home health, medical equipment and hospice. environmental analysis internal environment external...
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Home Health, Medical Equipment Home Health, Medical Equipment and Hospiceand Hospice
Environmental Analysis
Internal Environment
External Environment
Long Term Objectives
The industry Continues to change and evolve
Greatest current changes are technological
The next decade will bring greater change, and in other areas: Aging baby boomers
Obesity and diabetes epidemics are expanding
Technology will continue to advance
Every field of health care will be affected
Rising Costs Demand for home health care will increase The ongoing nursing shortage continues to inflate
costs of salaries and recruiting
Uninsured Patients 46 million Americans currently uninsured, up from
20 million in 2004 Increase in service jobs indicates that the number
will continue to increase Government funds and VA budgets face
increasing stresses
Rising Costs Health care spending currently 16.2% of GDP
Expected to increase to 20% by 2015
Will be more difficult to secure third-party payments (insurance and Medicare)
Aging Population >60% of home health patients are over 65
Demand will increase as baby boomers enter retirement
Coming changes will reverse former trends
Home Health Care Patients, 1992 – 2000
(National Home and Hospice Care Data, 2004)
Diabetes Epidemic CDC: diabetes now a general epidemic, no longer
localized to specific areas One-third of Americans born in 2000 can expect
to develop diabetes
Blindness, kidney disease and amputations are common complications
Diabetics are poor healers and can require home health care for months
Obesity – the leading risk factor – also is epidemic in the US
Two major changes: Increased numbers of people reaching retirement
age Changes in Medicare, VA and private insurers’
willingness to pay for home health care
Home care is more cost effective for insurers than hospital care
TCB Caring Hands must be prepared to meet future demand for home care, medical equipment and hospice services within the veterans groups it serves
Home Health,Medical Equipment and Hospice Services
Home Health Routine in-home assistance at the nurse’s aide, CNA
and LPN levels, with oversight by an RN Contracted home health services in the veteran’s
local community
Medical Equipment This is for equipment and support not provided by
other sources. Example: the ramp that VA does not include with the wheelchair it provides
Hospice Contracted licensed care and volunteer visits within
the veteran’s local community
Home Health and Hospice Benefits
Home is important, especially when other aspects of life are uncertain
Home health patients need assistance, not institutionalization
Home healthcare encourages individuals to do as much for themselves as they can
Home healthcare promotes faster return to health
Home hospice supports both the patient and the family
Physical Services Helper Services
Companionship and conversations
Monitor diet and eating Assist with evening tasks,
preparing for bed Help with morning tasks Prepare medications Assist with transportations
to and from appointments Assist with walking Assist with clothing
Provide light housekeeping Assist with laundry Change linens Plan, prepare and clean up
after meals Pick up prescriptions Assist with any pets Care for Alzheimer’s and
dementia patients Attend appointments with
the patient Outings
Eligibility extends to any veteran who has been honorably discharged
Home healthcare, medical equipment and hospice care must be ordered by a physician Home health proceeds according to physician orders
TCB Caring Hands’ involvement in medical equipment applies to filling in the gaps left by government agencies and insurance companies
Hospice care is provided for those expected to live six months or less
Program CostsProgram Expansion
Costs vary relative to geographical region Services will be contracted with local home
health and hospice agencies Costs increase with increased requirements Average costs nationwide are:
Assisted living: $2073 per month in rural Arkansas to $5231 in Washington, DC. “Average is under $2500 in many non-metro markets” (Nursing Home, Home Health, Assisted Living, 2011).
Home health aides: national average is $21/hour, with broad geographical differences. Hourly rates are $25 in Rochester, MN; $18 in New York City, $23 in Chicago, and $13 in Shreveport, LA (Nursing Home, Home Health, Assisted Living, 2011).
This service can be operational in any city at any time: Contracted with local agencies Dependent on veteran presence and request in
specific geographical areas
Most cities have home health and hospice readily available Now favored by federal government, including VA,
Medicare and Medicaid Services generally must be ordered by a
physician
Economic changes may change local costs
Market changes are underway and will be more dramatic in the future
Federal budget changes can affect local supply
A survey of veterans using the site can guide program development and expansion plans
Nursing Home, Home Health, Assisted Living - General Average Cost. (2011). ConsumerHealthRatings.com. Retrieved August 5, 2011 from http://www.consumerhealthratings.com/index.php?action=showSubCats&cat_id=208.
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