Sunday, May 24, 2015

Does Home Health Care have a future?

by Ralph Santos, CEO, MBA, OTR/L

They may forget your name, but they will never forget how you made them feel.
                                                                                                                                      Maya Angelou

Does home health care delivery either in the form of a traditional home care agency or a hospice agency have a future?  According to Kimberly Leonard in an article in U.S. News and World Report entitled, Is Home Health a Solution to Rising Health Costs?, the answer is a resounding yes! 

As a skilled home health care provider for the past twenty years, I have seen the tides ebb and flow in various directions with reimbursement being the common denominator when discussing the changes in home health care.  The fact has always been obvious:  Patients want to be home to begin their recovery from an illness, an injury, a surgery or any other life changing event.  In this time frame, timing, comfort and their [the patient's] overall quality of life are essential to the rehabilitation process.  How many times have I heard patients tell me that they love being home with their family, eating their home cooked foods, spending time with their pets, their familiar surroundings.  Now, before people start critiquing this blog, please understand that there are certain conditions that do warrant the patient to be placed in an acute care facility or a sub-acute care facility or in an extended care facility such as a convalescent home.  I do not want to in anyway infer that we should take our ill patients and put them all in their homes.  My point is that if the patient is stable and able to be in his/her own home with the proper family/caregiver support systems in place and the proper means to address shelter, safety, comfort, healthy meals, and a solid medical support system such as a home health agency that we should allow them [our patients] to that quality of life that is attained by being in their homes. 

Next, in the article written by Kimberly Leonard, it states many interesting facts, of which two are staggering:  (1) "since 2011 a wave of 77 million baby boomers only started to become eligible for Medicare" and (2) "the population of people 80 and over nearly triples between 2010 and 2050."  What do these number mean to us in the home health care industry?  The answer is simple.   We have an insurmountable task ahead of us in trying to keep up a high quality of care in alignment with a huge demand curve along with a huge decrease in reimbursement. 

In my case, I can attest that with the reimbursement levels coming down and the cost of living rising, my experience tells me that many healthcare providers may think twice about entering the home health care setting.  Variables such as the cost of:  rent, fuel, food, water (especially in California) commingled with our basic yearly rate of inflation and we have health care professionals scrambling to see where they will make enough money to pay for their basic staples. 

In my opinion, we are heading into a tsunami of patients needing home health care services with our current health care infrastructure in a position of uncertainty and instability.  Our uncertainty stems from our lack of understanding that patients want to be in their homes (when applicable) and that the cost of home health when compared to an acute hospital stay or when compared to a skilled nursing facility stay are notably different.  According to the article written by Kimberly Leonard, "a person who undergoes surgery and is transitioned to home care for a month can expect a bill for about $1,200 - as opposed to a $12,000 bill for a skilled nursing facility." 

In closing, we as healthcare providers need to be vigilant, patient centered, and consistent advocates on behalf of our patients and their families.  We need to educate our patients when it would be beneficial to them being placed in a facility for medical care versus when going home and receiving home health would be warranted.  We need to understand that the home environment is the most conducive to a psychosocial well being and a greater quality of life!
Will there be a future for home health care?  I believe a better phrase will be to ask:  What will be the future of our growing older adult homebound population without home health care?

Ralph Santos, CEO, MBA, OTR/L,is the owner of the Center for Physical Therapy Services, Inc. located at 1650 E. Walnut Street, #B, Pasadena, CA 91106. Their office number is: (626) 683-9959. The Center for Physical Therapy Services, Inc., specializes in the training and guidance of PT, OT, ST and MSWs in the home health care setting. The company’s website is: The Center for Physical Therapy Services, Inc., also provides home health agencies and hospices with in-office training, lectures to senior centers, training to caregivers, and is able to help clients with choosing a home health care or hospice agency.  Email:

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