What Medicaid Pays for Home Care

August 29, 2017 12:28 pm Published by

There’s no denying that home-based care services can prolong the amount of time that an individual can continue to live independently in their home, instead of an assisted living facility. In many cases, it is also the most cost-efficient way to provide care to patients who do not yet require 24/7 care.

Home Care vs. Assisted Living

Currently, two million Americans depend on home-based care services that are paid for by Medicaid to allow them to remain in their homes. While this might seem costly, it is actually two-thirds less expensive for Medicaid to keep these patients in their homes instead of nursing homes.

Depending on a state’s Medicaid program, alterations to a patient home, like safety features in the bathroom or safer flooring in the home, are covered along with home care. However, with the looming threat of reduced federal Medicaid funds to the states, the future of Medicaid covering home care services is uncertain. For specific answers about Medicaid coverage, it’s best to refer to your state’s Medicaid program.

Possible Cuts in Federal Medicaid Funds

The problem is that paying for home care services is not a given with all state Medicaid programs. Under federal law, all Medicaid programs are only required to cover the more expensive option of paying for care if the patient resides in a nursing home.

There is a push in Congress to greatly reduce Medicaid funds to the states. With cutbacks, it certainly would be in the states’ best interest to focus more on home care services to save money. This would keep more patients in their homes instead of nursing homes. And this could also generate more demand for home care workers in the industry, which is already expected to see an increase in demand.

Constituents have applied enough pressure on their representatives that many have walked back on supporting the more controversial aspects of an ACA repeal, including cuts to Medicaid. Regardless of the outcome, now is a good time to consider implementing DCI’s software products to track your Medicaid billables and allowable limits for services in each state.

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