States Starting to Prioritize Home Health, Hospice Workers in Vaccination Plans

Pfizer, Moderna and the University of Oxford are among the organizations to tout highly effective COVID-19 vaccines this month. With “the cavalry coming,” the focus is now shifting to how, when and where vaccines should be distributed.

In September, the American Health Care Association (AHCA) and National Center for Assisted Living (NCAL) urged state leaders to prioritize nursing homes and assisted living communities for vaccine distribution, pointing to the tragic deaths among both residents and staff. In-home care advocates and other aging services stakeholders have made similar overtures.

Early policies out of Texas suggest those outreach efforts are paying off.

Workers in long-term care settings serving high-risk, vulnerable populations should be part of the first group to receive COVID-19 vaccines, according to new recommendations from Texas’ COVID-19 Expert Vaccine Allocation Panel. That includes home health workers.

“These guiding principles established by the Expert Vaccine Allocation Panel will ensure that the State of Texas swiftly distributes the COVID-19 vaccine to Texans who voluntarily choose to be immunized,” Governor Greg Abbott, a Republican, said in a statement.

In addition to long-term care workers, hospital staff members and emergency medical responders directly caring for COVID-19 patients will likewise receive early access to a vaccine.

Specifically, home health workers are included in Texas’ “Tier 1” prioritization category, along with hospice staff. “Tier 2” includes outpatient settings where health care providers are treating patients exhibiting COVID-19 symptoms.

Nearly 3,700 health care providers and institutions in Texas have signed up to receive vaccine shipments, The Dallas Morning News reported, attributing the information to a spokesman from the Department of State Health Services.

“This foundation for the allocation process will help us mitigate the spread of COVID-19 in our communities, protect the most vulnerable Texans, and safeguard crucial state resources,” Abbott’s statement continued.

While Texas is one of the only states so far to directly call out home health workers, others have broadly identified “health care workers” as early vaccine recipients.

In California’s framework unveiled Monday, for example, state officials said the goal is to first vaccinate the state’s 2.4 million health care workers, including first responders and those who work in congregate care settings.

Full Phase 1 distribution recommendation will be ready by Dec. 1, according to Democratic Governor Gavin Newsom, who recently had to quarantine with his family after his children were exposed to the coronavirus.

“The first tranche of vaccinations will be extraordinarily limited,” Newsom clarified.

Considering the developments in Texas, it’s likely that even more states will focus on in-home care workers in days to come. Doing so certainly makes sense from a numbers standpoint, as home health and hospice agencies employ millions of workers who deliver care to even more high-risk individuals each year.

In 2018, the country’s network of roughly 11,500 home health agencies cared to 3.4 million Medicare beneficiaries, according to the Medicare Payment Advisory Commission (MedPAC). In doing so, they delivered roughly 6.3 million visits.

Most of those beneficiaries suffered from multiple chronic conditions and had trouble eating, bathing or dressing.

In 2019, home health agencies employed an estimated 1.5 million workers, according to the Alliance for Home Health Quality and Innovation’s 2020 Chartbook, produced in conjunction with Avalere Health.

While Texas is clearly prioritizing home health and hospice workers, it is unclear whether “health care workers” also includes front-line professionals in the non-medical home care field.

How government officials define “home care” has been an issue throughout the COVID-19 pandemic, especially in regard to paid-leave rules outlined in the Families First Coronavirus Relief Act (FFCRA).

Even if states prioritize home health and home care agencies for a COVID-19 vaccine, it’s not a guarantee that workers will opt for one, especially with all the unknowns and potentially unpleasant side effects.

Participants in Moderna and Pfizer’s coronavirus vaccine trials told CNBC in September, for instance, that they experienced “high fever, body aches, bad headaches, daylong exhaustion and other symptoms” after receiving the shots.

For the 2019-2020 flu, vaccination coverage among health care personnel was 80.6%, according to the U.S. Centers for Disease Control and Prevention (CDC). By occupation, flu vaccination coverage was highest among physicians, nurses, pharmacists, nurse practitioners and physician assistants.

Flu vaccination coverage was lowest among health care aides and non-clinical personnel, the CDC notes.

The post States Starting to Prioritize Home Health, Hospice Workers in Vaccination Plans appeared first on Home Health Care News.

Home Health Patient Demographics Continue to Shift

Individual and clinical characteristics of home health patients continue to shift, reflective of both America’s aging population and providers’ ability to handle more acute cases.

That’s according to the latest Home Health Chartbook, an annual overview of the home health landscape put together by the Alliance for Home Health Quality and Innovation and Avalere Health.

In addition to highlighting the industry’s ever-changing patient population, the Chartbook also details the economic contribution of home health providers on the U.S. economy.

Compared to the overall Medicare population, home health patients tend to be older and slightly more economically vulnerable, the Chartbook suggests. Home health patients additionally tend to reside in rural areas and live alone at slightly higher rates than the broader universe of all Medicare beneficiaries.

“The Chartbook helps to conceptualize the home health landscape via data and charts that roughly sketches home health care in the United States,” Jennifer Schiller, executive director of the Alliance for Home Health Quality and Innovation, told Home Health Care News in an email. “We continue to see the value of home health care to patients and the health care system, writ large.”

When it comes to the health status of patients, home health users are far more likely to suffer from several chronic conditions.

Nearly half of the home health patient population suffers from five or more chronic conditions, with another 19% suffering from four chronic conditions, according to the Chartbook. In comparison, just 22.4% of the overall Medicare population suffers from five or more chronic conditions.

The apparent imbalance is partly attributable to the rising population of dual-eligible beneficiaries in home health care, Schiller noted.

“We continue to see a small but fairly steady increase in dual eligibles receiving home health care,” she said. “Dual-eligible home health users tend to have more chronic conditions and need assistance with more activities of daily living (ADLs) than home health users as a whole.”

On top of needing more assistance with ADLs and their chronic conditions, home health patients also often need more support for a severe mental illness, such as depression, bipolar disorder or schizophrenia.

More than one-third of the home health patient population suffers from a severe mental illness, the Chartbook shows. But just 28.9% of the overall Medicare population suffers from such an illness.

Apart from basic demographic information, the Chartbook also highlights the most common diagnosis-related groups for beneficiaries discharged from the hospital to home health providers under Medicare Part A.

In order, the most common diagnoses of patients referred from the hospital to home health are: septicemia or severe sepsis; major hip and knee joint replacement; heart failure; hip and femur procedures; and pneumonia.

In 2019, 6.93% of all home health claims were coded for Type 2 diabetes, with another 6.47% coded for orthopedic aftercare.

The post Home Health Patient Demographics Continue to Shift appeared first on Home Health Care News.

Home Health Agencies Carving Out Bigger Role in US Economy

The home health industry continues to carve out a bigger role in the overall U.S. economy, with agencies creating more jobs and paying more in wages than ever before.

Overall, home health agencies created more than 2.22 million jobs in 2019, employing more than 1.51 million workers in the process. That workforce took home more than $49.52 billion in estimated total wages.

These and other findings were highlighted in the latest Home Health Chartbook, released earlier this week by the Alliance for Home Health Quality & Innovation. Compiled annually by the Alliance with the help of Avalere Health, the Chartbook is a comprehensive analysis of the home health industry and the Medicare beneficiaries who utilize its services.

Data from the Chartbook comes from a range of government sources, including the U.S. Bureau of Labor Statistics (BLS), Home Health Compare, Medicare fee-for-service claims and several other Centers for Medicare & Medicaid Services (CMS) files.

The fact that the home health industry is becoming such a major economic force couldn’t come at a better time.

Millions of Americans have lost their jobs over the past nine months due to the COVID-19 public health emergency and its far-reaching impact. BLS reported Thursday that another 709,000 individuals filed first-time claims for unemployment benefits last week, on a seasonally adjusted basis.

That total is a slightly smaller number of initial claims than economists had expected, but still an astronomical spike compared to recent periods of economic stability.

To offset economic losses tied to the COVID-19 pandemic, multiple policymakers and politicians have suggested diverting further government support to the in-home care workforce. President-Elect Joe Biden, for example, pitched a $775 billion plan to boost the caregiver economy in July.

Home health agencies employed a similar number of workers in 2018, paying out a smaller wage total of $46.2 billion, however.

Employment of home health aides and personal care aides is projected to grow 34% from 2019 to 2029, much faster than the average for all occupations, according to BLS. As the baby-boom generation ages and the elderly population grows, the demand for the services of home health aides and personal care aides will continue to increase.

Broadly, the economic contribution of home health agencies has steadily risen since at least 2003, the Chartbook suggests. That’s true despite the shrinking size of the industry, at least in terms of Medicare-certified freestanding home health agencies.

From 1994 to 2015, the number of freestanding home health agencies climbed from 4,613 to 10,554. That total has fallen since then, dropping to 10,034 in 2018, according to the Chartbook.

Total home health expenditures reached $35.88 billion last year.

The post Home Health Agencies Carving Out Bigger Role in US Economy appeared first on Home Health Care News.