Research continues to show that the benefits of community-based services outweigh those of institutional care.
States like Arkansas are promoting the use of home-based health care and community-based services as a way to help people manage the high cost of traditional medical services while continuing to live as independently as possible. These services can include personal care, health and mobility support, housekeeping assistance, therapy, socialization, and respite care. In addition to the cost-effective benefits of community-based services, those with special needs can also expect more freedom and better care in a home or community-based setting.
The trend towards community-based services away from institutional services is growing according to recent Medicaid reports: 51% of Medicaid expenditures in long-term health support went to home and community-based services (HCBS) between October 2012 and September 2013. This means that of the $145 billion spent in long-term care programs, $75 billion was allocated to community-based options. 49% was used the year before, meaning these programs now account for more than half of Medicaid spending in this arena.
1. Cost-Effectiveness
Medicaid is spending more on community-based services for long-term health support for a reason. A study released in 1999 compared those receiving conventional (institutionalized) care with people receiving mobile medical care (community-based services). Results showed that the community-based serviced group experienced a 50% reduction in expenses and a 65% reduction in the number of days they spent in a hospital.
Results of a Nevada house call program published in Annals of Long Term Care reported a 62% percent reduction in hospital days and savings of $440,000 annually when 91 clients utilized community-based services instead of institutionalized services.
In Arkansas, the benefits of home and community based care can be seen in the case of an elderly woman enrolled in ElderChoices. If she had entered a nursing home, Medicaid would pay close to $50,000 a year for her care. By choosing ElderChoices, the cost is under $7,500 per year.
2. More Choices
Institutional care of anyone with a physical or intellectual disability significantly reduces that person’s ability to make their own choices and interact with others. This is because most continuing care facilities structure their operations and activities around staff rotations rather than patients’ schedules. Patients spend more time lying in bed alone rather than interacting with others or receiving care.
Community-based services and home care services allows individuals to remain independent and have more control of their daily schedule. This way, they can maintain desired relationships with family members and friends while getting the daily assistance they need. Home care providers take the time to give their clients the emotional and physical support they need in contrast to the understaffed or underfunded institutions housing hundreds of people.
3. Better Care
The cost of institutionalized care has never been proportionate with the level of care it delivers, nor the outcome of such care. Although a house call by a specialized health professional may cost more than one trip to physician’s office, research shows that individuals receiving daily assistance and care in their own homes are less likely to make multiple visits to the ER or require frequent hospitalization.
Prevailing evidence shows that those transitioning from an institutional setting to a program with the benefits of community-based services see continued development of their daily living skills. Alternately, those remaining in institutional care do not experience positive growth in their abilities. They instead remain at or below the level of skills they had when initially admitted to a long-term care facility.
Integrity, Inc. has been providing compassionate, home care and community based services in Arkansas for over 25 years. Contact Integrity to take advantage of the benefits of community-based services at 501-406-0442 and find out more about our programs.
Image licensed by Jeffrey Smith on Flickr
