Trends in the Use of Medicare Home Health Care among Congregate Living Residents.
Jun Li, Bo Zheng, Brian McGarry
PMID 39956155WHAT IT FOUND
Medicare home health episodes in congregate living rose from 10.1% to 12.2% of episodes.
These residents had more planned physical, occupational, or speech visits and more referrals without a recent hospital stay, but dual and minoritized patients were less likely to use high-quality agencies.
Key findings
01In 2018 to 2019, 1,357,470 of 9,870,292 Medicare home health patients resided in congregate living, and congregate living episodes rose from 10.1% in 2014 to 12.2% in 2019.
02After adjustment, Traditional Medicare patients in congregate living had 0.7 more planned physical, occupational, or speech visits and were 14.9 percentage points more likely to have a community-initiated episode without a hospitalization in the prior 14 days.
03Dual-eligible and minoritized patients remained less likely to use high-quality agencies, and duals had 0.64 fewer planned visits in congregate living and 0.52 fewer in other home settings.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The estimates are descriptive and not causal, so congregate living may not cause the observed differences. Residual differences between groups may remain even after adjusting for zip code and patient characteristics. The study could not examine actual visits delivered, only planned visits. Congregate living status was documented by clinicians and may contain error. Chronic condition information was unavailable for Medicare Advantage patients, and analyses were restricted to people aged 67 and older. The study did not assess clinical appropriateness of community-initiated referrals or recertifications.
Declared interests
The authors declared no conflicts of interest. The article is listed as receiving non-U.S. government and N.I.H. extramural research support.
The easy way to misread this
Do not read the higher planned visits and community-initiated referrals in congregate living as proof that this care is clinically beneficial. The study is descriptive and not causal, and community-initiated referrals are flagged as potentially low-value.