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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Presentation Transcript
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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