Home Health Agencies Gear Up for Chronic Diseases

Arkansas has 219 licensed home health agencies, most offering a broad spectrum of services, and they employ more than 10,000 people, according to Nancy Elphingstone, executive director of the HomeCare Association of Arkansas.

Hard data on use is hard to come by. The federal Centers for Medicare & Medicaid Services collect data, but it is not readily available. Even Elphingstone, whose organization represents all but about 10 of Arkansas’ home health agencies, said she hadn’t seen patient use figures newer than 2009.

In that year, she said, Arkansas’ home health agencies served about 70,000 unduplicated patients by making more than 2 million in-home visits. And, she said, “things are going up.”

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Unlike nursing homes, which rely on large numbers of certified nursing assistants supervised by registered nurses, Elphingstone said home health agencies are primarily staffed by RNs along with some licensed practical nurses. In that way, they are competing for employees with hospitals and doctors’ offices, she said.

Agencies also employ physical therapists, speech therapists and occupational therapists.

The role that home health agencies play in the lives of patients is evolving, Elphingstone said, as the health care industry in general recognizes the need to manage the increasing number of people diagnosed with chronic diseases like diabetes, congestive heart failure and chronic obstructive pulmonary disease, commonly called COPD.

“Home health has done a lot of training of staff to work with chronic diseases,” Elphingstone said. “And the goal is to get people to where they can manage their disease on their own.”

There are two levels of licensure for home health agencies in Arkansas: A licensees, which are licensed to provide care to both Medicare and Medicaid patients, and B licensees, which can be reimbursed by Medicaid, but not Medicare. They primarily provide personal care services.