In the News

Payers Should Cover Home-Based Cardiac Rehabilitation Programs, Researches Argue

Fierce Healthcare | By Frank Diamond

Insurers need to rethink their coverage policies regarding home-based cardiac rehabilitation programs, according to a study published yesterday in the Journal of the American Heart Association.

In a press release, the study’s senior author Mary A. Whooley, M.D. said that “our biggest challenge in the U.S. is that home-based cardiac rehabilitation is not covered by many health insurers. Currently, Medicare only pays for on-site or facility-based cardiac rehabilitation.”

While problems persist on the supply side for providing these programs, the study also found a lack of demand.

“The biggest surprise of our analysis was how few patients chose to participate in cardiac rehabilitation,” Whooley said, a primary care physician at the San Francisco Veterans Affairs Medical Center and professor of medicine at the University of California, San Francisco.

HBCR programs focus on lifestyle changes. “However, changing behaviors is difficult, and while care facilities may offer on-site cardiac rehabilitation, many patients don’t choose to take advantage of follow-up treatment,” Whooley said.

The study, which authors tout as the first to show that home-based cardiac rehabilitation can help people with heart disease live longer, involved examining data of 1,120 patients eligible for cardiac rehabilitation at the San Francisco Veterans Health Administration between 2013 and 2018.

Excluded from the study were veterans who choose to attend facility-based cardiac rehabilitation programs or those who died within 30 days of hospitalization. Researchers compared outcomes for 490 home-based care participants to 630 patients who did not participate in the program. The patients were monitored through June 30, 2021.

Those in the home-based program had a 36% lower risk of death compared to those who did not participate.  

“Although no observational study can eliminate the possibility that healthier patients were more likely to participate in HBCR, we rigorously adjusted for confounding using an inverse probability weighted Cox regression analysis with the goal of equalizing the samples across all variables other than exposure to HBCR,” the study found. “These results suggest that participation in HBCR contributed to lower mortality among patients referred to [cardiac rehabilitation].”

The home-based rehabilitation program lasted 12 weeks and included nine coaching calls, motivational interviews and a health journal to track diet, exercise and vital signs. Participants were also given a stationary bike and a blood pressure monitor.

Patients were given physical activity goals, after consultation with a nurse or exercise physiologist. Follow-up calls were made to patients at three and six months after the program, and they were monitored an average of 4.2 years after being hospitalized.


Study: Stroke Rehab Rates 'Below Maximal Effective Dosing'


The Message

While it's generally accepted that rehabilitation therapy rates are relatively low in the U.S. among individuals who experience stroke, less is known about how those rates relate to multiple factors around acute and post-acute care and assessments. Authors of a new study that tracked clinical measurements among patients poststroke linked to 28 acute care hospitals believe they've shed some light on that relationship. The good news: Patients with more severe deficits tend to receive larger therapy doses. The bad news: Overall, therapy dosing is low, with 35% of patients receiving no physical therapy within the first three months of a stroke. Variation of therapy use is also wide depending on discharge location, with discharge patterns themselves varying dramatically across the hospitals studied. The big picture, according to authors, is that "therapy doses in the United States are below the maximal effective dosing and so contribute to incompletely realized functional gains in this population."

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Home Health Leads Senior Care Sector in Worker Demand, Report Finds

McKnight’s Home Care | By Diane Eastabrook 

The home health workforce is projected to grow a whopping 46% by 2040, representing the largest increase in the senior care sector. That’s according to a new report released Wednesday by Argentum, a trade association representing senior living facilities.
“The baby boomers are aging and will put a strain on our nation’s ability to provide senior care, supports and service,” Argentum researchers wrote in the report. “And, while our senior population grows, the American workforce is not keeping pace. We are facing a significant worker shortage across the economy generally but within senior care, in particular.”
The report said employment in the home health industry will reach 2.2 million by 2040, adding approximately 692,000 new jobs to the 1.5 million home health workers in 2021. Argentum also estimated home health will need to fill an additional 4.3 million positions as workers exit the industry or move to other occupations over the next two decades.
The report said demand will be strongest for home health and personal care aides, with 3.4 million workers needed for those jobs by 2040. Nursing assistants and registered nurses will also be in high demand filling 330,200 and 310,200 positions, respectively. The states that will see the strongest demand for home health workers by the end of this decade include Texas (415,800), New York (391,000) and California (156,000). 
The report reflects the changing demographics of an aging nation where 10,000 people are turning 65 each day. It also reflects the trend of seniors opting to age at home, rather than in a facility. Employment in senior living facilities is expected to grow just under 33% by 2040, while employment in skilled nursing is expected to decrease by 6.5%. 
Some of the states facing the most critical shortage of direct care workers are taking action. In January, New York took its first step in developing a master plan for aging which includes proposals for public-private partnerships to address long-term care initiatives. California, Texas, Colorado, Massachusetts and Minnesota have adopted similar plans.


Meet the 2023 APTA Home Health Award Recipients

The following recipients were nominated by various members of the Academy, and were selected based on the outlined criteria below by the executive committee of APTA Home Health. These Home Health Awards were presented to recipients at the APTA Home Health business meeting on Friday, February 24, 2023. 

To view award details and recipient bios, please click here

President's Award 

  • Christopher Chimenti, PT

Excellence in Home Health Leadership Award

  • Dr. Marcie Ganson, PT, DPT, MBA
  • Dr. Suzanne Havrilla, PT, DPT
  • Dr. Andrew Morgan, PT, DPT, MBA, COS-C
  • Kandy Ortgies, PTA

Excellence in Home Health Clinical Practice Award

  • Silke Mildenberger, PTA

Miss Out on San Diego? Catch Up with APTA CSM On-Demand!

What happens in San Diego doesn't stay there!  APTA CSM On-Demand will provide virtual access to approximately 100 educational sessions, plus digital posters. APTA CSM On-Demand allows you to experience the largest physical therapy conference in the country from anywhere, on your schedule. Gain up to 1.2 CEUs (12 contact hours) through successful completion of post-tests.

It all happens March 15 - April 15, 2023.

Those who attended APTA CSM in San Diego get free access to APTA CSM On Demand (without the ability to earn additional CEUs).

Click here to learn more! 

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