Home Health Agency Care

In the year 2000, about 12,800 home health agencies served approximately 8,600,000 clients across the United States.  In that year Medicare paid an estimated 85% to 90% of the total cost of home health agency services amounting to $8,7000,000,000.  Although current figures are not yet available, the number of home health agencies has been going up year after year as well as the number of clients being served.

Although home health agencies are privately owned, Medicare is the principle payer for their services.  Home health services through Medicare are available under parts A and B.  In order to qualify for Medicare home care a person must have a skilled need, must be homebound and there must be a plan of care ordered by a Physician.

Prior to 1997 Medicare typically paid for home care for as long as it was needed.  Prior to 1997 annual Medicare costs were almost double the amount cited above.  In order to save money Medicare has since gone to a prospective payment system where according to the plan of care, a certain amount of money is allocated to resolve the skilled need for the patient.

Monies are typically provided for a period of up to 60 days.  If the patient recovers sooner then money may have to be reshuffled to other patients who are not responding as well.  At the point where the patient does not respond or improve, no more Medicare money is forthcoming.  After Medicare cuts off, a person continuing to need long term care services must find sources other than Medicare.

In my next post I will explain what services a home health agency can provide.