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Private Duty Home Care During the Pandemic

What Is Private Duty Home Care?

Private duty home care is known by many names, including private pay or custodial home care. It is just one subset of in-home healthcare in which caregivers provide a broad range of services that are completely customized to the unique needs of the client, and the client is responsible for all costs.

What Sets Private Duty Home Care Apart?

Compared to its federally funded sibling services, home health and hospice, there is one key difference that sets private duty home care apart – there is no single regulatory body that standardizes private duty services. The reason for this is because home care licensure requirements vary from state to state.

While the funding of care for home health and hospice services dictates the delivery model, the funding for private duty is most often paid directly by the client, allowing them to define their care model completely.

Some examples of private duty home care include:

  • Personal care services, such as bathing, dressing and ambulation
  • Meal preparation
  • Companion services, such as homemaking and sitter services
  • Medication reminders
  • Transportation services

Could Private Duty Home Care Lead to Home Care Medicare Coverage?

During the coronavirus pandemic, private duty home care has been recognized as an important piece of the care continuum. It is so important that the Centers for Medicare and Medicaid Services (CMS) is expanding the covered home care benefits.

Some home care benefits became available to providers through Medicare Advantage in 2019, resulting in only four percent of plans offering the benefits, though not for lack of client interest.

The COVID-19 pandemic caused the number of plans to hit 619 in 2020 (an increase of 499). CMS acknowledged the need for home care by expanding plans to include more home care benefits, leading many industry experts to predict that these benefits will eventually be on par with home health and hospice.

An Industry Poised for Extreme Growth

Private duty home care is successful because of its flexibility and is typically the more affordable option, but the costs of hourly care can outweigh the price of 24-hour care in a long-term care facility for a client needing round-the-clock help.

Clients who cannot afford that level of private duty home care typically cannot rely on their Medicare coverage for support, as it is designed as a short-term option rather than a long-term solution. Adding to that, it is not uncommon for a Medicare-certified home health organization to deny a homebound patient home care services that are recommended by a physician.

The reason? Medicare will not cover most home care services, leaving the organizations (not the patients) to cover the costs if a claim is rejected.

These recent regulations offer a profitable position for home health organizations (and existing private duty home care organizations) to prepare for growth in home care services, both private and Medicare-funded.

Home health organizations should consider expanding services, preparing for the inevitability of home care demands to rise, a demand that CMS is already recognizing.

With its roots in customization and client satisfaction, private duty home care has shown its true value. While being federally funded can stifle the main benefit of private duty home care (customization), clients who can’t afford continuous private duty services will have their needs taken care of in the place they are most comfortable.

Axxess Home Care, a cloud-based home care software, provides support to organizations of all sizes, covering medical, non-medical and pediatric services. Its comprehensive scheduling center is easy to use and includes an intuitive caregiver matching feature, allowing for customizable shifts.


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