Nursing is considered one of the top 5 recession proof careers. Home care nursing may not be as economically viable based on the price of gas and this article on the number of miles driven by the average home care nurse over the course of a year.

According to a report from the National Association for Home Care and Hospice, recent cuts and freezes in Medicare and Medicaid reimbursement rates have caused many home health agencies to cut back on necessary home visits and decrease the reach of their services.  This is especially hard hitting in rural areas where homebound patients depend on the services provided by these nurses.

Some patients have been told they are no longer in a home care agency’s range due to these cut backs.  Medicare used to offer a rural access fee to allow home health agencies and ambulance services additional funds to cover the increased mileage traveled.  That rural fee allowance was removed even as fuel prices continued to rise.

This problem underlines the basic issues that are tearing apart the U.S. health care system.  The patients most in need of primary care and home based services are the ones who are told they no longer have coverage.  These patients have no recourse but to access emergency services to arrange hospital transport to the ER, taking up valuable resources that might be needed for true emergencies.

When these patients have access to affordable and nearby health care, they do not have to abuse an overtaxed EMS and 911 system.  The answer is put forth in the article over at Medical News Today.

1. Recognize home telehealth interactions as bona fide Medicare home health services; if home care nurses can do more monitoring of patients over the Internet, it will cut back in the number of miles they need to travel each week to visit patients and save those visits for critical care situations rather than routine monitoring
2. Require the Secretary of Health and Human Services to revise the method for calculating annual market-based inflation updates and establish a temporary fuel cost add-on to 5
3. Commit to preserve the annual inflation updates for home health and hospice as provided under the Medicare law
4. Reinstate the 5 percent rural add-on for home health services delivered to patients residing in rural areas

Seems like a collection of good ideas to me.  Let’s see what we can do about getting these programs amended to make some sense.