Mount Sinai study finds unmet demand for home-based care

Home-based care models are a better and more efficient allocation of healthcare dollars as demand for home-based healthcare programs soar, according to a study published Aug. 10 in the Journal of General Internal Medicine.

Researchers at the New York City-based Icahn School of Medicine at Mount Sinai analyzed National Health and Aging Trends Study data to identify older adults who are homebound and compared that to Medicare fee-for-service claims to measure healthcare utilization and spending.

They found that 40 percent of homebound older adults had a hospitalization annually, compared to 20 percent of non-homebound older adults. Meaning total annual Medicare spending was $11,346 higher among the homebound compared to the non-homebound. 

"When we adjusted for demographic, clinical and geographic differences, we found the homebound have a negligible increase in the probability of having a home health visit compared to the non-homebound, suggesting that the gap in outpatient care is not being addressed by a home-based care model within Medicare," said Benjamin Oseroff, third-year medical student at Icahn Mount Sinai, who led the study. "It's concerning but not surprising; the finding is consistent with well-known barriers in Medicare to accessing home health services."

Researchers suggest that home-based care models are important for health systems to engage in as it targets a critically important population for quality improvement and reductions in Medicare spending.

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