Medicaid also covers a lot of home health, like infusions, wound care, fall and home safety consults (including for acquired and developmental disabilities), and swallowing evals. Good luck in the sticks.
Prevalence of Disability and Disability Types by Urban-Rural County Classification – United States, 2016:
- According to this study, the prevalence of adults with a disability in the United States is significantly higher in rural areas compared to large metropolitan areas. These findings, along with a recent study showing that the percentage of adults having at least four of five health-related behaviors (sufficient sleep, current nonsmoking, nondrinking or moderate drinking, maintaining a healthy body weight, and meeting aerobic physical activity recommendations) was lowest in noncore counties,3 indicates the need for rural public health interventions to be inclusive of people with disabilities.
- Compared with adults with disabilities living in urban areas, those in rural areas may face additional barriers (e.g., lower socioeconomic position, transportation problems, access to education and vocational rehabilitation services, access to health care and accessible communities)4 to maintaining and improving their health, quality of life, and community participation. Making rural communities disability inclusive and accessible can potentially improve the health and well-being of this population.
And what most folks don't understand is the impact on rural hospitals isn't just a direct pay issue. It's an issue of time occupying a bed. Every day, a hospital bed costs a facility several thousands of dollars, irrespective of whether the patient is receiving care. Insurance only pays for hospital level care while the patient requires hospital level care; when the patient progresses to rehab level care, the hospital gets a rehab level reimbursement. When you reduce home health services, people rely on the hospital more frequently because they aren't, or can't, manage their meds or wound care or O2 renewal or personal hygiene, etc. Sometimes that's considered hospital level care, sometimes not. Additionally, SNFs go out of business, left and right. Therefore, patients linger in the hospital for days, often weeks - I've seen months - waiting for a safe post-acute setting, while generating a fraction of the insurance payment needed to cover their costs (we all eat those costs). These patients
devastate hospitals, particularly rural ones, which often operate on razor thin margins - hell, Mass General is losing hundreds of millions, what do you think is happening to the already barebones Rural Co. Hospital owned by HCA?
—> https://www.wsj.com/health/healthca...41?st=14XE9A&reflink=mobilewebshare_permalink
