Senior Telehealth Options
"The Approaching Telehealth Revolution in Home Care"
By Will Engle, March, 2009
Providing skilled care to patients in their home has long been an integral part of healthcare in the United States. In the last decade, homecare has become even more prominent due to an aging population, economic pressures, and patient preference (Kinsella, 2003a)
The demand for home healthcare services in the U.S. has increased 20% per year for the last ten years and is expected to continue at this rate (Kinsella,2003b)
Approximately 7.6 million Americans currently receive home care because of acute illness, long-term health conditions, permanent disability, or terminal illness (NAHC, 2008)
This increased demand for home care has inevitably led to a large increase in home care spending. In 2007, annual expenditures for home healthcare were projected to be $57.6 billion. Medicare is the largest single payer of home healthcare services and, in 2006, its spending accounted for approximately 37% of home health expenditures (NAHC, 2008)
Medicare's home health spending was anticipated to grow 13.7% in 2007, with an average a 10.2% growth rate per year from 2008 to 2017 (CMS,2008)
In 2001, The Centers for Medicare and Medicaid Services (CMS) implemented a Prospective Payment System (PPS) for Medicare home health, which set a national payment rate and enticed providers to deliver more efficient care (CMS, 2000)
The implementation of the PPS led to a number of challenges for the home care industry, including more accountability for patient improvement regardless of the patient's conditions and reimbursement limitations that significantly impacted the total visits on which home care nurses have to achieve positive results (Kinsella, 2003a). At the same time, home care agencies have been facing nurse shortages, greater regulations, and more complex care regimens.
The home care PPS requires providers to demonstrate and document that their patients' maintained or improved health outcomes; however, it does not automatically bias care towards or away from the use of telecommunications technologies. In 2000 when PPS was implemented, the idea of telehealth, the use of telecommunications technology to provide care services, would probably have only been abstractly familiar to most home care agencies. Today, eight years later, that situation is different, although less so than many anticipated. According to a recent national survey of almost 1,000 home care agencies, only 17.1% reported that they presently use a telehealth system (Fazzi Associates, 2008)
In the next several years, the use of telehealth will face a drastic change. Home care agencies which have implemented telehealth systems reported that their two biggest goals were to improve overall quality and to reduce unplanned hospitalizations or emergency room visits. A full 88.6% of these agencies reported that telehealth improved the overall quality of services provided to their patients. Specifically, 76.6% reported a reduction in unplanned hospitalizations and 77.2% reported a reduction in emergency room visits. Furthermore, 42.8% of agencies reported that their telehealth program has led to a reduction in cost (Fazzi Associates, 2008)
As the demand and pressure for home care services increases, and agencies are under increasing pressure to improve patient care and efficiency, the advantages inherent in telehealth technologies will be too big to ignore. Indeed, over 32% of home care agencies who do not currently have a telehealth system are planning on purchasing and using one in the next twenty-four months (Fazzi Associates, 2008)
We are clearly on the threshold of a revolution in how home care services are provided.
