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Home Health, Medical Equipment and
Hospice
 Environmental Analysis
 Internal Environment
 External Environment
 Long Term Objectives
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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
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Rising Costs
 Demand for home health care will increase
 The ongoing nursing shortage continues to inflate
costs of salaries and recruiting
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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
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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)
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Aging Population
 >60% of home health patients are over 65
 Demand will increase as baby boomers enter
retirement
Home Health Care Patients, 1992 – 2000
Coming changes
will reverse
former trends
(National Home and Hospice Care Data, 2004)
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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
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Two major changes:
 Increased numbers of people reaching retirement
age
 Changes in Medicare, VA and private insurers’
willingness to pay for home health care
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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
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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
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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
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Hospice
 Contracted licensed care and volunteer visits within the
veteran’s local community
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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
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Home healthcare promotes
faster return to health
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Home hospice supports both
the patient and the family
Home Health and Hospice Benefits
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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
Physical Services
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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
Helper Services
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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 Costs
Program Expansion
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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).
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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
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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
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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/inde
x.php?action=showSubCats&cat_id=208.