As of Nov. 1, the government pays a predetermined amount based on the patient s diagnosis, leaving it up to the home care agency to stretch the dollars to fit all the visits and staffing required. Others, however, look forward to knowing the amount of reimbursement in advance and the stability that pre-payment could offer. So in the long run it will be good, but you re going to have to run a real lean operation for the next three years of transition time. Managed care is a big driver of home care. As hospital stays shrink and more procedures move to an outpatient basis, discharges are coming earlier all the time.
Technology also plays a role.
Home care nurses administer IV medication, maintain respirators, even give blood transfusions. People are getting older. They re more chronically ill. The majority of at-home clients are people with diabetes, stroke, wounds and broken hips, Little said. While it takes a doctor s orders to assign a home care nurse, once inside, the nurse is largely in charge, coordinating a patient care team of physical and occupational therapists, social workers, LVNs and aides.