Usually people want what is free, but when it comes to medical in-home health care covered by Medicare or Advantage health plans, many unknowingly waive this benefit.
When a senior is discharged from a hospital or rehabilitation center, they are often eligible to receive insurance-covered, in-home physical therapy, occupational therapy, speech therapy and nursing and/or aide visits. This skilled, multi-disciplinary team visits the patient at their home and provides services in the home as long as the patient is considered “home-bound.”
According to Medicare’s definition, “home-bound” status is defined as “a normal inability to leave home and leaving home must require a considerable and taxing effort.” Most seniors of advanced age qualify as “home-bound” and could receive this benefit.
In talking with Southeastern Home Health’s Clinical Liaison, Ricky Vaccaro, a registered nurse, he revealed that even though Medicare and most insurances cover the skilled in-home health care benefit 100%, patients continue to refuse the medical in-home service. Vaccaro often hears patients say, “I’m fine. I don’t need anything.”
He believes that patients often deny this medical benefit because they just want to go home and do not fully understand the services being offered to them or the how these services will improve their recovery. Vaccaro says that education is the key to having more patients utilize this benefit.
“People don’t want to be re-hospitalized," he said. "Utilizing skilled in-home health services has been proven to reduce hospitalizations.”
One of the top reasons re-hospitalizations occur is medication errors. Vaccaro points out that with medical home health, all the medications are reviewed and reconciled.
"This provides feedback on how to properly take the medications and educates patients and their family members on any interactions multiple medications may cause," he said. "Additionally, staff can help assemble medi-planners or make a recommendation for pre-packaged medications. The goal is to decrease hospitalizations.”
Jeannie Horning, account executive and Licensed Practical Nurse at Encompass Home Health, agrees that the risk of re-hospitalization is higher for those waiving their skilled in-home health benefit. She believes it is a mistake not to take advantage of this benefit.
“There are a lot of misconceptions about in-home medical care," Horning said. "Communication is important. Most patients deny the benefit simply because they do not understand it.”
She encourages patients and their family members to ask questions at the hospital or rehab setting when discussing discharge.
“While the primary role of skilled in-home health care is to prevent re-hospitalizations, the secondary role is to educate patients and their family members on the signs and symptoms of their diseases such as congestive heart failure and diabetes," Horning said. "The goal is to get patients back to their baseline and be sure they are safe at home.”
The good news is that if a patient has denied or refused skilled in-home health services but now realizes their mistake and wants the care, the services can be reinitiated with a call to the patient’s primary care physician.
“Medical in-home health services are another layer of protection when you get home from a hospital or rehab stay and are not yet at 100% of your full capacity,” says Sharon Santoni, area manager of Encompass Home Health. “We are an extra set of trained eyes and ears in the home to notice a need and offer a solution. Often our staff can catch things early, like a urinary tract infection, and make suggestions for home equipment or share ideas to make the home safer.”
Santoni pointed out: “The primary function of skilled home health is to teach the patient and family to do proper and safe care at home. Take advantage of this benefit. The last thing you want to do is wind up back in the hospital.”