In Traditional Medicare, Modest Growth In The Home Care Workforce Largely Driven By Nurse Practitioners.
Nengliang Yao, Justin B Mutter, James D Berry, Takashi Yamanaka, Denise T Mohess, Thomas Cornwell
Author Information
Nengliang Yao: Nengliang (Aaron) Yao (ayao@virginia.edu) is the Cheeloo Scholar Professor in Healthcare Management and Nursing at Shandong University, in Jinan, Shandong, China. He is also the part-time research director of the Home Centered Care Institute, in Schaumburg, Illinois, and a part-time research scientist for the Section of Geriatric Medicine at the University of Virginia, in Charlottesville, Virginia.
Justin B Mutter: Justin B. Mutter is section head of geriatric medicine at the University of Virginia School of Medicine and a fellow at the Institute for Advanced Studies in Culture, University of Virginia.
James D Berry: James D. Berry is the chief of the Division of ALS and Motor Neuron Diseases and director of the Neurological Clinical Research Institute at Massachusetts General Hospital, in Boston, Massachusetts.
Takashi Yamanaka: Takashi Yamanaka is the chair of the Department of Home Care Medicine at the University of Tokyo, in Bunkyo City, Tokyo, Japan.
Denise T Mohess: Denise T. Mohess is the medical director and section chief of Geriatrics in the Inova Health System, in Fairfax, Virginia.
Thomas Cornwell: Thomas Cornwell is the executive chairman of the Home Centered Care Institute and is the senior medical director of Village Medical at Home, in Chicago, Illinois.
Little is known about the characteristics of the workforce providing home-based medical care for traditional (fee-for-service) Medicare beneficiaries. We found that the number of participating home care providers in traditional Medicare increased from about 14,100 in 2012 to around 16,600 in 2016. Approximately 4,000 providers joined or reentered that workforce annually, and 3,000 stopped or paused participation. The number of home visits that most participants provided each year remained below 200. Only 0.7 percent of physicians in Medicare provided fifty or more home visits annually, with little change over the course of five years. In contrast, the number of home-visiting nurse practitioners almost doubled, and the average number of home visits they made increased each year. Despite generally low overall participation of traditional Medicare providers in home-based care, the workforce has seen modest but steady growth, driven primarily by increasing nurse practitioner participation. Additional stimuli may be necessary to ensure workforce adequacy and stability.
