Pandemic proves value of homecare

Doctors, nurses, and the scientists who created COVID-19 vaccines have all emerged as heroes during the pandemic. But there's another, underappreciated group that's been crucial to the country's pandemic response -- those who provide home-based medical equipment, services, and care.

Without fanfare or headlines, home medical equipment providers saved thousands and improved millions of lives. And they could transform the way we care for our elderly and infirm -- for the better. In order to fulfill that promise, home medical equipment providers must be paid commensurate with the value they deliver for their patients and the broader healthcare system.

The people most vulnerable to the coronavirus are the elderly. And the most vulnerable among them, tragically, have been those living in nursing homes.

By treating people at home, home medical equipment providers kept millions of seniors safe from COVID-19. They've been able to connect face to face with patients -- and serve as valuable eyes and ears for family caregivers and clinicians.

Home-based care also relieved pressure on frontline healthcare workers and clinical facilities, which have been nearly overrun several times during the pandemic.

Homebound patients with respiratory disorders didn't stop needing oxygen. People who rely on wheelchairs to get around still had to have their devices serviced. Homecare providers ensured they could get the care they needed -- and preserved the time and attention of clinicians for COVID-19 patients.

As the pandemic begins to wane, homecare's importance will not. Rather, it will join remote work and contactless delivery as one of the staples of modern life.

The COVID-era surge in homecare is only an acceleration of long-developing trends. First, our society is aging. Seniors are living longer, more active, and independent lives than ever before.

Second, homecare is less expensive — often considerably so — than institutional care. So it represents a promising strategy for tackling our nation's health cost crisis.

In recent months, hospital discharge rates have started returning to "normal," pre-pandemic levels. But when seniors leave the hospital, they're increasingly going home, not to a nursing facility.

Doctors, too, are becoming more supportive. According to a 2020 survey by William Blair, the proportion of doctors preferring to send patients to home health agencies over nursing homes rose from 54% to 81% during the pandemic.

Homecare is even changing the real estate industry. Last year, according to the National Association of Realtors, the share of homebuyers planning for multigenerational living reached the highest level ever recorded. Families are taking care of elderly parents -- hence the growing trend of "in-law suites" in home listings.

All told, more than three in four seniors view homecare as the preferred way to age, according to an AARP survey. It's also cost-effective and promotes better health outcomes. Families should be able care for their loved ones in the setting that works best for them -- and fosters the highest quality of life.

Unfortunately, bad policy stands in the way of this vision. While our aging population and its preference for homecare should mean that home medical equipment suppliers are thriving, nearly 40% of them have closed their doors over the last decade.

Why? A faulty Medicare program is unsustainably cutting their reimbursement rates.

Congress and the Biden administration must update these rates without delay. An increase that considers increased product costs and new operational requirements is long overdue. The industry needs to be able to forecast costs and guarantee salaries for its skilled workers. Otherwise, we're setting seniors up for failure.

COVID-19 taught us that home may be the safest place to receive care. But policies that don't reflect the true cost of care for life-saving equipment represent a failure to heed that lesson. Without properly funded homecare, we can expect lower-quality outcomes for patients, increased hospital readmissions and reliance on skilled facilities, and an overall increase in health costs.

The trend toward home-based health care is only going to accelerate. The underappreciated heroes who helped us through the pandemic will now pivot to helping Baby Boomers age and helping their families care for them. Homecare is good for patient wellbeing, family happiness, and government budgets.

Washington needs to find a way to make the system take care of homecare providers as much as they take care of us.

Thomas Ryan is president and CEO of the American Association for Homecare (aahomecare.org).