Home health and hospice services thrive in Howard County Affluence, location cited as reasons HOWARD COUNTY HEALTH

January 12, 1993|By Sherry Joe | Sherry Joe,Staff Writer

Home health care providers are flocking to Howard County.

Drawn by its affluent population and proximity to Baltimore and Washington, at least 20 home health care operations regularly treat patients here.

About a dozen such firms are based in Howard.

"It's handy to both areas," said Bonnie Rehm, patient care manager at Howard County General Hospital. "We have access to Baltimore, Washington and Virginia."

The county's relatively well-insured population also attracts home health care agencies. Patients are "more likely to be insured in Howard County," said Joyce M. Boyd, health officer of the county Health Department.

The expansion of home health care agencies to Howard County is not atypical, experts in the field say.

Home health care services -- companies that provide nursing, hospice care and therapy in private homes -- are becoming more popular because of their cost-effectiveness, high-tech medical equipment and a growing elderly population.

"We're seeing a lot more applications" for certificates of need, said Susan Panek, spokeswoman for the state's Health Resources Planning Commission. "We approved a third more agencies from 1991 to 1992."

In fiscal 1991, the commission awarded certificates of need -- which must demonstrate the need for home health services in a particular area -- to four home health operations in 10 counties. Six were approved in 14 counties in fiscal 1992.

A home health operation must have a certificate of need before it can receive a license from the state Department of Health and Mental Hygiene, Ms. Panek said.

Home health agencies also are becoming more specialized, offering intravenous therapies, ventilators, pediatric care and prenatal services.

"Everyone is trying to get a piece of the pie," said Cathy Salerno, director of Bon Secours Home Health/Hospice.

At Howard County General, Ms. Rehm said she knows of 50 to 60 home health care operations that offer only intravenous therapy, in which companies teach patients or family members how to inject nutrients or medication. She said there is little room for additional home health care agencies in the county.

"It's very saturated," said Ms. Rehm, who has seen home health care referrals climb 25 percent at the county hospital in the past year. "I can't think of any service that's not offered in Howard County."

Since it expanded to Howard County in 1985, the Bon Secours Home Health/Hospice Program has ballooned from 11,000 visits each year to 49,000 visits last year. About 20 percent of those visits took place in Howard County, Ms. Salerno said.

"There's an increased need, and the natural outgrowth is more people expanding into Howard County," she said. "Every day it seems like a few more people show up."

Home health services are on the rise, partly because they are cheaper than hospitals.

"It's a substantial savings," said Ms. Rehm. She estimates that an intravenous antibiotic treatment delivered at home costs $125 a day, compared with at least $800 a day in the hospital.

Ms. Salerno of Bon Secours Home Health/Hospice figures that home health care can cut hospital bills by as much as two-thirds. "If you're in the hospital and you're receiving one IV treatment TC day you stay in the hospital all day," she said. "Obviously, it's much cheaper to stay at home."

Insurance companies are also fueling the rise in home health services. Reluctant to pay for hospital stays beyond three to four days, they are forcing patients to receive treatment at home.

"The length of stay is getting shorter and shorter," said Ms. Rehm, who added that the average length of stay at the county's only hospital is 3.7 days.

As a result, "patients are leaving the hospital sicker," Ms. Salerno said.

And patients want to leave the hospital for the comfort of their homes. "A lot of the younger patients want to go home and get on with their lives," Ms. Rehm said.

Home health care has also grown because advances in medical science have made certain illnesses easier to treat at home.

Doctors, once hesitant to place their patients under the care of home health services, have gained more confidence in the agencies, Ms. Rehm said.

"Physicians are starting to feel more comfortable with home health care agencies," she said. "We send home diabetics, and patients with colostomies."

Growing numbers of elderly people have contributed to the need for home health agencies as well.

"We have an aging population that's being kept alive longer, they have to be cared for and they're homebound," Ms. Salerno said.

Experts predict that home health care operations will face fewer restrictions in the near future and increasingly will specialize.

"Home health care will become a specialty in itself," Ms. Salerno said.

Home health care providers also predict a "general loosening" of restrictions under President-elect Bill Clinton, who supports managed competition among health care agencies.

"Clinton really sees this as the wave of the future," said Leah Fine, national marketing manager for HealthInfusion, which has an office in Columbia.

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