The average length of stay per episode of home health care reimbursed by Medicare decreased by 37%, from 106 to 69 days, after the Home Health PPS. In these cases, Part A coverage can last up to 90 days, with an initial period usually 60 days. The results of the first year of the Medicare home health care payment system, the PDGM (patient-driven clustering model), reveal that Medicare home health care payments for the first 30 days of care are, on average, more than 34% higher than those of the following 30-day periods of home care near Fallston MD, regardless of the amount of home health services a patient needs or their duration. Table 1 shows the weighted distribution of the duration of the episodes of stay according to this definition. More than 40 percent of HHA Medicare customers finished their Home Care near Fallston MD within 30 days (41.2 percent), and another third completed their episodes within 30 to 60 days (30.9 percent).Only about 5 percent of customers had episodes that lasted 6 months or longer.
Skilled nursing facilities provide the highest level of medical care outside of a hospital, with specialized staff and equipment. Because skilled nursing care is primarily for recovery and rehabilitation, most people stay in an SNF for a short time. The average stay is 37 days (MedPac, 201). While many nursing homes provide short-term skilled nursing care, some only provide long-term custodial care for their residents, including help with daily activities, such as eating, bathing, or dressing.
The purpose of this analysis was to systematically quantify the characteristics of Medicare home health care clients, the parameters of a total episode of care, and the bivariate associations that may exist between client characteristics and components of care. More recent studies on the use of Medicare-managed home health services could not be found, most likely because CMS (MedPar, HHSAF) do not require Medicare managed service providers to submit requests for analysis (Jencks et al. The Medicare service fee does not cover SNF care unless the patient has been in a hospital for at least three consecutive days. Medicare Part B covers home health care that is needed outside the hospital setting, such as skilled nursing care or therapy.
Medicare uses the number of days of hospitalization as a rough indicator of patients' conditions and provides free SNF services to patients for the first 20 days. Finally, the incentives of the Medicare hospital prospective payment system (PPS) have also helped to increase its use; the reduction in stays and the increase in care needs at discharge have helped to increase the demand for home care after discharge (Noether, 198. If the patient exhausts their assets and becomes eligible for Medicaid, Medicaid can cover the stay in a Medicaid certified nursing home). With the many threats currently facing the Medicare program, now is the time to come together as partners and explore ways to advocate for comprehensive Medicare coverage, health equity and quality health care. Second, low-quality, low-occupancy SNFs may have financial incentives to keep Medicare patients receiving care from the SNF longer than high-quality, high-occupancy SNFs. These results suggest that, due to the three-day rule, discharging patients with low-quality SNF may worsen the health of Medicare patients who use them, otherwise they would have gone home.
The Center for Medicare Advocacy regularly listens to beneficiaries, who are told by home health agencies that their agency “only provides short-term care.” The lack of an empirical basis for ensuring optimal home health care, combined with financial incentives to shorten home health care stays under the Medicare home care PPS, may be contributing to hospitalizations after home medical discharge among a growing population of older adults facing multiple chronic diseases. The findings of this study contribute to the body of evidence related to hospitalizations among beneficiaries of Medicare home health services and suggest that homecare LOS and the number of SNVs may be important components in reducing hospitalization among this vulnerable population.
