Vice President Harris: We Need Medicare Coverage for Home Care

Let's take a closer look at the challenges and benefits.

Vice President Kamala Harris on Tuesday announced a plan for Medicare to cover long-term-care services at home.

Focusing on the needs of family caregivers and older adults is imperative. It's a complicated situation, though.

Some thoughts about the Vice President's proposal:

The Challenges

• We don't have enough direct care workers to help everyone who needs help. Family caregivers struggle to find help now, even help they want to hire privately.

• We also have a huge turn-over problem within the home care space. Some research estimates that turn-over rate to be 80%. This kind of turn-over rate adds incredible stress to a family caregiver's day. The revolving door is awful. You train, manage, get someone new, train, manage, repeat. This is one of the reasons family caregivers sometimes feel they have no option but to provide care themselves. Sometimes, it's just too hard hiring outside help.

The Benefits

• Medicare currently covers short-term home health which means you have help for a few weeks and then help goes away. It's awful. I have one client who decided to no longer use the Medicare benefit for her husband because it's too stressful waiting for the news that services will stop.

• Family caregivers could minimize the time they spend researching to find help. It's Medicare.

• A Medicare benefit also will standardize the care received. For instance, Medicare Advantage plans often interpret coverage for services differently. They also contract with home health programs at rates sometimes making it difficult for home health programs to sustain the program. If Medicare makes this an embedded benefit with sustainable, standardized reimbursement rates, then the home health agencies, family caregivers and older adults will benefit.

• Sustainable rates must ensure that direct care workers receive a living wage that allows them to flourish.

I also hope we continue to expand the help that family caregivers need.

We need to make sure family caregivers receive support for their emotional well-being. A caregiving experience is an emotional one. You worry. You endure bad news. You feel alone. You lose friends. You feel frustrated at all the hoops you have to jump through to get an answer. You witness struggle and pain that stays with you. That's why it's so hard.

We also need to make sure family caregivers receive support for their emotional well-being. A caregiving experience is an emotional one. That's what makes it so hard.

What do you think? I'd love to hear your thoughts and insights.

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