ideally improving opportunities to build trust and communication.
How Choose Home Works
As you are rethinking home health billing in light of the Choose Home Bill, and possibly considering working with home health billing companies, it’s important to review the benefits offered and see how they align with services you currently bill. Here is a more detailed list of the benefits.
- Skilled nursing care (as needed)
- Physical and occupational therapy (as needed)
- Speech-language pathology services (as needed)
- Personal care, up to 360 hours (as needed)
- Non-emergency transportation
- Meals (clinically appropriate)
- Remote patient monitoring (RPM)
- Home adaptive equipment
- Respite care and caregiver support, including education and training
- Medicare management and patient supports
- Care coordination, transition supports, and discharge planning
There are a few specifics that you will need to be aware of in the context of home health billing as you evaluate how the bill could potentially impact your business and home health billing outsourcing practices. Here are a few specifics.
- Your patient must reside at home and meet SNF benefit eligibility
- Your patient will receive traditional home health benefit services and in addition, for 30-days will receive the expanded package of services
- No cost-shari
- Payment combines home health amounts and a fixed add-on for expanded services
- Add-on payments for expanded services are capped at 80% of the SNF 30-day payment amount, which assures savings under Choose Home of about $4,623 for each patient
What’s The Future Of The Choose Home Bill
Currently, the National Association for Home Care and Hospice (NAHC) has issued a call to act to lobbyists, asking them to support the bill. William Dombi, NAHC President has pressed, “you’re not the only ones asking Congress to do things. This is why you have to be extraordinarily loud.” During the same annual Financial Management Conference, Susan Ponder-Stensel, President and CEO of hospice and palliative care company Alivia Care added the comment, “What we are experiencing as healthcare providers is that caregivers and patients want care when they want it, where they need it and what is most convenient for them” .
Moving Health Home, “Choose Home Care Act Fact Sheet,” 29 July 2021. Available: https://movinghealthhome.org/choose-home-care-act-fact-sheet/.
R. Holly, “Choose Home Bill Looks to Make Home Health the Center of the Health Care World,” Home Health Care News, 1 August 2021. Available: https://homehealthcarenews.com/2021/08/choose-home-bill-looks-to-make-home-health-the-center-of-the-health-care-world/.
D. Eastabrook, “NAHC calls on members to press Congress on Choose Home bill,” McKnight’s Senior Living, 3 August 2021. Available: https://www.mcknightsseniorliving.com/home/news/home-care-daily-news/nahc-calls-on-members-to-press-congress-on-choose-home-bill/.