When examining a Medicare Advantage (MA) plan population, researchers found that there’s a substantial prevalence of homebound individuals.
As part of the study, Dr. Bruce Leff and his study co-authors examined the prevalence, characteristics, predictors, health service use, and mortality outcomes of 2,435,519 homebound Humana Inc. (NYSE: HUM) MA beneficiaries in 2022.
“We thought it would be useful to understand if this population exists in MA, because if it does, then we need to be thinking about how to optimize care for these people, and make sure they get the care that they need, and make this somewhat invisible population visible,” Leff, a professor of medicine and director of the center for transformative geriatric research at Johns Hopkins University School of Medicine, told Home Health Care News.
The researchers found that the prevalence of homebound individuals was 22%.
Additionally, researchers found that homebound status was independently associated with greater health service utilization and mortality.
“One thing that the study demonstrates is that being homebound is a very powerful predictor of poor outcomes, whether it’s emergency department visits, or inpatient admissions into the hospital, or skilled-nursing facility admissions or death,” Leff said.
What’s more, Leff and his colleagues were surprised to find out that homebound status was an independent risk factor.
“Beyond people having certain chronic conditions, beyond people being frail, it was still an independent risk factor for facility-based utilization and death, and that to us, spoke volumes,” he said. “We thought it would be in the mix, but were a little bit surprised by just how powerful a predictor it was. When MA plans are doing in-home wellness assessments, they’re asking a lot of questions, some of which are likely required by CMS, but adding a single question on homebound status might be really valuable.”
Arming MA plans with this knowledge could potentially encourage them to seek stronger partnerships with home-based care providers looking to enter partnerships.
Leff pointed to the study’s findings as an indicator that these types of collaborations are necessary.
“What this study suggests is the need for health systems and MA plans to collaborate with entities that know how to do things in the home, and that might be skilled home health care companies — and we’ve seen MA buying out some of the big players in the space — or it might be home-based primary care practices,” Leff said.
Leff also noted the opportunity to bring together home-based palliative care, hospital at home, skilled nursing facility care at home, home health care and home-based primary care – all as a part of a larger home care ecosystem.
“In the future, we’re going to be doing a whole lot more at home, and the hospital will become a big ER, OR and ICU,” he said.
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