|
What is Home Health Care?
Home Health Care is skilled health-care services that are provided
in your home. Home Health Care can include nursing, therapy, social
work and home health aide services.
Why is Home Health Care important?
Home Health Care may be the best type of care for you because, it
is convenient (no transportation problems), comfortable (there
is no place like home), in general there is a shorter recovery
time and often the costs are lower than hospital or long-term care
facilities.
Who pays for Home Health Care?
If all criteria are met Medicare, Medicaid and most Private Insurance
Companies pay for Home Health Care. Criteria that must be
met includes being homebound (this means you leave the home infrequently
because it is taxing, difficult and effortful and generally requires
the assistance of someone else), services must be under the direction
of your Physician (your Physician must order Home Health and certify
that the care is medically necessary), services required must be
skilled (this means that you must require care that is performed
by a nurse or therapist, if you qualify for skilled services you
may receive MSW and home health aide services)
- Medicare pays home health services at 100% with no co-pay or
deductible. The home health agency is reimbursed for a sixty-day
period, the reimbursement depends on the level of care that is
needed and determined by the answers to a Medicare questionnaire.
Supplies that may be needed during the course of the sixty-day
period are generally lumped into the home health reimbursement.
- Medicare HMO’s pay for home health services. Services
covered depend on the plan, you may be subject to a deductible
and/or a co-pay.
- Medicaid pays home health services at 100% with no co-pay or
deductible.
- Most Private Insurance Companies have a home health benefit. They
are generally subject to a deductible and co-pay. Horizon
Home Care contracts with many Private Insurance Companies and
accepts their negotiated rates.
- Some Long-Term Care insurance policies cover certain home health
services. Each individual policy would have to be checked
to see if there is a benefit for home health care.
- Private Pay – Home Health services can be paid by the patient
or a patients trust.
What type of services can I receive from
home health?
- Part time or intermittent skilled nursing care. This includes
services by a Registered Nurse or Licensed Practical Nurse.
- Physical Therapy services to restore mobility, regain strength
or relieve pain.
- Speech Therapy services to provide help in your home for many
speech disorders.
- Occupational Therapy services may help patients regain lost motion,
stay active and achieve independence.
- Medical Social Workers may help the patient and family adjust
to new roles related to their illness or injury.
- Home Health Aide services to help with personal care and exercise
(under the direction of a Physical Therapist)
How long can I receive home health
services?
You can receive home health services as long as you meet the criteria
for the payer (you are homebound, you require skilled services that
are medically necessary, and the physician continues to order services).
How do I choose a Home Health Care
Agency?
It is important to find caregivers you are comfortable with and an
organization that suits your needs. Call the Home Health Agencies
in your area and gather information, find out if the agency is Medicare
certified and Joint Commission accredited (Joint Commission on Accreditation of Healthcare
Organizations), what services they have available, what
training their staff has, will the agency be in regular contact with
your Physician, and ask them why you should choose their agency. You
may also want to ask your neighbors, family, friends, health care
provider, hospital discharge planner or other professionals for their
suggestions.
Why should I use a home health agency
that is Joint Commission accredited?
Joint Commission accredited agencies are held accountable for higher standards
of care through development and implementation of polices and
procedures above and beyond those required by state and federal regulations. Joint Commission
accredited agencies are surveyed on a regular basis to ensure they
meet the requirements of the organization.
What is quality assurance and why is
it important?
Quality assurance is a process in which the organization evaluates
its policies and procedures on a regular basis and makes changes
as needed to avoid problems or negative outcomes. The quality
assurance group also monitors patient satisfaction, infection, hospitalizations,
reviews medical records to identify problems, develops, and implements
new procedures and evaluates the effectiveness of changes made.
Quality assurance is an important process for all healthcare organizations
to follow to ensure they are taking all measures possible to provide
the highest quality healthcare.
What is Home Health
Compare and why
is it important?
Home Health Compare is a Medicare website that can be accessed via
the Internet. The website offers information about the home
health agencies in your area, such as, Home Health Agency name, address
and phone, services offered by agency, date agency became certified
and type of ownership. Most importantly you can access the
quality measures for each certified agency. The measures provide
information about the agency’s patient population regarding
improvement in physical and mental health and whether their ability
to perform basic daily activities is maintained or improved. The
quality information can be used to help compare home health agencies
in your area.
You can access Home Health Compare at www.medicare.gov/hhcompare.
Select compare Home Health Agencies in Your Area, then service by
state, county or zip code. You can look at an individual agency
or all agencies. You may also select Compare all Quality measures
and the program will compare all agencies in your area against one
another.
How can I change home health agencies?
If you are dissatisfied with the services you are receiving and have
been unable to resolve the problems you are having with your home
health agency you may change to another home health agency. To
change home health agencies you will need to contact your Physician
and let them know you would like to change agencies. Either
you or your Physicians office will need to notify the old home
health agency to discharge you from their services and notify the
new home health agency of your need to begin services.
|