Trends in the Use of Medicare Home Health Care among Congregate Living Residents
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View abstract on PubMed
Summary
This summary is machine-generated.Home health care (HHC) use in congregate living increased by 20.5% from 2014-2019. While congregate living patients received more HHC visits and referrals, disparities in quality of care access were observed for dual-eligible and minority populations.
Area Of Science
- Gerontology
- Health Services Research
- Public Health
Background
- Home health care (HHC) is crucial for aging populations, with congregate living settings housing a significant number of Medicare beneficiaries.
- Understanding HHC utilization patterns within congregate living is essential for optimizing care delivery and addressing health disparities.
Purpose Of The Study
- To analyze trends in HHC use among Medicare patients residing in congregate living facilities.
- To compare the characteristics of HHC use (quality, visit frequency, referral source, recertification) between patients in congregate living and those in other home settings.
- To investigate disparities in HHC use based on patient characteristics such as dual eligibility and race-ethnicity.
Main Methods
- A retrospective cohort study utilizing national Medicare claims, assessment, and administrative data from 2014 to 2019.
- Comparison of HHC use patterns across different settings, focusing on agency quality, planned visit quantity, referral source (post-acute vs. community-initiated), and recertification rates.
- Multivariable regression analyses were employed to examine differences, controlling for patient factors including dual eligibility and race-ethnicity.
Main Results
- HHC episodes in congregate living increased by 20.5% between 2014 and 2019, accounting for 15.9% of all HHC episodes in 2018-2019.
- Patients in congregate living, under both Traditional Medicare (TM) and Medicare Advantage (MA), were more likely to use high-quality agencies, receive more planned visits, and have community-initiated referrals compared to those in other settings.
- Dually eligible and racial-ethnic minority patients in congregate living experienced reduced access to high-quality agencies and fewer planned visits, indicating inequitable care delivery.
Conclusions
- Congregate living settings may enhance access to higher quality and quantity of home health care, but this benefit is not equitably distributed.
- Significant disparities persist for vulnerable populations within congregate living, necessitating targeted interventions to ensure equitable HHC access.
- Further research is warranted to evaluate the impact and value of high-frequency, community-initiated HHC referrals in congregate living environments.
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