APPLAUDING CMS: Covering In-Home Care a Step in the Right Direction for Better Care and Outcomes

The Centers for Medicare and Medicaid Services (CMS) started February with a positive bang, releasing a number of changes aimed at improving the quality of life for Medicare Advantage beneficiaries by addressing their unique needs. One of the most progressive changes outlined in the CMS release (read here) is to allow in-home, non-medical services as a supplemental benefit for 2019. In a statement, CMS Administrator Seema Verga called it a “big win for patients” - and she’s right. Medicare currently allows for skilled in-home care, however there are many people who do not qualify for skilled home care who could benefit from non-skilled home care.   90% of older adults want to age comfortably within their homes but the ability to do so is compromised as we age. Approximately three in four adults over the age of 65 have multiple chronic conditions, making this population at greater risk of not being able to complete daily functional tasks like cooking or bathing. As a result, this population accounts for more than 90% of all Medicare fee-for-service healthcare spending.  Andy Slavitt, the former acting head of CMS, said in January of this year, “If you have two different people with the same disease, it costs a lot more to take care of someone if they have housing insecurity, food insecurities, if they don’t have access to transportation to pick up their medications. And as a result, if they show up in ER after they haven’t taken their medication, you have to manage back a situation that’s much more challenging.”  One of the primary reasons I founded CareLinx more than 8 years ago was because it would allow me to play a major role in helping people maintain their dignity, independence and purpose while they age in their home. With this new change, CMS has clearly seen the positive impact in-home non-medical care can have on improving the health of older adults, including positively impacting key social determinants of health including loneliness, anxiety, depression, and social isolation. About 10,000 baby boomers turning 65 every single day. The impact of better health for our older adults can quickly translate into lower healthcare costs, which is a win for us all.  We strongly support fast adoption of these proposed changes, and applaud CMS for taking such an important and progressive stance toward better care for America’s aging family members. At CareLinx we have already had very positive conversations with some of the nation’s largest health plans as they look for a partner to scale this new benefit nationally.