Felice J. Freyer reports for Kaiser Health News on how some hospitals now provide at-home rehab services for patients post surgery. At-home rehab can be helpful to patients who would otherwise have to wait in hospital until a rehab bed opens up for them.
People with Medicare in Medicare Advantage plans often struggle to get rehabilitation services after a surgery or other procedure that leaves them in pain, unsteady and/or unable to care for themselves. The cost is high and insurers would prefer to deny the care and save money, even when lack of rehab services keeps patients from a speedy and full recovery.
People in traditional Medicare are more likely to receive rehab services when needed post hospitalization. But, too often there are no rehab beds available. They are forced to sit in hospital until a bed opens up. And, sometimes the facility is located far from their homes and their loved ones.
At-home rehab gets patients out of the hospital more quickly. Caregivers can more easily visit patients. And, patients are monitored remotely.
The at-home rehab program is being tested in New York, Pennsylvania and Wisconsin. Some say it is working well. But, there are no rules surrounding how they should work, which patients qualify, or what services should be offered. And, Medicare does not cover these services as of now.
In short, at-home rehab is only being offered by a few hospitals that are paid upfront to manage their patients’ care. In some cases, a state Medicaid program pays for the care.
The trade association representing nursing homes and rehab facilities does not support this at-home rehab model. Skilled nursing facilities (SNFs) and rehab facilities are required to provide a range of services to their patients, which the at-home model does not require. Do these requirements necessarily improve patient care?
Many SNFs and rehab facilities offer precious little to their patients, other than unhealthy meals, endless hours in bed, and a short period of physical and/or occupational therapy. One quarter of patients end up with bed sores, infections or other poor health outcomes. At home, patients could be up and about a lot more and trained on how to navigate their homes safely.
One at-home rehab program reports no bedsores, infections or other adverse events for their patients. But, this program provides services only when there is also an in-home fulltime family caregiver to help. Consequently, many patients do not qualify for the at-home program.
Another at-home rehab program enrolls patients living alone and provides them with a call button to speak with a live person when needed. It’s not clear how well this program works. Home alone, patients needing rehab could be at serious risk of falling or otherwise hurting themselves.
Here’s more from Just Care:
- PACE helps older adults stay in their community
- Private equity-owned hospice and home health agencies drive up Medicare spending, jeopardize quality of care
- Need home health care? Don’t count on Medicare
- UnitedHealth deprives members of critical rehabilitation care
- Medicare covers physical, speech and occupational therapy