scholarly journals Inequities in Access to High-Quality Home Health Agencies Among Racial and Ethnic Minorities With and Without Dementia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 330-330
Author(s):  
Bei Wu ◽  
Abraham Brody ◽  
Chenjuan Ma
Keyword(s):  
Ethnic Minorities ◽  
Home Health ◽  
High Quality ◽  
Racial And Ethnic Minorities ◽  
Black And White ◽  
Percentage Points ◽  
Health Agencies ◽  
Home Health Agencies ◽  
Race Ethnicity ◽  
To Receive

Abstract There are rising concerns of inequities in access to high-quality home health agencies (HHA). Using multiple national data sources that included 574,682 individuals from 8,634 HHA, we examined access to high-quality HHA care among racial and ethnic minorities with and without dementia. Approximately 9.9% of the individuals were Black, 6.2% Hispanic, and 3.3% other race/ethnicity. Over one-third (36.3%) had been diagnosed with dementia. Black and Hispanic individuals were 5.5 percentage points (95% CI, 5.2% - 5.9%) and 7.4 percentage points (95% CI, 7.0% - 7.8%) respectively more likely to receive care from agencies defined as having low-quality compared to White counterparts. Persons living with dementia were 1.3% less likely to receive care from high-quality agencies. Having dementia increased the inequity in accessing high-quality HHA between Black and White individuals. Racial and ethnic minorities, particularly those with dementia were at a disadvantaged position to receive care from high-quality HHA.

scholarly journals COVID Vaccine Rollout for Older People: East Meets West

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 189-189
Author(s):  
Nengliang Yao ◽  
Tom Cornwell ◽  
Cheryl Camillo
Keyword(s):  
Older People ◽  
Home Health ◽  
Lessons Learned ◽  
Community Partners ◽  
Health Agencies ◽  
Distribution Logistics ◽  
Home Health Agencies ◽  
Transport Safety ◽  
To Receive ◽  
System Characteristics

Abstract Older adults should be one of the first groups to receive COVID-19 vaccines, because the risk of dying from COVID-19 increases with age. However, it takes time to distribute the vaccines to different countries, and the challenges in administering vaccines may differ by health system characteristics and local culture. This international symposium will discuss the vaccine rollout issues in eight countries (Isreal, Japan, South Korea, China, France, United Kingdom, Canada, and United States). We will use an interview and dialog format, instead of presentations. We will cover extensive topics including: Availability - What vaccines? Access, Acceptance, Caregivers – How are providers responding/handling caregivers wanting to be vaccinated?Cost/Financing Issues, Distribution Logistics/Transport/Safety, Lessons Learned, Mutations/Variants, Partnerships needed to vaccinate homebound patients (community partners; home health agencies, etc.), Who can/should provide vaccination? The situation with COVID-19 is still very fluid. Countries are at different stages of vaccinating older people. The chair didn't ask the speakers to write an abstract now, instead, the speakers will collect more information during the next few months and plan to have a prep meeting one month before the Annual Meeting.

Work Environment Characteristics of High-Quality Home Health Agencies

2010 ◽  
Vol 33 (6) ◽  
pp. 767-785 ◽  
Author(s):  
Susan Tullai-McGuinness ◽  
Jennifer S. Riggs ◽  
Amany A. Farag
Keyword(s):  
Work Environment ◽  
Home Health ◽  
High Quality ◽  
Health Agencies ◽  
Home Health Agencies

scholarly journals Home Health Agencies With More Socially Vulnerable Patients Have Poorer Experience of Care Ratings

2021 ◽  
pp. 073346482110538
Author(s):  
Jinjiao Wang ◽  
Meiling Ying ◽  
Yue Li
Keyword(s):  
Ethnic Minorities ◽  
Care Delivery ◽  
Healthcare Providers ◽  
Home Health ◽  
Experience Of Care ◽  
Health Agencies ◽  
Dual Eligible ◽  
Home Health Agencies ◽  
Specific Care ◽  
Racial Ethnic

Objectives Examine the relationships between dual eligibility and race/ethnicity characteristics of Medicare-Certified Home Health Agencies (CHHAs) and experience of care ratings. Methods Analysis of 2017 national Consumer Assessment of Healthcare Providers and Systems and matched datasets of 10,906 CHHAs Results CHHAs with higher concentrations of dual-eligible patients were less likely to have high experience of care ratings for all three domains (e.g., for care delivery, quartile 4 vs. 1: odds ratio [OR] = 0.622, p < .001); CHHAs with higher concentrations of racial/ethnic minorities generally were less likely to have high experience of care ratings in care delivery (e.g., Black: quartile 4 vs. 1: OR = 0.418, p<0.001), communication (e.g., Black: quartile 4 vs. 1: OR = 0.316, p<0.001), and specific care issues (e.g., Hispanic: quartile 4 vs. 1: OR = 0.397, p < .001). Discussion CHHAs with greater concentrations of dual-eligible patients and racial/ethnic minorities were more likely to have poor experience of care ratings.

scholarly journals Racial and Ethnic Disparities in High-Quality Home Health Use Among Persons With Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 666-666
Author(s):  
Shekinah Fashaw ◽  
Kali Thomas
Keyword(s):  
Predominantly White ◽  
Ethnic Disparities ◽  
Home Health ◽  
Ethnic Composition ◽  
Policy And Practice ◽  
High Quality ◽  
Health Agencies ◽  
White Neighborhoods ◽  
Predominantly Minority ◽  
Home Health Agencies

Abstract Prior research suggests minorities and racially-diverse neighborhoods have decreased access to high-quality hospitals, physicians, and nursing homes. It is not clear how this varies for persons with dementia (PWD) and home health agencies (HHAs). With the Medicare enrollment file, linked to the home health OASIS, the American Community Survey, and Home Health Compare, we examine the influence of individual’s race/ethnicity, as well as the racial/ethnic composition of neighborhoods, on the likelihood of high quality HHA use among PWD in 2016. Minority PWD receiving home health are significantly less likely to use high-quality HHAs than their white counterparts (33% vs 39%, respectively). PWD using HHA in predominantly minority neighborhoods are less likely to use high-quality HHAs compared to PWD in predominantly white neighborhoods (31% vs 40%, respectively). This study is the first to examine racial disparities in the use of HH for PWD. Policy and practice implications will be discussed.

Home Health Agencies: Empirical Evidence on the Patient-Driven Groupings Model’s Expected Effects on Agency Reimbursements

2021 ◽  
pp. 108482232199038
Author(s):  
Elizabeth Plummer ◽  
William F. Wempe
Keyword(s):  
Ordinary Least Squares ◽  
Process Quality ◽  
Home Health ◽  
Least Squares Regression ◽  
Residual Variation ◽  
Health Agencies ◽  
Dual Eligible ◽  
Home Health Agencies ◽  
Seriously Ill Patients ◽  
Seriously Ill

Beginning January 1, 2020, Medicare’s Patient-Driven Groupings Model (PDGM) eliminated therapy as a direct determinant of Home Health Agencies’ (HHAs’) reimbursements. Instead, PDGM advances Medicare’s shift toward value-based payment models by directly linking HHAs’ reimbursements to patients’ medical conditions. We use 3 publicly-available datasets and ordered logistic regression to examine the associations between HHAs’ pre-PDGM provision of therapy and their other agency, patient, and quality characteristics. Our study therefore provides evidence on PDGM’s likely effects on HHA reimbursements assuming current patient populations and service levels do not change. We find that PDGM will likely increase payments to rural and facility-based HHAs, as well as HHAs serving greater proportions of non-white, dual-eligible, and seriously ill patients. Payments will also increase for HHAs scoring higher on quality surveys, but decrease for HHAs with higher outcome and process quality scores. We also use ordinary least squares regression to examine residual variation in HHAs’ expected reimbursement changes under PDGM, after accounting for any expected changes related to their pre-PDGM levels of therapy provision. We find that larger and rural HHAs will likely experience residual payment increases under PDGM, as will HHAs with greater numbers of seriously ill, younger, and non-white patients. HHAs with higher process quality, but lower outcome quality, will similarly benefit from PDGM. Understanding how PDGM affects HHAs is crucial as policymakers seek ways to increase equitable access to safe and affordable non-facility-provided healthcare that provides appropriate levels of therapy, nursing, and other care.

scholarly journals Is Health Information Exchange Use by Hospitals and Home Health Agencies Associated with Lower Readmission Rates?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 914-914
Author(s):  
Christine Jones ◽  
Jacob Thomas ◽  
Marisa Roczen ◽  
Kate Ytell ◽  
Mark Gritz
Keyword(s):  
Health Information ◽  
Information Exchange ◽  
Transitional Care ◽  
Care Transitions ◽  
Home Health ◽  
Hospital Length Of Stay ◽  
Care Hospital ◽  
Readmission Rates ◽  
Health Agencies ◽  
Home Health Agencies

Abstract For older adults transitioning from the hospital to home health agencies (HHAs), clinical information exchange is key for optimal transitional care. Hospital and HHA participation in regional health information exchanges (HIEs) could address fragmented communication and improve patient outcomes. We examined differences in characteristics and outcomes for patients with either Medicare or Medicare Advantage (MA) insurance who transitioned from hospitals to HHAs based on HIE participation with 2014-2018 data from the Colorado All Payer Claims Database. We performed analyses including chi square and t tests to compare patient characteristics and 30-day readmission rates for high versus lower HIE use, determined by HIE participation (+) and non-participation (-) among HHAs and hospitals: High HIE use dyads (Hospital+/HHA+) were compared to lower HIE use dyads (Hospital+/HHA-, Hospital-/HHA+, Hospital-/HHA-). We identified 57,998 care transitions from 123 acute care hospitals to 71 HHAs. On average, patients were 75 years old, had a three day hospital length of stay, over half were female (58%), 82% had Medicare and 18% had MA insurance. Although most characteristics were similar between high versus lower HIE use dyads, high HIE use dyads had a higher proportion of Medicare patients compared to the lower HIE use dyads (85% vs 79%, p &lt;0.001). Thirty-day readmissions were 12.4% for care transitions that occurred among high HIE use dyads (n=27,784) compared to 12.8% among lower HIE use dyads (n=32,929, p=0.102). For adults transitioning from hospitals to HHAs among high HIE use dyads, a trend toward lower 30-day readmission rates was identified.

Disaster Preparedness for Vulnerable Persons Receiving In-Home, Long-Term Care in South Carolina

2008 ◽  
Vol 23 (2) ◽  
pp. 133-142 ◽  
Author(s):  
Sarah B. Laditka ◽  
James N. Laditka ◽  
Carol B. Cornman ◽  
Courtney B. Davis ◽  
Maggi J. Chandlee
Keyword(s):  
Health Care ◽  
South Carolina ◽  
Home Health Care ◽  
Disaster Planning ◽  
Home Health ◽  
Personal Care ◽  
Term Care ◽  
Care Services ◽  
Health Agencies ◽  
Home Health Agencies

AbstractPurpose:The purpose of this study was to examine how agencies in South Carolina that provide in-home health care and personal care services help older and/or disabled clients to prepare for disasters.The study also examines how agencies safeguard clients' records, train staff, and how they could improve their preparedness.Methods:The relevant research and practice literature was reviewed. Nine public officials responsible for preparedness for in-home health care and personal care services in South Carolina were interviewed. A telephone survey instrument was developed that was based on these interviews and the literature review. Administrators from 16 agencies that provide in-home personal care to 2,147 clients, and five agencies that provide in-home health care to 2,180 clients, were interviewed. Grounded theory analysis identified major themes in the resulting qualitative data; thematic analysis organized the content.Results:Federal regulations require preparedness for agencies providing inhome health care (“home health”). No analogous regulations were found for in-home personal care. The degree of preparedness varied substantially among personal care agencies. Most personal care agencies were categorized as “less” prepared or “moderately” prepared. The findings for agencies in both categories generally suggest lack of preparedness in: (1) identifying clients at high risk and assisting them in planning; (2) providing written materials and/or recommendations; (3) protecting records; (4) educating staff and clients; and (5) coordinating disaster planning and response across agencies. Home health agencies were better prepared than were personal care agencies.However, some home health administrators commented that they were unsure how well their plans would work during a disaster, given a lack of training. The majority of home health agency administrators spoke of a need for better coordination and/or more preparedness training.Conclusions:Agencies providing personal care and home health services would benefit from developing stronger linkages with their local preparedness systems. The findings support incorporating disaster planning in the certification requirements for home health agencies, and developing additional educational resources for administrators and staff of personal care agencies and their clients.

Increasing Home Health Face-to-Face Certification: Impact of a Hospital-Based Intervention

2018 ◽  
Vol 30 (3) ◽  
pp. 110-115
Author(s):  
Kimberly Pelland ◽  
Emily Cooper ◽  
Alyssa DaCunha ◽  
Kathleen Calandra ◽  
Rebekah Gardner
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Home Health ◽  
Hospitalized Patients ◽  
Post Intervention ◽  
Face To Face ◽  
Hospital Physicians ◽  
Health Agencies ◽  
Community Physician ◽  
Home Health Agencies

Medicare requires that home health patients have a face-to-face visit with a physician when services are initiated and that physicians provide certification of this encounter before home health agencies (HHAs) can be reimbursed. We assessed an intervention to increase completion of face-to-face certification by hospital physicians at discharge using a retrospective chart review. We found a shift in the source and timeliness of certification among intervention hospitals. Pre-intervention, hospital physicians completed face-to-face certifications for 18.7% of patients and community physicians completed certifications for 47.2% ( p < .001), compared with 44.4% and 24.3% ( p < .001) post-intervention. Shifting the source of certification from community to hospital physicians helped HHAs by reducing the burden of tracking down certification from community physician offices and facilitating timely care for recently hospitalized patients.

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