National trends in home and community based services february 19 2009
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National Trends in Home and Community-based Services February 19, 2009. What is HCBS?. Adult Day Services Home Care/ Nurse Practitioner/ Nurse staffing, etc. Home Health PACE DME/ Oxygen provider Home Infusion Housing with Services Senior Centers/Meals/Transportation

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National Trends in Home and Community-based Services February 19, 2009

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National trends in home and community based services february 19 2009

National Trends inHome and Community-based Services February 19, 2009


What is hcbs

What is HCBS?

  • Adult Day Services

  • Home Care/ Nurse Practitioner/ Nurse staffing, etc.

  • Home Health

  • PACE

  • DME/ Oxygen provider

  • Home Infusion

  • Housing with Services

  • Senior Centers/Meals/Transportation

  • CCRC without walls

  • Intentional Communities


Trends in hcbs

Trends in HCBS

  • 43 states increased HCBS coverage

  • 7 states decreased HCBS coverage

  • Between 2001 and 2006 the percentage of Medicaid dollars spent on HCBS spiked 65 percent

  • Between 1999 and 2004 the number of participants enrolled in those services spiked by 43 percent

  • Increase use of Managed care, Medicare/Medicaid integration to control costs of HCBS


Adult day services

Adult Day Services

  • There are currently more than 3,500 adult day services programs that serve 150,000 people annually (2002)

  • Types: Social, Medical, Disease specific

  • National Average daily rate $59

  • For-profit growth

  • 25 states require licensure, 10 certification, 4 both, 13 states require a contract/CON with a state agency


Home health

Home Health

  • There are over 9700 Medicare certified home health agencies

  • # of agencies increased 32% since 2003

  • In 2007, 3.1 million beneficiaries were served (24% increase compared to 2002)

  • 80% for profit- 14% non-profit

  • Average hourly payment HHA- $38. ( 18% increase in a year)


Home care

Home Care

  • 11,000 home health agencies that are not Medicare certified.

  • Multiple types: private duty home care, staffing registries, nurse practitioner services, durable medical equipment, pharmaceutical and infusion therapy, home care and homemaker services.

  • Average hourly rate $18 homemaker (4% increase)


Hospice

Hospice

  • In 2008, there are more than 3,253 hospice

  • # of hospices grew 13% from 2005 to 2007

  • In 2000 about one in every four Americans who died received hospice care at the end of life, roughly 600,000 individuals

  • 51% for-profit in 2007, 37% non-profit, 12% government


P a c e

P.A.C.E.

  • 53 operating PACE or Pre-PACE in 25 states.

  • The Rural PACE Provider grant program from 2007 should expand PACE to 33 states

  • About 16,000 individuals are currently enrolled in PACE.


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