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How Medicare Can Save Millions by Investing in Home Modifications

Updated: Apr 5

Accessible home modifications are an overlooked but extremely cost-effective way for Medicare to save millions of dollars on healthcare for America’s senior citizens. Bureaucratic red tape and political healthcare arguments in general have kept us from moving forward. However, the benefits in both reduced healthcare costs and increased quality of life for our elderly mean that Medicare should begin investing in these critical healthcare solutions. Where do we want to put our healthcare dollars?

Why Home Modifications?

Home modifications are just what they sound like—changes to a home to accommodate the needs of the person living in it. As we age, we may need accommodations that specifically address limited mobility, arthritis, sight or hearing loss, and other issues.

These can be as simple as installing lever-style door handles, grab bars, better lighting, or ramps—or as extensive as smart technology, stairlifts, walk-in tubs, widening doors and hallways, or eliminating thresholds.

Occupational therapists can determine what modifications are needed and make targeted recommendations.

Cost Benefits of Home Modifications

The #1 cause of senior citizen medical expenses is accidents in the home. They fall, sustain a traumatic injury, and it’s a downward spiral from there. Once you’re injured, you’re more likely to have another fall within the first year. A second fall means that at the very least, you may need a walking device. Worse, you may very well become dependent on a caregiver, need to move to a care home, or even die.

Accessible home modifications can prevent these accidents. And they can do it at a fraction of the cost of medical care.

For example, widening a doorway to accommodate walkers or wheelchairs can cost less than $100 in materials. A step-free entrance can range from $1000 to $4000. Non-slip flooring can cost as little as $3 per square foot. (AARP) Remodeling a bathroom is one of the most effective projects for preventing falls, and can cost anywhere from $2000 to $20,000.

But compare those costs to the costs of moving into a care home, or needing more intensive care after an accident. Long-term care is expensive. Assisted living facilities can cost $4000 per month, and residential care homes can cost up to $10,000 per month. Nursing homes can easily cost $7000 per month. These outcomes could be delayed or avoided with the proper prevention.

Even with a clear understanding of both the potential for improved quality of life and the enormous cost savings of accessible home modifications, one of the biggest roadblocks is how to pay for it.

Medicaid Is Already Doing It—Why Not Medicare?

Medicaid already pays for home modifications through waiver programs. Each state provides a way to waive the traditional guidelines of Medicaid so that whatever modifications are needed can be completed. These are not always ADA compliant—they are specific solutions for individuals.

The truth is that Medicare could replicate what Medicaid is doing. Original Medicare doesn’t pay for home modifications. However, we’ve started to see some movement with Medicare Advantage plans that allow states to customize their plans in order to cover accessible home modification. In some cases, Medicare Advantage plans will pay for an occupational therapy evaluation or a very few rare modifications. One of our goals locally is to work with our Medicare Advantage plans to try and have home modifications be a benefit for everyone in our area.

However, these changes are only partial, patchwork fixes that do not adequately address the need. What’s more, by failing to provide adequate means to age in place, they end up spending more money on more expensive care.

Medicare Could Save Millions by Investing in Home Modifications, Too

Medicare already provides healthcare benefits for US citizens over the age of 65. These are the very people who often need home modifications to avoid more expensive medical care.

In addition, Medicare provides healthcare benefits for those under 65 but who have certain disabilities. This is another group that would also be helped with home modifications to avoid accidents and extended or expanded home care.

The data shows that healthcare dollars can be saved by implementing programs that invest in home modification. In 2015, the total medical costs for falls totaled more than $50 billion, with 75% of that cost paid by Medicare and Medicaid. And studies have shown that installing home modifications directly results in a reduction in the need for care in the home by up to 46%.

For questions and assistance with your home modification needs, contact Thrive for Life.

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