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National Trends in Home and Community-based Services February 19, 2009

National Trends in Home and Community-based Services February 19, 2009. What is HCBS?. Adult Day Services Home Care/ Nurse Practitioner/ Nurse staffing, etc. Home Health PACE DME/ Oxygen provider Home Infusion Housing with Services Senior Centers/Meals/Transportation

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National Trends in Home and Community-based Services February 19, 2009

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  1. National Trends inHome and Community-based Services February 19, 2009

  2. What is HCBS? • Adult Day Services • Home Care/ Nurse Practitioner/ Nurse staffing, etc. • Home Health • PACE • DME/ Oxygen provider • Home Infusion • Housing with Services • Senior Centers/Meals/Transportation • CCRC without walls • Intentional Communities

  3. Trends in HCBS • 43 states increased HCBS coverage • 7 states decreased HCBS coverage • Between 2001 and 2006 the percentage of Medicaid dollars spent on HCBS spiked 65 percent • Between 1999 and 2004 the number of participants enrolled in those services spiked by 43 percent • Increase use of Managed care, Medicare/Medicaid integration to control costs of HCBS

  4. Adult Day Services • There are currently more than 3,500 adult day services programs that serve 150,000 people annually (2002) • Types: Social, Medical, Disease specific • National Average daily rate $59 • For-profit growth • 25 states require licensure, 10 certification, 4 both, 13 states require a contract/CON with a state agency

  5. Home Health • There are over 9700 Medicare certified home health agencies • # of agencies increased 32% since 2003 • In 2007, 3.1 million beneficiaries were served (24% increase compared to 2002) • 80% for profit- 14% non-profit • Average hourly payment HHA- $38. ( 18% increase in a year)

  6. Home Care • 11,000 home health agencies that are not Medicare certified. • Multiple types: private duty home care, staffing registries, nurse practitioner services, durable medical equipment, pharmaceutical and infusion therapy, home care and homemaker services. • Average hourly rate $18 homemaker (4% increase)

  7. Hospice • In 2008, there are more than 3,253 hospice • # of hospices grew 13% from 2005 to 2007 • In 2000 about one in every four Americans who died received hospice care at the end of life, roughly 600,000 individuals • 51% for-profit in 2007, 37% non-profit, 12% government

  8. P.A.C.E. • 53 operating PACE or Pre-PACE in 25 states. • The Rural PACE Provider grant program from 2007 should expand PACE to 33 states • About 16,000 individuals are currently enrolled in PACE.

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