Page 2 - 2018HomecareHighlights
P. 2
Homecare Clients, Agencies Benefit
Medicare Advantage
from New Specialized Care Options
Opens Door for Non-Medical
PHA and homecare members worked with the Department
of Health (DOH) in 2018 to develop guidance for providers Homecare Benefits
offering specialized care services. Under this policy, which
DOH announced in 2016, providers are able to offer The Medicare world FINALLY began to realize
assistance with tasks like administering medications, and elevate the importance of non-medical
simple wound care, colostomy care, and more to help homecare services when CMS announced this
individuals maintain their independence at home. summer that it would allow Medicare
Advantage health plans to include personal
Members report the key to successful implementation of care as part of the supplemental benefits they
this new option has been personalized, focused training offer. Until now, these supplemental benefits
for each direct care worker involved in the client’s care. were required to be “primarily health-related,”
DOH requires individualized training and demonstrated but with the 2019 plan year, CMS will relax this
competency for each consumer’s needs, taking into interpretation to allow benefits like personal
consideration the preferences of the consumer. This is care at home, transportation, home-delivered
truly a win for the homecare industry because it gives meals and more. Many view this move as a
these families the option to continue care with their valuable opportunity for homecare agencies,
current provider as their needs increase rather than but one that will require providers to
turning to facility-based care. demonstrate their value in improving patient
outcomes.
OLTL Waiver Program:
34,439 Seniors over age 60 in
Aging waiver
31,166 Adults with physical disabilities in
CommCare, Independence,
Attendant Care, OBRA waivers
Based on the timing of this change, there were
ODP Waiver Program: not many health plans that could implement
the new benefit package for the 2019 benefit
30,931 Children & adults with intellectual year. In-home support and personal care
or developmental disabilities in services are being offered by 107 plans
nationwide. Other more popular benefits for
Autism, Consolidated & Person/ the first year are nicotine replacement therapy,
Family Directed Supports waivers transportation services and family caregiver
support. However, the industry will be able to
fully take advantage of this change for the
2020 benefit year, with more than 50%
reporting that they will soon offer personal
care at home to their beneficiaries. Details are
yet to be announced on how homecare
agencies can participate with their local
Medicare Advantage plan, but this is sure to be
a game changer and PHA will help members
prepare for this new opportunity.
