Currently, one of the most frequent causes for delays in seniors accessing home health services is due to physician orders. This problem stems from the fact that many seniors live in rural or remote areas, making it difficult for them to easily access a physician. Consequently, Medicare beneficiaries must wait weeks or even months until they can get an appointment with their primary care physician or see another physician who is not familiar with their medical history, before they get their care covered by Medicare. As a result, patients in need of home health care services are either placed in more expensive health care settings, or experience a delay in receiving the care they need. Furthermore, time delay to get the correct certification has created backlogs for home health agencies, as well as issues related to billing and payment. In order to resolve these issues, Congress has introduced the Home Health Planning Improvement Act of 2015 (S. 578).
The Home Health Care Planning Improvement Act of 2015, introduced by Senator Susan Collins (R-ME) and Senator Charles Schumer (D-NY) on February 26, allows providers apart from physicians to prescribe home care services for their patients. H.R. 1342 will permit nurse practitioners (NPs), clinical nurse specialists (CNS), certified nurse midwives (CNMs), and physician assistants (PAs), to certify and make changes to home health plans of treatment. Additionally, analysts have estimated that this bill could help Medicare save $82.5 million over 5 years (2015-2019) and $252.6 million over 10 years (2015-2024). Furthermore, the analysis shows the potential to reduce beneficiary admissions and lengths of stay in institutional settings under the policy change. Some analysts even suggest that non-physician practitioners will make 70% of home care certifications by 2025, which will not only drastically improve Medicare savings but also ultimately improve the patient’s quality of life.
Despite the mounting evidence that demonstrates that advanced practice nurses significantly improve quality of care and outcomes for patients, opponents of the law still state that broadening a nurse’s range of practice might be harmful. Unfortunately, this has caused a delay in the bill being signed as it is still under review by the Senate Finance Committee. Speculators are optimistic and state that the bill will reach the floor in both the Senate and House during the next session of Congress, taking effect on January 1, 2016. Hopefully, Medicare beneficiaries will have faster access to getting the proper home healthcare treatment if the bill is passed.
Stay tuned for more information about the Home Health Planning Improvement Act or visit our website.