Mass. doctors value home health services, but note barriers

Home health services are designed to help patients and family caregivers cope with acute medical needs after a hospital stay or manage ongoing chronic conditions, in hopes of keeping patients out of the hospital or emergency room. A recent survey of Massachusetts doctors found that most think home health care services help their patients while also reducing some healthcare costs, but they also said paperwork, payment, and access problems keep the services from being more widely used.

The survey, conducted last fall by the Massachusetts Medical Society in collaboration with the Home Care Alliance of Massachusetts, asked questions about services provided in the home that include skilled nursing, physical and occupational therapy, speech-language therapy, and medical social services. From a random sample of 3,000 doctors licensed to practice in the state, there were 248 responses from 12 specialties. More than half of the answers came from primary care physicians.

Almost all the doctors said home health services allowed them to better manage their patients' care, and most of them also agreed that they eased stress on family members. Nearly 9 in 10 doctors said the services can cut the number of patients who need to be admitted to the hospital and two-thirds believe emergency room visits can be reduced. Two-thirds of respondents also said remote monitoring of vital signs could cut costs. Fewer than half said home health services can trim overall costs.

Administrative paperwork was a barrier to ordering home health services, according to a little over half of the doctors. Under half said payment for supervising home health services was a problem, but most of the doctors who did not seek reimbursement from Medicare did not know the oversight was eligible for payment.

About half of the doctors said they had to keep their patients in the hospital longer because they could not find home health services for them.

Primary care doctors were more likely than specialists to arrange home health services for their patients, both for managing chronic disease and for hospice care.

"With a rapidly aging population, more seniors will rely heavily on health care services, and many will have chronic conditions. Those factors will add to already-soaring health costs," Dr. Mario Motta, president of the doctors' group, said in a statement. "As physicians see it, greater use of home services can ease costs without compromising quality of care."