How might home health care services be impacted by the level of care the chronically-ill require?

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kipling2448 | (Level 3) Educator Emeritus

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The growing financial and social burden of caring for the increasing numbers of elderly in the United States –mainly Baby Boomers born between the years of 1946 and 1964 – will represent a major challenge for the United States in the near future.  More than 75 million babies born in America during those years will reach retirement age, with the increasing, and increasingly severe, physical maladies that aging people normally experience representing a tremendous burden on existing social welfare systems.  The cost of providing adequate medical care for that expanding population is one of the most serious financial problems currently confronting U.S. policymakers.  According the U.S. Government statistics, as much as one-quarter of the nation’s population will be elderly by 2030 and in need of greater levels of medical care.  This will present problems both for those elderly who choose, and are able, to remain in their homes and for those who move into assisted living facilities and nursing homes. 

It is, obviously, those who are able to remain in their homes who are the subject of those inquiring into the future of home health care.  Given the cost of caring for assisted living and nursing home patients, with the around-the-clock care that entails as well as the feeding, bathing, exercising, and entertaining of those individuals and couples, all expenses for the facilities in question that rely in turn on Medicare reimbursements and occupant fees, it may actually be the home health care component that survives the coming fiscal crunch in better shape.  Home health care involves utilizing the facilities and utilities associated with the patient’s home.  In other words, it is the patient’s infrastructure – heating and cooling, electricity, water, etc. – that is utilized as opposed to the assisted living facility’s resources.  Now, countering that somewhat simplistic calculation is the cost of providing a trained individual to spend half a day or more, five or more days a week, at a private residence caring for the elderly individual or couple.  According to one article, MetLife Insurance ran the numbers and concluded that home health aides, under some circumstances, are more expensive than assisted living facilities (assuming a $29 per hour wage scale for the aide). [www.pinnacleservices.org/cost-comparison-assisted-living-vs-home-health-care/]

If MetLife’s numbers are accurate – and they are specific to the Minneapolis-St. Paul and Rochester, Minnesota regions – than the impact of increased elderly care could prove as financially burdensome for home health care as for assisted living facilities or nursing homes.

The following website presents a useful system for calculating relative costs of home health care versus institutionalized living, that also includes additional variables not used in the MetLife data: www.payingforseniorcare.com/longtermcare/home-care-vs-assisted-living.html.

An additional, and not inconsequential, factor is the solvency of Medicare.  It is no secret that Medicare is perched precariously on a line between solvency and insolvency when projected growth in the number of retirees is factored into the equation – in effect, when the Baby Boomers enter the system.  Whether home health care will be adversely affected is unknown, but it is hard to believe that it will escape the budget crisis unscathed.

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