Long-Term Care: The Second Career That Benefits Our Healthcare System

The demographic changes affecting our country are inescapable and our healthcare system is feeling the strain.  The CDC reports:

  • 13% of the population is over the age of 65 and will increase to 19% by 2030;
  • In the same time period, the number of people over the age of 85 will grow from 5.8 million to 8.7 million;

As legislators attempt to stretch available dollars to cover the costs of care for our aging population, there is more news:

  • About 80% of older adults have one chronic condition, and 50% have at least two. Infectious diseases (such as influenza and pneumococcal disease) and injuries also take a disproportionate toll on older adults. (CDC)
  • 45.3% of adults have two or more of nine selected chronic conditions, which include heart disease, hypertension, diabetes and cancer; these conditions are among the top five contributors for home health care utilization by Medicare beneficiaries.  (CDC)
  • The National Academy on an Aging Society projects that by 2040, the number of people               in the    U.S. with chronic conditions will increase by 50%.

It’s important to keep in mind that our aging population increasingly requires two types of care:  skilled care, such as nursing or rehabilitative therapy, and personal care which entails assistance with activities of daily living (ADLs) and instrumental activities of daily living (IADLs).  These acronyms represent activities we take for granted:  bathing and grooming, preparing meals and eating, using the bathroom or the telephone, and ambulating independently and safely in and out of the home.  Skilled care is provided in a hospital or nursing facility, but can also be carried out by licensed professionals in the patient’s home at a fraction of the cost.  The National Association for Home Care and Hospice (NAHC) adds to the case for home care by pointing out the 4000% cost difference between one hospital day and a home health care visit.

Uncertain economic times and dwindling retirement accounts sometimes lure individuals to pursue entrepreneurial ventures.  The motivations range from wanting to exert more control over one’s future and finances as well as serving people in need to the challenge of delivering high quality health care while lowering overall system costs.  Whatever the allure, various structures exist to meet the urge to be self-employed in Florida:

Home health agencies providing skilled care – these are generally accredited and Medicare-certified organizations that provide nursing care and rehabilitative therapy.  A new agency can take a year to become operational.

Home health agencies  providing non-skilled care  – these organizations (which are sometimes called private duty agencies) provide assistance with personal care and activities of daily living, such as bathing, dressing, eating, toileting and ambulating.  Florida requires these agencies to be accredited, which translates to approximately an eight to 10-month start-up period.

Nurse registries – these companies can provide nursing care as well as personal care services, but cannot provide therapy services or bill Medicare for services.  Generally speaking, these organizations have lower capital requirements and can be operational in less than six months.

Homemaker/Companion services – these organizations meet the least number of regulations and provide homemaking services such as cleaning and laundry, as well as companion care.  This type of business can be operational in about six weeks.

Home health care has gone from an afterthought of the health care industry to its rightful place as a solid vehicle to lower healthcare costs, reduce re-admissions, improve patient care and preserve the independence of our country’s elderly.

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