Choose Home Care Act Puts Home Healthcare Agencies Front And Center

Elderly wheelchairs and care helpers take a walk in a flowered park

A new bill introduced in August 2021 has created quite a stir in the world of senior healthcare. The Choose Home Care Act is bipartisan legislation that, if enacted, would enable home healthcare providers to provide home-based services typically covered by nursing home facilities. Here, we examine the impact this pending legislation could have on home- and community-based services (HCBS) and providers.

How It Works

The Choose Home Care Act proposes a new add-on payment option that would allow some Medicare users to access HCBS for up to a month following surgeries or hospitalization stays. 

This 30-day, post-hospitalization option for HCBS would be in addition to the home health allowance they already receive. In some cases, beneficiaries would qualify for HCBS beyond 30 days, for as long as they are required.

If passed, the bill could permanently transform health care for Medicare beneficiaries, putting home healthcare at the center of post-hospitalization or post-surgical options for seniors. Enactment would provide opportunities for partnership among providers of HCBS and could potentially yield an annual savings of $247 million for Medicare.

Why It’s Likely To Pass

Opponents of the bill include skilled-nursing facilities (SNF) and organizations like The American Health Care Association and National Center for Assisted Living (AHCA/NCAL), which represent over 14,000 long-term care facilities and nursing homes. However, it seems support for the bill outweighs opposition.

Advocates working to support passage of the Choose Home Care Act include:

  • AARP;
  • LeadingAge;
  • National Association for Home Care and Hospice;
  • National Council on Aging; and 
  • Partnership for Quality Home Health Care.

Keith Myers, LHC Group Chairman and CEO, recently made the prediction that the bill will pass by the end of 2021. He notes strong support from lawmakers in both the Senate and House, making him cautiously optimistic about its chances of success.

Additional pressure was put on lawmakers when the U.S. Centers for Medicare & Medicaid Services (CMS) released a study conducted between March 1, 2020 and December 31, 2020. Results indicated “nursing home residents were 14 times more likely to be diagnosed with COVID-19 compared to beneficiaries in the community.” In addition, the study demonstrated that nursing home residents accounted for 22% of all COVID-19 cases for Medicare beneficiaries, yet they only make up 2% of the full Medicare population.

The Long-Term Impact

While some have hailed the new legislation as a “boon” for HCBS, there has also been practical discussion of how the law could impact providers if passed. Most notably, it opens significant opportunities for new partnerships. For example:

  • Providers can explore starting or expanding home-based service lines to offset lower occupancy rates during the pandemic.
  • Private-pay senior living providers can give residents skilled, home-based care in their apartments or independent and assisted living facilities directly, bypassing outside settings.
  • Private-pay providers not currently qualified for Medicare billing can work with Medicare-certified home health agencies to expand care for residents.

Perhaps the most significant advantage to come from the passage of the bill would be for older adults and their families, who could soon benefit from a wider range of skilled care options from the comfort of their homes and communities.