SNF-Diversion Bill ‘Choose Home’ Introduced, Projected to Save Up to $247M Annually

The home health industry reached a major legislative milestone on Thursday, with U.S. Sens. Debbie Stabenow (D-Mich.) and Todd Young (R-Ind.) teaming up to introduce a new bill to support in-home care alternatives to skilled nursing facilities (SNFs).

Endorsed by the AARP and supported by a long list of home-based care advocates, the Choose Home Care Act of 2021 has been gaining momentum on Capitol Hill over the past several months. If enacted, the legislation would enable certain Medicare patients to receive extended care services as an add-on to the existing Medicare home health benefit for 30 days following a hospital stay.

In addition to receiving skilled nursing or rehabilitation services from their home health provider, for example, a patient could potentially receive meals, non-emergency transportation, remote patient monitoring and more. The idea is to give today’s highly diversified in-home care providers more flexibility and financial support to keep at-risk Medicare beneficiaries at home and out of costlier facility-based settings, in turn saving the U.S. health care system hundreds of millions of dollars a year.

Operationally, many home health providers are already positioned to deliver such all-inclusive care, too, LHC Group Inc. (Nasdaq: LHCG) Chairman and CEO Keith Myers told Home Health Care News.

“Bringing these two things together — home health care and personal care — has been a dream for a long, long time,” Myers said. “Because, if you think about it, many home health operators operate a skilled home health business and a personal care business out of the same building, or right next to each other. You’ve quite often heard LHC Group talk about co- or tri-locating services in the same community.” 

Myers and LHC Group have been strong proponents of the Choose Home concept. The Lafayette, Louisiana-based home health, hospice and personal care services provider actually piloted a similar program to offer SNF-level care in the home years ago with Ochsner Health.

“We were caring for patients at a fraction of what it costs to go to a SNF, and the patients were happier,” Myers said. “I knew we could do this at scale, but I never believed that I would see major legislation like Choose Home at this point in my career. Then COVID happened, and this — shifting health care into the home — has been one of the ‘awakenings.’”

LHC Groups delivers in-home care services to patients in 35 states and the District of Columbia. Its national footprint means it can reach 60% of the U.S. population 65 and older, according to the company.

Co-sponsors of the newly introduced Choose Home bill include Sens. Ben Cardin (D-Md.), Susan Collins (R-Maine), Maggie Hassan (D-N.H.), James Lankford (R-Ohio), Bob Casey (D-Pa.) and Cynthia Lummis (R-Wyo.).

“This is a terrific, groundbreaking day. It recognizes that we have a Medicare home health benefit that could use modernizing,” Joanne Cunningham, executive director of the Partnership for Quality Home Healthcare, told HHCN. “Through the Choose Home proposal, hundreds of thousands of Medicare beneficiaries would have the option of going home and receiving home health care at a nursing home level. It’s very exciting, and it’s all about choice, safety and increasing health care options for Medicare beneficiaries in their homes.”

Strengthening the nation’s home- and community-based services (HCBS) infrastructure has become a priority for the Biden administration, but the support behind Choose Home also suggests lawmakers are clearly willing to reach across the aisle in order to reshape the post-acute care landscape, according to Cunningham.

“We have so many Republicans and Democrats who understand and value the opportunity to enhance at-home care options for Medicare beneficiaries,” Cunningham said. “Every time we’ve sat down with lawmakers of both political parties on this topic, the clear message back was, ‘Yes. We’re excited about this opportunity. We see the value in enhancing at-home care for more Medicare beneficiaries.’”