Home Health, ADRD, Telehealth, and Patient Outcomes

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PROJECT SUMMARY/ABSTRACT Close to 40% of home health patients have been identified as persons with Alzheimer’s Disease or Related Dementias (ADRD). As the prevalence of ADRD in the population in general is expected to double by 2050, so will the percent of patients with ADRD treated by home health agencies. During the Covid-19 pandemic many home health agencies have begun using telehealth technologies, including virtual visits and biomonitoring, to augment and partially substitute in-person, traditional care. This is an acceleration of a trend that began over a decade earlier. A survey has found that by July of 2020, 49% of agencies used some form of telehealth. These two emerging trends, the expected increase in patients with ADRD on the one hand and the increased penetration and utilization of TH by HHAs on the other, raise questions about whether the two are compatible. Can home health care provided via telehealth to patients with ADRD be as good as the care provided to these patients in person? Would it be comparable in terms of patients’ health outcomes and patients’ experience? These questions have not been addressed to-date. Furthermore, there is no information about the type of agencies that adopted telehealth, and in particular among those agencies that care for a majority of ADRD patients. There is also no information about the differences in types of telehealth technologies (e.g. communication telehealth versus biomonitoring) that were adopted. This study will address these questions by: 1.) performing a national survey of home health agencies caring for a majority of patients with ADRD about their telehealth capabilities and use, and the timing of telehealth adoption; 2.) linking survey data to agency characteristics, patients’ health outcomes and patients’ experience data; 3.) analyzing the data statistically to identify agency characteristics associated with different stages of telehealth adoption, the association between telehealth and better patients’ health outcomes and experiences, and the relative ranking of specific telehealth technologies in terms of their association with better patients’ health outcomes and better patients experiences. The information gained in this study will inform home health patients and families, advocates, the industry and CMS, as the issue of payment for telehealth services for home health is moving forward towards consideration by Congress and will influence federal and state policies in the coming years.