Bobby Lolley: The Future of Healthcare is Right At Home

InOurOpinion_12HCAF Executive Director Bobby Lolley submitted the following op-ed to the South Florida Sun-Sentinel following its March 11, 2013 article ‘Home Care, Tele-Medicine Cut Health Costs‘.

In Washington, D.C. and in communities across the nation – like in Southeast Florida – it would be impossible to deny that times are tight when it comes to healthcare dollars. As Congress continues to grapple with various budget plans and proposals, and with the sequester beginning to take a serious bite out of Medicare reimbursement, healthcare providers are turning over every stone to try and stretch the precious dollars allotted for care of America’s seniors. We’re also trying to do what’s best for patients – giving them quality, choice and the best value possible.

An important part of this effort is keeping seniors out of hospitals. The reason is twofold: first, seniors prefer to be cared for at home when possible. Second, providers face tough financial penalties when patients are sent back to the hospital for costly readmissions when their conditions could have been properly managed elsewhere. Taking care of patients in the least expensive setting – which is most often the home setting they most prefer – simply makes sense, both financially and for the patient.

Home healthcare is the obvious, but often under-utilized answer to this effort. As demonstrated in the recent Sentinel article, “Home Care, Tele-Medicine Cut Health Costs,” episodes of care that should cost Medicare a few hundred dollars in a post-acute setting end up costing $20,000 in an hospital setting, creating both suffering for the patient and unnecessary spending for Medicare.

As the Executive Director for the Home Care Association of Florida and a registered nurse (RN), I witness daily the difference home healthcare makes in the lives of patients and their family members. Patients are able to avoid the high cost of a facility and remain surrounded by friends and family in the place they feel most comfortable. In such an environment, patients simply heal more quickly and have far less complications.

Special skilled nurse interventions that focus on keeping patients out of the emergency room, like those implemented at Florida Atlantic University, effectively treat patients at home and help avoid costly emergency room visits. Other Florida providers are implementing telemedicine and even physician house calls to keep patients healthy at home for as long as possible. Many treatments and therapies once only available in the hospital can now be safely administered in the home setting at a fraction of the cost.

The Home Based Primary Care Program (HBPC) run by the Department of Veterans Affairs is another shining example of an innovative care approach that utilizes home health.

The HBPC program was established in 1972 to help chronically aging veterans receive comprehensive healthcare services in their home while reducing costs. The program’s success in subsequent years is unparalleled with a 62 percent reduction in hospital days and an 88 percent reduction in nursing home days resulting in a 24 percent reduction in total healthcare costs. In addition to huge cost savings, veterans in the HBPC program receive excellent care coordination from a team of healthcare providers.  It is because of these results that Medicare should greatly consider the HBPC program as a model for reform.

We are thankful that Senator Bill Nelson (D-FL), the new Chairman of the Senate Committee on Aging recognizes the importance of reducing hospital readmissions for the benefit of older, frail beneficiaries and the preservation of our Medicare system. The Senator wisely advocates moving away from a fee-for-service model and towards care that is efficient and patient-centered.  We believe fully that home healthcare can contribute greatly to achieving the goal of keeping patients healthy and preserving Medicare dollars for future generations.

Medicare should take copious notes from successful programs that keep patients in their homes and out of doctor’s offices and hospitals. With as many as 10,000 Americans turning 65 everyday, the demand for home care services is rapidly increasing.

Home healthcare is ripe to provide coordinated care for our nation’s aging population and is widely recognized as cost-effective, clinically advanced and patient preferred. However, we must continue to pursue new innovative models of care, but also look to programs that have stood the test of time. By combining new and old initiatives and Congressional leadership, the daunting task of providing quality healthcare to a rapidly aging population begins to look a bit more manageable.

Bobby Lolley, RN is the Executive Director of the Home Care Association of Florida. 

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