A new article from the LeadingAge LTSS Center @UMass Boston outlines a study examining the use of home-based clinical care and home-based long-term services and supports (LTSS) among homebound Medicare beneficiaries aged 65 and older. That study, co-authored by Robyn Stone of the LTSS Center, focused on a sample of 974 older adults.
Approximately 30% of the older adults in the study received home-based clinical care—provided at home by physicians, PAs, or nurse practitioners; skilled home health care; or home-based clinical care from other providers. Approximately 80% of the older adults received home-based LTSS, including assistive devices, paid helper assistance with a functional task, transportation assistance, senior housing, home-delivered meals, or 40 or more hours of caregiving support from nonpaid helpers each week.
The researchers found three distinct patterns of service use among those studied:
8.9% received extensive home-based clinical care.
44.5% received some home health services but few other forms of home-based clinical care.
46.6% received little home-based care of any kind.
“Given that this is a homebound population, such findings likely reflect not a lack of need but rather a lack of acceptability, availability, and/or affordability of home-based LTSS,” wrote the authors.