Home Delivered Meals Promote Rebalancing, Save States Money, Says Health Affairs
October 18, 2013 04:39 PM
Earlier this month, Health Affairs released a study titled “Providing More Home-Delivered Meals is One Way to Keep Older Adults with Low Care Needs out of Nursing Homes” (the Study). In the Study, authors Kali S. Thomas and Vincent Mor of Brown University demonstrated how programs that deliver meals to seniors can transfer “low-care” senior out of nursing homes into the home and community. The Study showed 26 out of 48 states seeing savings, which would approach $110 million. Highlights of the Study are discussed below.
The Study gave 2011 expenditures on home delivered meals as totaling approximately $769 million nationally. Baseline data from 2009 showed that approximately 3 percent of senior citizens nationwide received home-delivered meals, with state percentages varying from a high of 8 percent in Wyoming to a low of less than 1 percent in Maryland.
Also, in 2009, low-care nursing home residents accounted for approximately 13 percent of the nursing home population, with state percentages varying from a high of 28 percent in Illinois to a low of 1 percent in Maine. The Study defined “low-care nursing home residents” as “those who neither require assistance with the five core activities of daily living nor fall into the Clinically Complex or Extensive Rehabilitation Resource Utilization Groups.”
Assumptions and Results
Given that the authors’ “previous work” showed a correlation between increased expenditures of home-delivered meals and a decrease in proportion of nursing home residents that are low-care, the authors assumed that many low-care nursing home residents can live in the home or community if given proper access to home-delivered meals.
The Study used data from 2005 to 2009 to draw cost saving and utilization projections of home-delivered meals. Projections showed that if a state increased its proportion of senior citizens who received home-delivered meals by only 1 percent, that state would experience a 0.2 percent decrease in its low-care nursing home resident population. Also, a total of 1,722 dual eligible, low-care nursing home residents would be able to leave the nursing homes and enter the community.
As a result, total savings to all state Medicaid programs would be greater than $109 million, with half of all states saving $1 million or more, and ten states saving greater than $3 million. New York would stand to save the most ($11.4 million), while Wyoming would see the least savings ($173,000). The authors of the Study stated that, “what we believe to be most important is that states’ savings will increase as the number of low-care cases they avoid increases.”
The Study suggested that home-delivered meals promote rebalancing. The Study cited that 92 percent of recipients of home-delivered meals stated that these meals helped them to stay in their homes. The authors argued that increased investment in home-delivered meals would thus reduce the amount of those that are permanently placed in nursing homes.
Quality of Life
The Study also argued that home-delivered meals improves the recipients’ quality of life and helps to maintain their independence. Of recipients surveyed, 90 percent rated their level of satisfaction with the meals as good to excellent. Further, the Study claimed that the drivers delivering the home-delivered meals serve an integral function to many of the recipients: they serve as a human contact for many who would otherwise be isolated. Further, the drivers can also help check up on the recipients.
To access the Study, click here. For an article on the Study, click here.
The National Council on Medicaid Home Care – a NAHC affiliate - supports the growth of home-delivered meals in Medicaid home care. As the Study demonstrates, such programs are both cost-effective and contribute to greater rebalancing and quality of life. Home care providers should note that the Council will continue to pursue greater payments for Medicaid home care generally. The Council also calls on state associations and other stakeholders to advocate on a state level to promote an increased integration and coordination of home-delivered meals through Medicaid or other funding source. Home care providers are encouraged to keep abreast of developments with regard to home-delivered meals, and to contact the Council with any questions or concerns.