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Homecare Is Part of the Solution for Medicaid, Medicare


ALEXANDRIA, Va., June 29 -- A survey of healthcare literature documents that homecare is the most cost- effective setting for healthcare. U.S. Department of Health and Human Services Secretary Michael Leavitt recently called home- based care “radically more efficient” for Medicaid. The American Association for Homecare believes the same principal applies to Medicare.

“Homecare is cost-effective, clinically effective, and it’s preferred by patients and their families,” said Kay Cox, President and CEO of the American Association for Homecare. “Homecare is an important part of the answer to our nation’s Medicare and Medicaid crises.”

Several studies are summarized below. Details and full citations are available at

The May 2004 Journal of the American Geriatrics Society reports that homecare directed by Advanced Practice Nurses (APNs) reduced total costs of care for patients suffering from heart failure and comorbid conditions, attributable to fewer and later hospitalizations and fewer deaths.

A 1998 study in Clinical Infectious Diseases quantifies cost savings of a home intravenous antibiotic program in a Medicare managed care plan. The average cost per day of home therapy was $122, compared to $798 in the hospital and $541 in a skilled nursing facility (SNF) setting.

Oxygen can be provided to a chronic obstructive pulmonary disease (COPD) patient who lives at home for one year at less than the average Medicare cost for one day in the hospital, which is $3,606. Direct medical costs for COPD in the U.S. total $18 billion per year, nearly 9 percent of Medicare expenditures.

A 2002 study published in Health Care Financing Review describes the characteristics of Medicaid home and community- based (HCB) programs in seven states. In Washington, the state imposed strict fiscal caps, keeping spending to 40 percent of the cost of nursing home care on a per capita basis. In 1999 in Alabama, spending per enrollee in HCB services was $6,612 compared to a per capita cost in nursing homes of $22,771.

A 1999 study reported in the Journal of the American Medical Association reported savings of about 65 percent in a randomized- controlled trial of post-acute home-based management by advanced practice nurses.

The American Association for Homecare represents every line of service in the homecare community, including home health and home medical equipment providers, respiratory and infusion therapy, telemedicine, rehab and assistive technology, and hospice. Web:


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