While home care has no reported outcomes regarding smoking cessation defined, both hospitals and physicians do. Smoking has been identified as a contributing factor to pneumonia, heart disease, cancers, etc. (National Cancer Institute) and would logically contribute to the hospitalization costs.

The Department of Health and Human Services published a Surgeon General’s report that indicates that counseling and pharmacologic treatments such as nicotine replacement therapies and bupropion are effective for smoking cessation (U.S. Department of Health and Human Services, 2010). Home care could support the smoking cessation efforts for hospitals and physicians by integrating appropriate interventions in the plans for the care of the patient. Reporting, though not public, could further strengthen marketing efforts for home care providers with referral sources.

An area of commonality between all the hospital, physician and home care outcomes is immunizations.  Two types of immunizations / vaccines are the focus:

1. Influenza
2. Pneumococcal

Immunizations are an integral part of avoiding hospitalization.  Nichol KL, Wuorenma J, and von Stemberg (as cited by the Center for Disease Control, August 6, 2010) report a ‘substantial reduction in hospitalization and deaths among persons aged 65 and greater with influenza immunization’.  Read more...

Perhaps the most publicized topic is hospital readmission rates.  In 2007, MedPAC reported that “17.6% of admissions result in readmissions within 30 days of discharge, accounting for $15 billion in spending.  Not all of the readmissions are avoidable, but some are” (MedPAC, June 2007, p. 103).

The majority of hospital readmission costs are associated with four distinct medical conditions, which lead to over $1.6 billion in spending on readmissions alone.  These conditions include heart failure, chronic obstructive pulmonary disease (COPD), pneumonia, and acute myocardial infarction (AMI) (MedPAC, June 2007, p.116).  Granted these numbers are based upon 2005 Medicare hospital discharges and they could be even higher in 2011.  Read more...

While accountable care has been receiving a lot of press lately, let’s look at the objectives of accountable care, as defined by the Center for Medicare and Medicaid Services (Federal Register, November 2, 2011).  Within the context of the aforementioned final rule, the overarching objectives of accountable care were defined as:

1. Better care for individuals
2. Better health for populations
3. Lower growth in health care expenditures

With so much focus on the hospital and physician providers, how can home care, a lower cost provider, substantively contribute to accountable care objectives?  Read more...