Going Back to the Roots of Healthcare: Home Health

Home care or nowadays known as home health is a return to the roots of healthcare.  In the early 19th century, doctors and nurses provided care in patients’ homes, but often female family members, neighbors, and sometimes servants assisted.  However, individuals who did not have this type of support system often had few care options.

The United States’ First Organized Home Health Services

The first attempt at providing home care services started in 1813 when the Ladies Benevolent Society (LBS) was formed by a group of women volunteers in Charleston, South Carolina.  This group of untrained women not only provided home care, but also helped the sick poor to obtain medicines, food and supplies.

However, in the North initially it was a different story.  Women from wealthy northern families volunteered to help those who were sick poor, but it was quickly realized that trained nurses were necessary to help these folks overcome diseases.  The trained nurses who were hired came to be known as “visiting nurses”, which was based on the “district nurse” model started in 1875 in England by the National Nursing Association for Providing Trained Nurses for the Sick Poor.  These nurses not only attended to the physical needs of their patients, but also taught them about how disease spreads and the importance of maintaining a clean home to prevent the spread of infection.

Next, the Visiting Nurse Societies were established in major cities in the Northern United States, and they also were based on England’s model mentioned above. Using this model, rapid growth was experienced with 21 home care visiting nursing associations by 1890.  However, the mission changed and expanded so that care was not only provided for the sick poor, but also preventative services for infants, children, mothers and those with infectious diseases, such as tuberculosis, were offered too.  Even though deaths related to infectious diseases decreased, the concern for prevention and good hygiene increased.

The first organization to reimburse for home care was the Metropolitan Life Insurance Company in 1909.  It hoped that home care would reduce the number of death benefits claimed.  However, in the late 1920s many home care agencies closed their doors due to the poor economy as a result of the Great Depression, and then the nursing shortage during World War II caused further issues.  Even though The Health Insurance Plan of Greater New York and Blue Cross tried to include coverage for home care services, it was not widely accepted at the time.

Home Care Becomes Popular Again

During the late 1950s and early 1960s it became clear once again that there was a growing need for home care services.  Patients with chronic illnesses could be cared for in their homes instead of hospitals.  This not only saved money, but also the negative long-term effects due to lengthy hospitalizations became apparent.

In 1965 when Medicare was established in the United States for people over 65 years of age, home care services were once again covered by insurance.  Medicaid was also established that same year, and continues to provide health insurance coverage today for people with low income, which is one in five Americans.

Home health has a long and varied history, but it has solidified its position in today’s healthcare market.  Currently, it is the fastest growing industry in the United States not only due to the aging Baby Boomers, but also to an increasing number of treatments, such as joint replacements, which are provided in outpatient settings with the bulk of care handled in patients’ homes immediately following surgeries.  According to the Centers for Medicare & Medicaid Services (CMS) Office of the Actuary,  the annual growth rate for home health spending is predicted to be 6.7 percent by 2020 and will be almost $173 billion annually by 2026, outpacing the U.S. gross domestic product, which is anticipated to increase 4.5 percent per year.

We can Help with Your Home Health Needs

Finding good talent is becoming increasingly difficult in the quickly expanding home health market.  As your home health agency’s needs grow, the 5 Star team is here to help with its RN certified coders, many training options and consulting services.  To learn more, please feel free to contact us at [email protected] or 866-428-4040.


©2018 Elizabeth E. Hogue, Esq.  All rights reserved.

“The History of Home Healthcare”, CareJoy.com

Southern Web SupportGoing Back to the Roots of Healthcare: Home Health
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