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The role of unpaid family caregivers is drawing focus as Congress decides the future of a hospital care at home waiver.
Unpaid family caregivers are increasingly a linchpin in healthcare as more patients opt to get care where they live and providers struggle to recruit and retain staff. Nearly one-third of individuals provide care or assistance to at least one person with an illness or disability, according to the University of Michigan's National Poll on Healthy Aging released in August.
Hospital-at-home programs are a growing example. More than 300 hospitals and 136 health systems across 38 states offer such programs through a Centers for Medicare and Medicaid Services waiver, which is set to expire at the end of December unless Congress acts. Under the waiver, patients receive twice-daily in-home visits by a nurse or paramedic, which is supplemented with virtual visits and remote patient monitoring. They may also receive meals or help with activities of daily living, if family caregivers cannot provide those supports.
While hospitals are expected to carefully screen patients for eligibility in hospital-at-home programs, the waiver does not have specific guidelines for screening family caregivers or what is expected of them.
Care-at-home company Contessa called for uniform standards around screening for caregiver burden when admitting patients to acute-care-at-home programs in an analysis published last month. It echoes recommendations a bipartisan think tank recently made to Congress that called for more robust caregiver support as hospital-at-home programs expand.
Contessa, a unit of Amedisys, has hospital partners that carefully screen family caregivers, said Caroline Rogers, vice president of quality and safety —...