Essay Sample on Home Health Care & Hospice: A Growing Need for Elderly Care

Introduction

Home health care is a continuum of services rendered to the elderly and provided in a home and community setting. It is an ambulatory care setting where health promotion and teaching, end-of-life care, support and maintenance, rehabilitation, social adaptation, and curative intervention are administered. Hospice care entails provision of palliative care and support services to the clients who are terminally ill. Home health care and hospice settings are becoming progressively significant are hence replacing the hospital setting as alternative health care service providers (Clark, 2015). Due to the abrupt expansion of home care services, there has been a call to improve patient safety, quality of services provided, and reduction of the liability. As a result, various recommendations and legislative priorities have been suggested to aids in the improvement of the care services provided by the home care and hospice care. Although the demand for home health and hospice services has been on the rise, there is a need to shape the healthcare policy through involvement in a legislative action framework.

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One of the legislative priorities relating to the provision of home health and hospice services is "encourage states to adopt home care quality of care standards through voluntary accreditation or licensure laws" (NAHC, 2019, p.46). Agencies that are Medicare-certified or non-Medicare-certified are required to obtain licensure. However, the laws governing licensure are not uniform and there is no available model licensure law and regulations to guide the agencies (Bosler, 2016). In this regard, inadequacy in state regulation for both the states with licensure law and those without. This has created home care agencies that are not fiscally stable, staffed and organized to provide quality care services (Bosler, 2016). Although the Certificate of Need laws has been suggested, they have not been significant to warrant regulatory solution that can guarantee quality and fiscal stability instead of licensure. Besides not all the states have enacted laws requiring home care agencies and personal care service providers to be certified. Hence, due to the lack of uniform or state minimum mandatory training and supervision requirement, the quality of care has deteriorated and presented significant problems hindering the quality of care services. As a result, National Association for Home Care and Hospice (NAHC) has recommended that the congress develop a uniform model for accreditation or licensure standards to govern the home care agencies to 3encurage the states to adopt and implementation model laws (Bosler, 2016). Having a uniform licensure and accreditation requirement is critical in creating varying levels of patient care, fiscal stability, and staffing. Besides, creating uniform licensure and accreditation creates appropriate consumer protection and ensures that home care agencies provide high-quality care (Bosler, 2016). It also creates a health care system that is fully staffed and organized to deliver thee core mandate to the patients in need of the services. However, the challenge is that the states cannot be forced to adopt the model laws but encouraged which may not yield positive results within a short time.

The second legislative priority is to "require community paramedics that provide non-emergency services in the home to meet regulatory and licensing home care standards" (NAHC, 2019, p. 46). While it is critical for the uniformity of licensure and accreditation of the home care and hospice agencies, it is also critical to have the home care workforce meet the regulatory and licensing home care standards. Since the home care services can be provided by any person whose credentials may not be verified, it becomes challenging to provide quality care services. It is, therefore, required that the workforce be well-qualified and reliable. Some states fail to focus on maintaining the home care workforce and allow paramedics to operate home care and hospice. Paramedics are allowed to perform the work done by the home care providers. Initially, the communities relied on the salaries and grants to fund the care being offered but after the Paramedics are seeking compensation from Medicaid hence straining the resources provided by Medicaid (NAHC, 2019). Such a system of care provided to the patient is flawed and fails to achieve the core mandate of reducing cost and providing quality care services. As a result, the NAHC recommended regulation of the paramedics such that they are bound by similar regulation and licensing standards that govern the operation of home care agencies in providing services and receiving payments from Medicaid. Also, the NAHC recommended that the services provided by paramedics should not overlap with those offered by the home care providers (NAHC, 2019). Home care providers should have holistic expertise to provide comprehensive care services to community members. Eliminating overlap of services provided by the paramedics and the home care providers helps to reduce the strain imposed on Medicaid services and this makes the home care cost-effective. When both the home care providers and the paramedics perform similar works, Medicaid is made to pay double services hence, increasing the cost. Conversely, regulation the work is done by the two professionals ensure that cost of care is reduced. A well trained and reliable workforce is a pillar of successful patient care. It has been established that as the quality of care improves the cost of care reduces and equal-to-better care outcomes are attained (Landers, 2016).

The third legislative priorities are "long term care insurance establish meaningful standards for long-term care insurance" (NAHC 2019, p.57). The cost of health care is generally expensive and few people afford the services. However, while a day's care is relatively cheap, it is more expensive for a long term patient who stays in the home care setting for a long duration. In such cases, neither the private insurance cover nor Medicare is willing to cover the expenses incurred at the center. For the Americans, there is hence a challenge with the financing method of a long-term care bill. In addition to the inability of Medicare, and private insurance agencies to settle the long term bills, there is inadequate state regulation of the private long-term care insurance market. The market is characterized by abusive sales practices and ineffective policies. There has been a plethora of acts such as Deficit Reduction Act of 2015, Long Term, Care Insurance Partnership Program, Health Insurance Portability and Accountability Act of 1996 and National Association of Insurance Commissioners (NAIC) model act which have suggested the expansion of the long term insurance bill coverage and protection of patient (NAHC 2019). However, the acts did not meet the up-t-date federal minimum standards. In this regard, NAHC recommended that the Congress amend the Deficit Reduction Act and the Health Insurance Portability and Accountability Act to demand that all long term care insurance policies adhere to the most up-to-date federal minimum standards. The policies on long-term care should be made to cover the full range of home care and hospice services and create a reimbursement scheme that ensures equal opportunities to those at the nursing home care (NAHC 2019). Increment of such generous plans would make the cost of care achievable and hence increase the number of people receive the services at the home center. The significance of the long -term care insurance is that protect the community members from large out-of-pocket expenses. Besides, ensuring that private long-term care insurance meet the currently accepted minimum standards would ensure that patent is adequately protected from excess personal expenditure in catering for medical expenses (NAHC 2019). A protected market creates confidence with the receivers of care and fosters satisfied customers towards the services offered by the private long-term care insurance.

Conclusion

In conclusion, as the demand for home health and hospice services increase, there is a need to shape the healthcare policy through involvement in a legislative action framework. Adoption of recommendations on legislative priorities is essential in ensuring that the quality status of the home care and hospice health improves. Moreover, effective adoption and implementation of the legislative priorities is critical in aiding in the cost reduction and increase the viability and organization of the home care agencies and hospices services. With the increasing demand for the services offered at the home health care and hospice centers, it is important to move with haste to take up the legislative priorities such as creating uniformity in the licensure and accreditation of the homecare and hospices services, ensure that community paramedics meet the regulatory and licensing home care standards, and establishing a long term care insurance with meaningful standards for long-term care insurance. With the increasing demand for home care and hospice services, cost, patient preference, care, and satisfaction are increasingly becoming the measures of performance.

References

Bosler, B. (2016). The Legislative Priority of Home Healthcare and Quality. Home Healthcare Now, 34(2), 110-111. DOI: 10.1097/nhh.0000000000000344

Clark, M. (2015). Population and community health nursing (6th ed.). Upper Saddle River, NJ: Pearson.

National Association for Home Care & Hospice. (2019). National Association for home care & hospice 2015 legislative priorities. Retrieved from https://www.nahc.org/wp-content/uploads/2019/06/2019-Legislative-Blueprint.pdf

Landers, S., Madigan, E., Leff, B., Rosati, R. J., McCann, B. A., Hornbake, R., ... Breese, E. (2016). The Future of Home Health Care: A Strategic Framework for Optimizing Value. Home health care management & practice, 28(4), 262-278. DOI:10.1177/1084822316666368