What is Home Care?
Home care is a broad term that describes a wide variety of health and health-related services provided in the home setting. Home care is health care brought to your home to maintain or restore your health and well being. Services include: nursing, physical therapy, occupational therapy, speech therapy, medical social work, in-home aide services, medical equipment and supplies, infusion therapy, respiratory therapy and nutrition.
Care provided in the comfort and security of your home through a certified home health agency gives you, your family and friends a sense of control and peace of mind. Home care provides a wide range of health and social services to patients and teaches families to help care for their family member. Home care is personalized care that reduces the anxiety and stress associated with most forms of healthcare and allows a maximum amount of freedom for the individual. In most cases, home care also means significant savings in the cost of care when compared to institutional settings.
Millions of Americans rely on home care to stay out of a hospital, nursing home, rest home or other institution, and remain in the comfort of their own homes. There is no more important social value than keeping families together, particularly in time of illness. There is much scientific evidence that patients heal more quickly at home and there is very high consumer satisfaction associated with care delivered in the home.
Home care not only helps add years to life, but also life to years. Studies in the US and abroad indicate that those receiving home care have higher rates of satisfaction with life.
How Can I Access Home Care Services?
Patients or family members may directly contact home health agencies to access services. Many agencies are listed in the yellow pages of your telephone directory. Your physician may also make recommendations about home health and, if needed, will provide the necessary medical orders for services.
Who Pays for Home Care Services?
Many home care services are reimbursed by Medicare, Medicaid, worker's compensation, private or group health insurance, HMOs, Veteran and military benefits (VA/Tricare), or through other special funds such as block grants. Also, private payment may be arranged with many agencies on an individual basis. When services are reimbursed by either public sources of funding or through insurance, it's important to understand the eligibility criteria for reimbursement.
Medicare requires that the following conditions be met before reimbursing for home health services:
- The individual to whom the services are provided is an eligible Medicare beneficiary
- A physician certifies the need for services and establishes a plan of care
- The beneficiary must meet Medicare's definition of "homebound"
- The care must be provided in the patient's place of residence
- The services are provided by a Medicare-certified home health agency
- The individual needs skilled nursing on an intermittent basis or physical therapy or speech therapy or has a continued need for occupational therapy once one of the other skilled disciplines has established a plan of care
When the above conditions are met, physicians may also order home health aide services. Medical social worker services may also be provided under Medicare.
How Do I Select A Home Health Provider?
As in selecting any healthcare provider, patients and families should ask questions and make an informed selection, based on the specific needs of the patient. It is also critical that individuals take advantage of consumer protections that currently exist to promote high quality care.
Those agencies that provide Medicare and Medicaid home health services must also be certified by the Federal Government and meet their conditions of participation. The State of South Carolina makes on-site survey visits to all certified home care agencies to assess the quality of their services.
Agencies accredited by nationally recognized accrediting bodies demonstrate they meet yet another set of quality standards during on-site surveys.
A Word on Patient Choice of Care Provider
According to the Health Insurance for the Aged and Disabled Act (title XVIII of the Social Security Act), known as "Medicare," a "patient is free to choose any qualified institution, agency, or person offering him/her services."