The Future of Home Health Care Workshop Summary (2015) / Chapter Skim
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Home health agencies and others are rising to the challenges of meeting the needs and demands of these populations to stay at home by exploring alternative models of care and payment approaches, the best use of their workforces, and technologies that can enhance independent living. All of these challenges and opportunities lead to the consideration of how home health care fits into the future health care system overall.
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4 in their homes and avoid potentially higher-cost, institution-based care. The workshop planners were especially interested in evaluating how home health care fits into evolving models of health care delivery and payment resulting from the Patient Protection and Affordable Care Act of 20105 and other policies, including those resulting from potential changes in the Medicare home health care benefit (which was designed nearly 50 years ago)
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; 2. Inform understanding of the evolving role of Medicare home health care and its role in the future by examining and exploring innovative models for the delivery of care that involve Medicare-certified home health agencies, home health care professionals, and other aspects of health care at home to achieve the triple aim of improving the patient experience of care (in cluding quality and satisfaction)
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As a result, some workshop speakers focused primarily on Medicare home health care, but many other topics included under a broader definition of home health care were also discussed, to varying degrees. overview Workshop participants were welcomed by planning committee cochairs Bruce Leff, Johns Hopkins University School of Medicine, and Elizabeth Madigan, Frances Payne Bolton School of Nursing, Case Western Reserve University, who began with an overview of home health care across the spectrum of services and supports (see Figure 1-1)
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Finally, on the far right of Figure 1-1 are acute-care, hospital-level services provided in the home, including care provided through hospital-at-home-type models, such as the model developed by the Johns Hopkins Schools of Medicine and Public Health.6 To date, many fewer people receive these more intensive home-based services, although the workshop discussion suggested that the trend is for more and more people to receive such services. Leff noted that the move from left to right in Figure 1-1 entails a move from the provision of health care services to individuals with lower-acuity levels of need to individuals with higher-acuity ones requiring a mix of acute and chronic care services and, finally, to the provision of acute care in the home.
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In a true system of home health care, she said, services would be integrated and those providing these services would provide care along a continuum that would involve collaborations with partners in the community as well as those in facilitybased long-term care, because patients often end up there at least for short periods, before going home again and receiving home health care services. In other words, across the spectrum of care, from informal services to the hospital in the home, what is needed is a focus "on what the patient needs and how we can help provide that in a seamless way," said Madigan.
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Rosati and Steven Landers, both of whom are with the Visiting Nurse Association Health Group) that address the current state of home health care overall
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I only remember one agency at the time, which served a pretty broad multicounty area. That experience shaped how my family felt about home health care for a while, and it wasn't necessarily a positive experience.
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In retrospect, it would've helped us tremendously to look at the home health care options. My dad was a little particular about how he wanted to be cared for, and we didn't want to disrupt his expectations that much.
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Chapter 4 examines the key issues and trends currently framing the discussion of home health care, such as trends in population health and public policy. The next several chapters explore the health care workforce (Chapter 5)
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