Medicare’s Role in Supporting Caregivers

   

elderly

Caregiving is a full-time job. Supporting a loved one through a disability, health battle, chronic condition, or old age can be time-consuming, emotionally draining, and expensive. It can also be harmful to one’s health. 

There are more than 50 million caregivers in the United States providing unpaid care. According to AARP and the National Alliance for Caregiving’s 2020 study, 23% of caregivers claim that caregiving has made their own health worse. Of those who care for family members, 61% are still working. 

Family caregivers are often the ones navigating Medicare to understand benefits and enroll individuals in plans and programs, even though the majority don’t qualify themselves. There are many online resources available that give caregivers guidance through the healthcare system–and even help them get coverage for certain home health services–but not a lot of support is offered around social drivers of health like financial support, housing assistance, and food delivery.

Recognizing the costs of caregiving

In 2020, the Center for Medicare Advocacy found that half of all Medicare beneficiaries live on less than $29,650 per year and 25% live on less than $17,000 per year. For those needing health-related care, which many do, costs can be unbearably high. 

In-home care costs $4,338 per month, a home health aid costs $4,385 per month, and assisted living costs $4,051 per month, for example. For some, these services aren’t affordable, and the burden of care–or paying for care–is put on loved ones. AARP, according to this same report, found that family caregivers who provide care to an adult loved one spend an average of $6,954 of their annual income on out-of-pocket costs.

Caregivers often pay for rent, food deliveries, transportation to and from the doctor’s office, tax assistance, home modifications, and other non-negotiable services which aren’t always covered by Medicare. They bear the brunt of the costs, both on their budget and time. Even paid caregivers find themselves paying for out-of-pocket expenses, or failing to provide much-needed services because they aren’t reimbursed by the health plan.

A University of Michigan study, highlighted by The Aspen Institute Financial Security Program (Aspen FSP), found that the poor health status of a caregiver results in higher rates of emergency department visits and higher overall health care costs, suggesting that Medicare beneficiaries and their caregivers need more support. 

But what can health plans do?

Establish waivers for SDoH

Health plans can help minimize the work of a caregiver by making social services more accessible and reimbursable, especially in vulnerable communities where the need is most significant. During the pandemic, some health plans waived prescription refill limits, telehealth costs, and meal plans for those with chronic conditions. 

When more health-related services are provided to beneficiaries, the burden on caregivers can be reduced. 

Broaden supplemental care benefits

More than 61 million Americans are enrolled in Medicare, which is an increase of 19 million over the last ten years. Since not all plans are created equal, caregivers are in the unique position of comparing Medicare policies to determine the best plan for their loved ones.

According to a recent brief published by The Commonwealth Fund, some Medicare Advantage (MA) plans are now offering food, nutrition and wellness, and other services under their supplemental benefits, but the offerings are limited. Only 46% of MA plans are offering supplemental meals, only two percent are offering community-based services, and only two percent are offering support for caregivers of enrollees. Expanding these offerings is a critical step in supporting caregivers.

Work with CBOs to develop longer-term solutions

Healthify specializes in building accountable networks of community-based organizations to provide social services–and support–to Medicare beneficiaries.

One of Healthify’s partners is Benjamin Rose Institute on Aging in Cleveland, Ohio and their work is centered around older individuals and their caregivers. They offer classes on financial wellness, nutrition, behavioral health, and other key issues, and in addition to their services (companionship, coaching, etc.), they conduct research and advocacy work. 

Another partner, The Senior Alliance, Area Agency on Aging 1-C, serves more than 34 communities in Wayne County, including Detroit. While they are considered an agent for the MI Choice Waiver Program, they offer services to all residents 60 and older, though they give precedence to those in greatest need. Among their many services, they provide home delivered meals, evidence-based disease prevention, transportation, and caregiver support, education, and training. 

Easing the burden on caregivers

Our aging population is increasing and the United States Census Bureau believes more than 94.6 million people in the United States will be 65 or older in 2060. Of Americans who turn 65, 56% will develop a serious disability that requires long-term care, according to the HHS Office of the Assistant Secretary for Planning and Evaluation Office of Behavioral Health, Disability, and Aging Policy.

Old age can be a blessing, if needs are met. But many aren’t receiving the care they need, even with dedicated caregivers sacrificing their own health to offer ongoing support. At Healthify, we’re working with health plans and CBOs to build long-lasting partnerships that can support the comprehensive needs of aging Americans. 

Caregivers shouldn’t have to care on their own. Learn more about Healthify’s mission here and join us in supporting better health outcomes for all Americans.

Topics: Healthify healthcare delivery public health community-based organizations value-based care care coordination health equity senior care elderly care

Related posts