Health Affairs: In Traditional Medicare, Modest Growth In The Home Care Workforce Largely Driven By Nurse Practitioners

Little is known about the characteristics of the workforce providing home-based medical care for traditional (fee-for-service) Medicare beneficiaries. This study found that the number of participating home care providers in traditional Medicare increased from about 14,100 in 2012 to around 16,600 in 2016. Approximately 4,000 providers joined or reentered that workforce annually, and 3,000 stopped or paused participation. Despite generally low overall participation of traditional Medicare providers in home-based care, the workforce has seen modest but steady growth, driven primarily by increasing nurse practitioner participation. Additional stimuli may be necessary to ensure workforce adequacy and stability.

Excerpt“Reimbursement and cost constraints remain barriers to the wide readoption of home care medicine, although this is changing with increasing use of value-based payment. Home-based medical care thus has been described as a low-volume, high-value service that is not easily rewarded by fee-for-service payment. For this reason, integrating value-based payment options within traditional Medicare for homebound older adults—for example, as in the proposed Independence at Home Act—may be essential to the growth of home-based medical care.”

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