Essay about It 's No Place Like Home

Essay about It 's No Place Like Home

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There’s No Place like Home
There is no place like home is a well-known adage that the healthcare industry has recently embraced as it enters in the early years of the 21st century. According to the Joint Commission, the home is the best place for healthcare, and it has proven to benefit the patients in many ways, because the cost of care is lower, the patients are happier and the environment is friendlier (Dilwali, 2013). CMS defines home care as “prescribed services delivered in the patient’s home such as nursing care; physical, occupational and speech language therapy; and medical social services” (Dilwali, 2013, p. 269). Home care includes disease prevention, health promotion and illness related services (Stanhope & Lancaster, 2014). The goal of home care is to ensure that the client’s health improves while increasing the individual’s independence. This combination guarantees an optimal level of well-being (Dilwali, 2013). Many models fall under the umbrella of home care and assist in the success of these goals: population-focused, transitional, home-based primary, home health and hospice. In order to fully understand home care, one must analyze each of these models and understand the financial, ethical and legal challenges that the community health nurse faces while serving the clients.
Studies have proven that population-focused care prevents avoidable hospital readmissions, improves quality of care and reduces costs. Population-focused care has “improved understanding of chronic disease complexity and improved care coordination in the population” (Hewner, 2014, p. 109). The premise for population-focused care is that the population is divided into groups that have comparable needs, which redirects care to needed servic...


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...ues. Home health agencies are reimbursed by a variety of sources however the process is rather complex. The majority of the reimbursement comes from Medicare and Medicaid, but other funds come from grants, contracts or third-party payers (Stanhope & Lancaster, 2014). Once Medicaid is billed as the primary payer, the other insurances are utilized such as Medicare or third party. Medicare has instilled a payment process to prevent fraudulent billing. Consequently, nurses must be extremely conscientious on how they bill and they must explain to patients what Medicare will cover and what it will not, which sometimes is difficult for patients to understand. In the patient’s eyes they require the services that these nurses render; it is difficult for them to understand that the services are covered only if their condition become unstable (Stanhope & Lancaster, 2014).

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