Home Health Care Keeping Healthy

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When our family members need everyday assistance due to aging or disabilities, why wouldn’t we want them to be cared for in their own homes? Home has all the comforts and familiarity gathered over a lifetime, not to mention closeness to family and friends. That makes it hard for anyone to choose to live in a nursing home, with its institutional furniture and smells, surrounded by strangers.

This growing preference has resulted in an “explosion” of new companies specializing in home-based care. That should be good, right? Unfortunately the industry’s quick growth has gone unchecked, resulting in rampant fraud: charging for care that has not been given.

In this fraud, Ohio has been a leader and Columbus a national leader: Franklin County has three times as many Medicare-certified home health agencies per person as Cuyahoga County and nearly four times as many as Hamilton County (source: The Columbus Dispatch). And Franklin County takes the lead in home-care fraud cases that have resulted in criminal convictions.

Though home health care accounts for only about 5 percent of Ohio’s Medicaid spending, it has consumed more than 50 percent of payments to providers in the last three years. Analysis of billing records by The Columbus Dispatch showed that short 15-minute visits are skyrocketing in number. This data seems to suggest that providers are exploiting the billing policy of paying for a full hour of care after only 15 minutes. The government may need to revise Medicaid’s payment policy of paying for a full hour of care even when less time is spent.

Requiring licenses is the first step toward improving care, but Ohio is currently one of only eight states that do not require home health care agencies to be licensed. These home health care fraud and payment issues — and hopefully a concern for our state’s most vulnerable citizens — are prompting Ohio lawmakers to consider legislation that would require the licensing of home health agencies. The legislation aligns with the National Association for Home Care & Hospice, one of whose officers stated that licensing “is a best practice and a no-brainer” (Source: The Columbus Dispatch).

I am quite certain that we all agree that home care is the preferred option for our family members. But we need to make sure that the care we’re billed for is the care we’ve been provided. Licensing these agencies will help create an expectation of quality care. It’s time for Ohio to take this step and require licensing of home health care agencies.

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