A growing lineup of health care companies thinks Congress can get a win-win on Medicare policy — both improving the quality of care and saving money — by moving more care to the home. Krista Drobac, who leads the Moving Health Home coalition of tech-enabled home care companies, including Best Buy’s Current Health, health system Intermountain and dialysis provider DaVita, as well as Amazon, cites surveys that show moving more care from hospitals and other health care facilities to patients’ homes is both popular and cost-effective. Lawmakers like what they’re hearing: Last week a bipartisan House duo, Adrian Smith (R-Neb.) and Debbie Dingell (D-Mich.), introduced a bill to facilitate the shift. “Seniors and their caregivers want the option to stay home. It’s better for overall health and recovery,” Drobac said. “The pandemic showed us it is possible, and we need to build on that.” And the evidence around costs is promising, too. The Congressional Budget Office scored an extension of existing hospital at-home care through 2024 as costing $5 million — a drop in the bucket of overall health care spending. What’s in the bill? The legislation would: — Create a new Medicare benefit allowing certain beneficiaries ineligible for Medicaid to have a home health worker for up to 12 hours a week — Facilitate house calls by allowing doctors to be paid monthly in place of the existing fee-for-service structure — Broaden reimbursement for home-based services, including dialysis, lab tests and infusions. “When you look at the numbers and demands on Medicare in the years on the horizon, we need to innovate,” Smith said. Even so: Some health economists are skeptical of the advocates’ rosy vision. “There is potential for cost savings,” said Rachel Werner, executive director of the University of Pennsylvania’s Leonard Davis Institute of Health Economics. But she added that the package is difficult to assess. “The cost implications probably vary across the different provisions, and it’s hard to know what the total costs might be,” she said.
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