The healthcare industry is changing and the discussion around whole-person care has started a widespread discussion on how to take a holistic approach to a member's health. While the buzz around social determinants of health (SDoH) has surged in mainstream healthcare discourse, Medicaid has long been at the forefront of this conversation.
Whole-person care, as it’s commonly referred to within Medicaid, recognizes that a member’s health is influenced by a variety of factors - physical, mental, social, economical. It also recognized that many of these factors begin right at home. From the structural layout of a home to the air a member breathes, all factors found within the four corners of the home can either positively or negatively affect health outcomes.
While whole-person care is a top priority for Long-Term Services and Supports (LTSS) plans, and many recognize how the home impacts whole-person care, many decision makers struggle to implement and pull on innovative levers that can better address the complex needs of this population, especially the need for face-to face interventions.
So what can plans leverage to better address member’s health at home? We believe clinically-led, and specifically occupational therapist-led, home evaluations are the answer.
In-Person Evaluations Are Not A Nice To Have, They’re Needed
The COVID-19 pandemic spurred a wave of digital innovations, particularly telehealth, to support the LTSS population. However, these interventions often fall short given the complexities of the population. Over 89% of LTSS enrollees ages 19-64 are living with a chronic condition, many are reliant on multiple medications and even more challenging, most are limited to the technology needed to adequately identify needs and administer care virtually. To accurately assess this complex population and all potential health risks, it is crucial that plans are implementing programs that support whole-person care through in-home, face-to-face evaluations.
Such evaluations are not only helpful for identifying physical risks like fall hazards, malnutrition, or unsafe living conditions but also for detecting unfortunate signs of elder and child abuse. Plans that aim to improve outcomes such as reducing institutionalization rates and keeping members in the community must shift towards a whole-person, whole-home intervention, and we believe occupational therapists (OTs) are perfectly suited to lead this process.
Unique Value of Occupational Therapists
Trained extensively in evaluating all factors that contribute to an individual's well-being, OTs don't just look at medical needs; they consider the full spectrum of social and environmental factors that influence a member’s life at home. In fact, research shows that those who implement home modifications without an OT involved are 2x more likely to fall than those that chose modifications based on OT recommendations.
This is why Jukebox Health trains and works exclusively with OTs on identifying low-cost, high impact modifications. Because of this training they can act as an extension to a plan’s existing clinical team addressing everything from social isolation and pest infestation to mold issues.
OTs play a crucial role in assessing risk factors to prevent the worsening of pre-existing conditions. For example, during a home evaluation, an OT might discover a mold issue in the home of a member who suffers from severe COPD. Prolonged exposure to mold exacerbated the member's symptoms, resulting in debilitating shortness of breath and reduced activity levels. This situation also forced the member to increase their medication usage to manage asthma-like symptoms. By identifying and reporting this critical hazard, the OT ensures that the plan is made aware and can proactively address the problem before symptoms get any worse.
In another scenario, an OT discovers that a member recently fell while navigating the front steps of their home. It became clear during the evaluation that the member is no longer able to safely use their stairs.This limitation has not only restricted the member's ability to leave their home but has also impacted their access to essential activities, such as grocery shopping, doctors appointments and socializing within their community. Recognizing the impact on the member's independence and broader health, the OT recommends the installation of a ramp at the front entrance.
And these types of interventions not only enhance health outcomes, they are also cost-effective.
Preventing falls, injuries, and other health complications through thoughtful environmental improvements can lead to fewer avoidable emergency room visits and reduced medical interventions, decreasing continuous care needs. The cost of implementing modifications like ramps, stairlifts, or mold remediation is substantially lower compared to the expenses of treating serious injuries, which may include prolonged hospital stays and extensive rehabilitation.
By promoting greater independence, occupational therapists help keep members in their homes longer with less personal care hours, engaged in their communities and delay or avoid a move to a long-term care facility.
To see how occupational therapists can transform in-home safety for your members, email our partnership team to learn more hello@jukeboxhealth.com
Support for In-Home Caregivers
Lastly, OTs are particularly skilled at understanding and navigating the dynamic roles that other individuals in the home, such as caregivers, play in a member’s health. They excel not only in assessing the physical needs of members but also in recognizing the psychological and logistical challenges faced by caregivers. This perspective allows OTs to provide further education on home modifications that enhance the safety and functionality of the home for everyone involved.
For instance, OTs are trained to instruct caregivers on the correct use of assistive devices, ergonomic techniques to prevent injuries, and strategies that can encourage member independence in activities of daily living (ADLs).
By involving caregivers in the planning and implementation of modifications, OTs foster a collaborative environment where caregivers are seen as partners in care. This approach recognizes and utilizes the unique insights that caregivers have about the member’s needs and preferences, which can lead to better outcomes and adoption of the modifications.
Finding The Support Needed for In-Person Evaluations
For health plans committed to delivering effective, person-centered care, integrating occupational therapists into your care strategies is not just a strategic choice—it is a commitment to significantly enhancing the well-being of members. Occupational therapists are vital in conducting comprehensive in-home evaluations, identifying potential hazards, and recommending practical modifications that make homes safer and life at home more independent for members.
Jukebox Health is ready to work directly with your plan to connect you with our robust network of licensed occupational therapists. Our advanced technology simplifies the documentation and reporting processes, allowing OTs to efficiently record their findings and share those invaluable insights with your existing care team.
If you’re interested in enhancing your plan's in-home evaluations and want to learn more about how we partner, reach out to us anytime at hello@jukeboxhealth.com.
