The Choose Home Care Act was introduced July 29th by Sens. Debbie Stabenow (D-Michigan) and Todd Young (R-Indiana); with Sens. Ben Cardin (D-Maryland), Bob Casey (D-Pennsylvania), Susan Collins (R-Maine), Maggie Hassan (D-New Hampshire), and James Lankford (R-Ohio) signing on as co-sponsors. This bipartisan bill would expand eligible Medicare patient benefits by adding services at home such as:
- Up to 360 hours of personal care
- Non-emergency transportation
- Respite care and caregiver supports, education, and training
- Medication management and patient support
- Home adaptive equipment
- Skilled nursing care
- Physical and occupational therapy
- Speech-language pathology services
- Remote patient monitoring
- Care coordination, discharge planning, and transition supports
Under the Choose Home Care Act, Medicare patients who qualify for a Skilled Nursing Facility (SNF) stay following a hospitalization would have the option to receive nursing, therapies, and home care services at home instead.
Medicare patients would receive these add-on care services to their existing Medicare home health benefit for 30 days after hospital discharge. “Choose Home has the ability to completely reshape the U.S. health care system for seniors,” Bill Dombi, president of the National Association for Home Care & Hospice (NAHC), told Home Health Care News.
Eligible patients would be referred to a certified home health agency that offers the Choose Home option. Not every home health agency would qualify to offer the home-based extended care benefit, which will most likely not be available in every community. As far as payment, Choose Home would act as an add-on to a normally paid home health episode under the Patient-Driven Groupings Model (PDGM).
This new program is expected to save Medicare between 2 and 10 billion dollars over a ten-year period[i] by avoiding nursing home and skilled nursing facility costs for some patients who are able to receive nursing home-level care in the home.
What does this mean for home care? Not much. Non-Medicare certified agencies will not benefit directly from the Choose Home Care Act; it simply expands the current Medicare benefit. The proposed plan appears only to benefit home health agencies that are Medicare certified. The initial disadvantage would be home health agencies broaden their services to include the personal care portion of the benefit. Doing so could put an additional burden on caregiver recruitment for home care agencies. The advantages for the home care industry are twofold. First, The Choose Home Care Act is a big step forward in recognizing the value and benefits of care at home. Secondly, if enacted, the Centers for Medicare & Medicaid Services (CMS) will require reporting, which in turn will provide data demonstrating cost savings generated by home care. In turn, this could pave the way for additional funding, which could potentially expand to non-Medicare home care agencies.
The Choose Home Care Act of 2021 has plenty of support but has received considerable pushback from the Skilled Nursing and Assisted Living industry. The bill was referred to the Committee on Finance on July 29th. The Senate returned September 13th, and house members will return to Capitol Hill on September 20th. LHC Group, home health company’s Chairman and CEO Keith Myers, and a 30-year veteran on Capitol Hill stated that key lawmakers’ support on the Senate Finance Committee and Special Committee on Aging bode well for Choose Home’s passage in the Senate. He thought the bill would also pass the House of Representatives and be enacted reasonably quickly. Many things have happened since Mr. Myer’s made this statement which has taken the attention away from The Choose Home Care Act. Therefore, it will come down to a wait and see what Capitol Hill can get through during this next session.
Read the National Association for Home Care & Hospice’s Choose Home Care Fact Sheet for more information.