The Future of
Home Health Care
WORKSHOP SUMMARY
Victoria Weisfeld and Tracy A. Lustig, Rapporteurs
Forum on Aging, Disability, and Independence
Board on Health Sciences Policy
Division of Behavioral and Social Sciences and Education
INSTITUTE OF MEDICINE AND
NATIONAL RESEARCH COUNCIL
OF THE NATIONAL ACADEMIES
THE NATIONAL ACADEMIES PRESS
Washington, D.C.
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
NOTICE: The workshop that is the subject of this workshop summary was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.
This activity was supported by contracts between the National Academy of Sciences and the Alliance for Home Health Quality and Innovation, the American Academy of Home Care Medicine, the American Nurses Association, the American Physical Therapy Association, Axxess, the Community Health Accreditation Program, Home Instead Senior Care, the National Alliance for Caregiving, and Unity Point at Home. The views presented in this publication do not necessarily reflect the views of the organizations or agencies that provided support for the activity.
International Standard Book Number-13: 978-0-309-36753-0
International Standard Book Number-10: 0-309-36753-0
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Suggested citation: IOM (Institute of Medicine) and NRC (National Research Council). 2015. The future of home health care: Workshop summary. Washington, DC: The National Academies Press.
THE NATIONAL ACADEMIES
Advisers to the Nation on Science, Engineering, and Medicine
The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.
The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. C. D. Mote, Jr., is president of the National Academy of Engineering.
The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Victor J. Dzau is president of the Institute of Medicine.
The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. C. D. Mote, Jr., are chair and vice chair, respectively, of the National Research Council.
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PLANNING COMMITTEE FOR A WORKSHOP ON
THE FUTURE OF HOME HEALTH CARE1
BRUCE LEFF (Co-Chair), Professor of Medicine, Johns Hopkins University School of Medicine
ELIZABETH MADIGAN (Co-Chair), Associate Professor of Nursing, Frances Payne Bolton School of Nursing, Case Western Reserve University
CHRISTINE E. BISHOP, Atran Professor of Labor Economics and Director of the Ph.D. Program at the Heller School of Social Policy and Management, Brandeis University
BARBARA B. CITARELLA, Founder, RBC Limited
THOMAS E. EDES, Executive Director, Geriatrics and Extended Care, U.S. Department of Veterans Affairs
MARGHERITA C. LABSON, Executive Director, Home Care Program, The Joint Commission
TERESA L. LEE, Executive Director, Alliance for Home Health Quality and Innovation
ANNE MONTGOMERY, Senior Policy Analyst, Altarum Institute
IOM Staff
TRACY A. LUSTIG, Forum Director
Y. CRYSTI PARK, Senior Program Assistant
ANDREW M. POPE, Director, Board on Health Sciences Policy
______________
1 Institute of Medicine and National Research Council planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.
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IOM-NRC FORUM ON AGING, DISABILITY,
AND INDEPENDENCE1
ALAN M. JETTE (Co-Chair), Boston University School of Public Health, Boston, MA
JOHN W. ROWE (Co-Chair), Columbia University, New York, NY
KELLY BUCKLAND, National Council on Independent Living, Washington, DC
JOE CALDWELL, National Council on Aging, Washington, DC
MARGARET L. CAMPBELL, National Institute on Disability and Rehabilitation Research, Washington, DC
EILEEN M. CRIMMINS, University of Southern California, Los Angeles
PEGGYE DILWORTH-ANDERSON, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
STEVEN C. EDELSTEIN, PHI, Bronx, NY
THOMAS E. EDES, U.S. Department of Veterans Affairs, Washington, DC
TERRY FULMER, Bouvé College of Health Sciences, Northeastern University, Boston, MA
NAOMI L. GERBER, Center for the Study of Chronic Illness and Disability, George Mason University, Fairfax, VA
ROBERT HORNYAK, Administration for Community Living, Washington, DC
LISA I. IEZZONI, Harvard Medical School, Boston, MA
JUDITH D. KASPER, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
KATHY KREPCIO, John J. Heldrich Center for Workforce Development, Rutgers, The State University of New Jersey, New Brunswick, NJ
NANCY LUNDEBJERG, American Geriatrics Society, New York, NY
RHONDA MEDOWS, United HealthCare, Washington, DC
LARRY MINNIX, LeadingAge, Washington, DC
ARI NE’EMAN, National Council on Disability, Washington, DC
RENÉ SEIDEL, The SCAN Foundation, Long Beach, CA
JACK W. SMITH, U.S. Department of Defense, Falls Church, VA
RICHARD SUZMAN, National Institute on Aging, Bethesda, MD
______________
1 Institute of Medicine and National Research Council forums do not issue, review, or approve individual documents. The responsibility for the published summary rests with the workshop rapporteurs and the institution.
IOM and NRC Staff
TRACY A. LUSTIG, Forum Director
GOOLOO WUNDERLICH, Senior Program Officer, Division of Behavioral and Social Sciences and Education, National Research Council
Y. CRYSTI PARK, Senior Program Assistant
ANDREW M. POPE, Director, Board on Health Sciences Policy, Institute of Medicine
Reviewers
This workshop summary has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published workshop summary as sound as possible and to ensure that the workshop summary meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this workshop summary:
AMY BERMAN, The John A. Hartford Foundation
MARGARET CAMPBELL, National Institute on Disability and Rehabilitation Research
REBECCA CONANT, University of California, San Francisco, School of Medicine
LINDA DECHERRIE, Mount Sinai Hospital
WARREN HEBERT, HomeCare Association of Louisiana
MELISSA O’CONNOR, Villanova University
Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the workshop summary before its release. The review of this workshop summary
was overseen by RON ACKERMANN, Indiana University. Appointed by the Institute of Medicine, he was responsible for making certain that an independent examination of this workshop summary was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this workshop summary rests entirely with the rapporteurs and the institution.
5 THE HOME HEALTH CARE WORKFORCE
Care Coordination and the Consumer Voice
6 MODELS OF CARE AND APPROACHES TO PAYMENT
Overview of the Range of Models and Approaches to Payment
Experience of the Visiting Nurse Service of New York
Experience of Optum Complex Population Management
Experience of the CAPABLE Model
Evidence Base for Home Health Care Technologies
Use and Development of Assistive Technology
Connecting to the Larger Health Care Ecosystem
MediCaring Accountable Care Communities: Connecting Health Care and Social Services