A new study by the Commonwealth Fund concluding that many US adults over age 65 struggle with access, coordination, and patient-centered care underscores the need to prevent the imposition of a Medicare home health benefit copayment.
The Partnership for Quality Home Healthcare (PQHH), a Washington, DC-headquartered coalition of home health providers dedicated to improving the integrity, quality, and efficiency of home healthcare for seniors, published an analysis of the study. The PQHH reports that the study analyzed older people across 11 countries and found that, “Despite having Medicare coverage, US adults age 65 or older were the most likely to report that cost posed a barrier to care. One-fifth (19%) said cost was the reason they did not visit a doctor, skipped a medical test or treatment recommended by a doctor, did not fill a prescription, or skipped doses.”
According to PQHH, home health beneficiaries are documented as being older, poorer, sicker, and more likely to be from a minority population than Medicare beneficiaries as a whole. Data from Avalere Health indicates that 24.4% of home health recipients are older than age 85 years compared to just 12.1% of all other Medicare beneficiaries. Notably, 66.2% of home health seniors live at or below 200% of the Federal Poverty Level compared with just 47.9% of all other Medicare beneficiaries.
Additionally, 74.7% of seniors who receive the Medicare home health benefit have four or more chronic conditions, compared to just 48.5% of the general Medicare population. Currently, the Medicare home health benefit does not impose a copayment on its beneficiaries, but many in Congress and the administration are weighing the possibility of saddling a vulnerable population with additional out-of-pocket costs.
“These study findings, coupled with Avalere Health’s research into the vulnerability of Medicare home health patients, underscore the risk of reimposing a copayment on Medicare home health patients,” stated Eric Berger, CEO of the Partnership for Quality Home Healthcare. “Congress repealed the home health copayment in 1972 for a very good reason: it failed to reduce healthcare costs and instead drove seniors to higher-cost institutional settings. Reimposition of such failed policy has the potential to compel poor seniors to forego cost-effective home healthcare simply because they cannot pay.”
Berger went on to say that it is clear from multiple sources that re-imposing a copayment on the home healthcare population could make it impossible for many to continue receiving care in the setting they prefer: their home. “Instead of imposing copayments that target innocent seniors, the Partnership is calling for program integrity reforms that would achieve significant savings while safeguarding patient access to vital home healthcare services,” Berger adds.
[Source: Partnership for Quality Home Healthcare]