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Understanding the Different Home Health Models of Care

All home care organizations are not alike. The term “Home Health Care” is used to describe both medical and non-medical services that are normally provided in or around the home setting.  Licensure laws provide a minimum requirement for doing business and the quality of home care can differ significantly. Voluntary accreditation is a method of establishing a higher standard than state or federal requirements.  There are differences in home health care businesses and services covered by insurance.  What are these differences?

Home Care Businesses:

There are two basic home care businesses: Medicare Certified and Private Duty.

There are two models of Private Duty Home Care services: A full service agency and a nurse registry. 

Home Health Services Provided:

Medicare Certified Home Health Agencies provide a full spectrum of skilled services including skilled nursing care, physical therapy, speech therapy, occupational therapy, medical social worker services and home health aides.  The services are provided intermittently and not on an hourly basis. Normally, the home care visits are less than an hour in length and average about 2-3 visits per week for an average of 6-8 weeks.  The goal of this service is to teach and coach the client and their caregivers in behaviors and treatments that will improve their health.  Medicare pays 100% of certain health care services to be provided in the home setting if the eligibility criteria are met, and if the services are considered reasonable and necessary for the treatment of an illness or injury. 

A full service Private Duty Home Care Agency is licensed to provide only one skilled specialty and does not cover the full spectrum of skilled services.  These services are offered on an hourly basis and can include 24-hour services if desired. Many private duty agencies in Maryland offer skilled nursing, certified nursing assistants (personal care) and non-skilled companion care (ie, homemaking, errands, bill paying, transportation services.) The goal of Private Duty Home Care is to provide the help and care that the individual needs in order for them to remain in their home.  Services are available for extended periods of time and are generally paid for by the individual client.  The following programs may cover Private Duty services:

Hospice Home Care:  Home Hospice is a specialty in itself and has not been included in this review of home care models.  Hospice is a program that is designed to provide comfort and support for people who are no longer responding to cure-oriented treatments. Hospice care can be provided at home, in a hospice or another freestanding facility, or within a hospital. Hospice coverage is widely available and offered through Medicare, Medicaid and most private insurance providers.

In Summary

There are many agencies and choices available for home care services.   The individual to receive home care services can choose the agency they want to provide that care.  Understanding the various home health models, quality of services offered and the cost of care will help when it is time to make an informed decision.

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