Saturday, December 31, 2011

An Overview Of The US Home Care Industry

By Darryl Jones


Helping people continue to live their lives even when they are incapable of doing so alone is a very old human tradition. The home care industry expanded as the industrial revolution occurred and then continued as more and more people worked outside the home, thus removing the informal caregivers that used to perform these services.

Assisting the elderly and the infirm with their basic needs is a tradition that goes back to the beginning of mankind. However, specialized medical assistance became a thing that was received in an in-patient center during the industrial revolution. Funding for other types of care revitalized the industry in the 1960's.

During the 1960's there was a tax break available for setting up nursing homes. This unfortunately resulted in a low quality of life for many residents of facilities that were more concerned with money than patients. New rules resulted in both stricter regulations on nursing homes and funding for in-home care by Medicare.

Medicare still pays for a large portion of the total expenditure of the home care industry. Some 37 percent of the total costs for this type of aid come from Medicare. Services included are things like wound care and medication administration, but also things like help with bathing, dressing, cooking, and other life skills. Aides who are not specially trained perform most of the non-medical work, and LVNs or RNs provide most of the medical services.

Like other health services, this type of assistance is expensive. Care from an unskilled aide can run from $7 per hour on up, and nurses commonly make $40-$60 per visit. Some 600,000 people receive this type of assistance, and the cost is significant, for patients, insurance companies, and the US government.

A complete picture of spending for this area is difficult to draw, because of several reasons. One is that services provided in-home are not necessarily listed as home-care services. Another is the many companies, agencies, and individuals paying for the services. Medicare spending was estimated at $428 billion for in-home services in the year 2008.




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