New Bill Seeks to Give Medicare Patients More Choice With Home Care

A new bill before Congress — the Choose Home Care Act of 2021 — received support on both sides of the aisle when it was introduced on Thursday, though one of the loudest voices in the long-term care lobby is disappointed to see it move forward.

In a statement released on Thursday, the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) argued that the legislation lacks clear quality and safety provisions and will leave patients vulnerable to inadequate care.

“We adamantly oppose this bill in its current form,” the statement read.

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AHCA/NCAL felt the bill would supplant existing benefits, create duplicative payments, confuse beneficiaries and increase out-of-pocket costs. It supports offering “rational” population health framework approaches for beneficiary’s preferred care options.

“We need proposals that add options to Medicare beneficiaries, not limit them,” AHCA/NCAL added.

The bill looks to reimagine and reshape where seniors can receive care, giving them more choice to stay at home rather than going to a long-term care facility to recover following a hospital stay.

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LeadingAge, which represents more than 5,000 non-profit senior housing and care providers, is among those in support of the bill and sees it as meeting the current needs of older Americans.

The trade association for nursing homes and senior care is pushing for Choose Home as a way of giving seniors more choice with Medicare benefits.

“It takes important steps toward increasing choice by supplementing the existing Medicare home health benefit and expanding the services providers can offer at home for hospital discharged Medicare recipients,” Katie Smith Sloan, president and CEO of LeadingAge, said in a statement released on Thursday. “Passing the Choose Home Care Act would be a much-needed move toward achieving our vision of making America a better place to grow old.”

The Choose Home Care Act of 2021 seeks to enable Medicare patients to receive extended care services as an add-on to the existing Medicare home health benefit for 30 days following a hospital stay.

Sens. Debbie Stabenow (D-Mich.) and Todd Young (R-Ind.), introduced the bill on Thursday. Co-sponsors of the bill include Sens. Ben Cardin (D-Md.), Susan Collins (R-Maine), Maggie Hassan (D-N.H.), James Lankford (R-Ohio), Bob Casey (D-Pa.) and Cynthia Lummis (R-Wyo.).

Endorsed by the AARP and supported by a long list of home-based care advocates, the bill has gained momentum on Capitol Hill. It seeks to create a new pathway for providers using both medical and non-medical services in order to keep Medicare beneficiaries out of skilled nursing facilities (SNFs).

These services can include receiving meals, non-emergency transportation, remote patient monitoring and more.

The Choose Home model could generate as much as $247 million in annual savings to the Medicare system, an analysis from health economics firm Dobson DaVanzo & Associates found.

Intended as a potential substitute for institutional services provided in SNFs, particularly for low-acuity patients who would prefer home care, in Dobson DaVanzo & Associates simulations, the Choose Home add-on provided significant Medicare savings when substituting for SNF institutional care.

The Partnership for Quality Home Healthcare is among those pushing for the bill to pass after the pandemic showed the limitations and risks of SNFs.

“Medicare reforms are overdue to provide viable, extended care services at home for patients who otherwise have only one option: Medicare’s SNF benefit,” according to information found on the PQHH site. “There is a better way to care for seriously ill Medicare beneficiaries after hospital discharge.”

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