The pandemic has impacted every facet of our society. Health care is now in a race to catch up with society and technology. In the past 10 months it made great strides to catch up, but there is still space to grow. “We’re bringing care to where people are, in their homes and in their neighborhoods,” said Dr. Vivek Murthy, former Surgeon General under President Obama and President-Elect Biden’s nominee for that role. Murthy was pondering the future of health care.
Today, home health care is a $102 billion industry. Federal and state health programs have paid for about $76 billion of these services; commercial health insurance has paid about $12 billion. Medicare’s rules, which govern most of the health care industry, have allowed for most rehabilitative care such as physical, occupational or speech therapies, medical social services, and intermittent home health services to be covered.
The industry has begun to innovate and to deliver more services to the home. The pandemic has brought telehealth to the forefront of care. The University of Michigan Institute for Healthcare Policy and Innovation’s Telehealth Incubator reported that its video visits rose from 390 in January to 20,600 in April. In 2019, DaVita Kidney Care announced its home hemodialysis programs had expanded at four times the rate of its in-center care; the center has a goal to move a quarter of its care to homes by 2025.
And a bright sign has emerged in the overlooked area of mental health. The availability of counseling from a patient’s home has increased visits and provided care in a healthy space. The next generation of telehealth may include tele-stroke, tele-ER and tele-hospital services where the patient can be home, but be monitored remotely by medical teams.
The insurance industry in Michigan has responded in kind. During the pandemic, the industry supported new laws and executive orders encouraging the use of telehealth and allowing for insurers to cover these services. Medicaid updated antiquated laws limiting telehealth services based on the patient’s location. Insurers have put programs in place to offer telehealth services without cost-sharing to their individual or employer-sponsored plans.
A change championed by Michigan’s own Dr. Mark Fendrick for over a decade has allowed telehealth visits to be offered without cost-share for high deductible health plans. The plans responded by implementing this for enrollees. Medicare, on December 1, released new guidance allowing 144 more services to be available as telehealth. This change allowed emergency room visits and discharge visits, among other services, to be performed virtually.
State and federal law and guidance has innovated, and health plans have supported and scaled these changes in the home health landscape.
The definition of home health care has evolved from the days of your neighborhood physician walking up to your door. Now, we connect with providers through a secure portal to have a growing number of services delivered to the patient. State and federal governments have amended laws to lower the barrier to implementation for the industry. The health insurance industry has maximized these opportunities to deliver affordable care by increasing services and decreasing costs. Future opportunities for home health care are poised to grow.
Learn more at MAHP.org.