Medicare and Home Health: Taking Stock in the COVID-19 Era (Commonwealth Fund, US)

Courtney Harold Van Houtven and Walter D. Dawson

The COVID-19 pandemic’s impact on home health provided through the Medicare program has received little attention compared to other parts of the U.S. health system. This brief published by the Commonwealth Fund provides insight into the pandemic’s effects on Medicare home health beneficiaries, providers, and public policies, and examines changes to improve home health care during and after the pandemic. This includes an analysis of the current Medicare home health sector, including interviews with home health agencies, and a review of recent policy changes.

Data on COVID-19’s impact on home health are lacking. COVID-19 infection rates among Medicare beneficiaries and workforce have not been systematically reported during the pandemic. U.S. federal policy changes in response to COVID-19 have provided financial support to home health agencies, expanded provider licensures to certify use of home health, facilitated wider use of telehealth, and increased flexibility in Medicare Advantage plans.

Home health is an increasingly important care option during the current pandemic. However, the current design of the Medicare home health benefit is insufficient to meet the post-acute care needs of beneficiaries. Changes to Medicare policy could increase the value of the Medicare home health benefit in the COVID-19 era and beyond.

Specific recommendations include:

  • Expand opportunities to provide care at home by paying family caregivers supporting COVID-19 patients’ recovery.
  • Bolster the home care workforce through increased pay to home health aides and expanding scope of practice for providers.
  • Enhanced quality and oversight including publicly reporting data on COVID-19 infections amongst home health beneficiaries/workers

The full report is available here:

Courtney Harold Van Houtven: Center of Innovation to Accelerate Discovery and Practice Transformation,
Durham Veterans Affairs Health Care System and Department of Population Health Sciences and Duke-Margolis
Center for Health Policy, Duke

Walter D. Dawson: Oregon Health & Science University School of Medicine, Portland State University’s Institute
on Aging and Atlantic Fellow with the Global Brain Health Institute at the University of California, San Francisco

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