A new bill seeks to support the use of patients' homes and community-based services as care sites, potentially providing several different financing incentives to the healthcare system.
Sens. John Kerry (D-Mass.) and Charles Grassley (R-Iowa) have introduced the Empowered at Home Act with the intent of increasing access to home- and community-based services.
The law would give states new tools and incentives to make services more available to those who need them and would affect care provided in homes and in long-term care facilities.
The goal is to keep infirm elderly and the disabled in their homes to receive care, rather than placing them in long-term care settings that are more expensive and expose them to other risks and infections.
"Far too many elderly or disabled Americans can't get the help they need in their home or community," Kerry said. "Home- and community-based services are high-quality, cost-effective and help people live independent lives, but Medicaid continues to favor nursing homes. The nation's largest purchaser of long-term care is tilted toward nursing homes rather than home- or community-based services. This bill would level the playing field."
Kerry said the bill would also give states more options and funding possibilities to pay for alternate-site care.
"It will give cash-strapped states new tools to provide cost-effective long-term care options to the most vulnerable," he said.
The bill has four basic parts. First, it improves the Medicaid Home and Community Based Services State Plan Amendment Option by giving states more flexibility in determining eligibility for which services they can offer under the program. The sponsors believe the bill will thus offer more options for individuals who need long-term support.
Second, the bill ensures that the same-spousal impoverishment protections offered for new nursing home beneficiaries will be in place for those recipients who instead choose home- and community-based services. In addition, recipients of these services with low incomes will be able to keep more of their assets when they become eligible for Medicaid.
The bill also offers tax-related provisions to support family caregivers and promote the purchase of long-term care insurance. Finally, the bill aims to improve the quality of alternative-site care by providing grants for states to invest in organizations and systems that can help ensure a supply of high-quality workers, promote health and ensure the alternative sites will be more consumer-centric.