CMS on Monday sent state Medicaid agencies a guide on how states should move beneficiaries into long-term care such as home and community-based settings instead of nursing homes.
"The COVID-19 crisis has shone a harsh light on the human costs of a long-term care system that relies too heavily on institutional services like nursing homes. Too often, they are seen as the default option, even for those who may not require round-the-clock care," CMS Administrator Seema Verma said in a prepared statement. "While nursing homes will always be an important part of a complete care continuum, many elderly individuals and their families should have access to a more robust set of home care and community-based care options."
CMS, the largest payer of long-term care services, said it wants to "ensure that Medicaid beneficiaries receive high quality, cost-effective, person-centered services in the setting of their choice." While all states cover institutional care such as nursing homes, not all states cover home- and community-based services, CMS said.
Since fiscal year 2013, home- and community-based care has represented more than 50% of Medicaid spending on long-term care services, and that trend is expected to continue as more people choose to receive care at home or in their community, CMS said.
In fact, during the pandemic, hospitals have chosen to discharge patients into home care for long recoveries. A recent study by healthcare consulting firm Avalere shows that hospital discharges to home health increased 4.6% year-over-year in June, while discharges to skilled nursing facilities were down 25.4% compared to 2019.
The tool kit offers example of efforts being made at the state level to shift to home- and community-based care. In Pennsylvania, for example, managed care plans must recruit, retain and train home care workers in their programs. Meanwhile, Georgia includes structured family caregiving in its elderly and disabled waiver program and pairs family caregivers with health coaches.
The American Health Care Association and National Center for Assisted Living, which represents more than 14,000 nursing homes and assisted living communities in the U.S., said it encourages policymakers to support every type of long-term care, as well as efforts to change care delivery.
"Individuals who require long term services and supports should be able to access the setting of their choice as well as the most appropriate setting for their needs," AHCA/NCAL said in a prepared statement. "We support efforts to expand home and community-based settings and integrate all settings to better serve individual needs, but not at the expense of nursing home care. Each long-term care setting has an important role to play, each contributing to a continuum of care."
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November 03, 2020 at 03:44AM
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CMS releases long-term care rebalancing tool kit for state Medicaid agencies - Modern Healthcare
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