Home Care vs. Home Health: Understanding the Key Differences
Have you ever wondered why some people can receive care at home while others don’t seem to qualify? The terms “home care” and “home health” are often used interchangeably, but they actually describe two very different types of services. Understanding these distinctions is essential when it comes to determining eligibility, knowing what kind of care is provided, and figuring out how these services are paid for.
Here, we’ll break down the key differences between home care and home health based on the type of care, eligibility, payment, frequency, length, and location of services.
What Is Home Health?
Home health is a form of medical care that adheres to the rules set by the Centers for Medicare and Medicaid Services (CMS). It is designed to provide professional healthcare in the patient’s home and is always ordered by a physician. Home health services are typically short-term and intermittent, focusing on recovery and education.
Key Home Health Services Include:
- Skilled nursing care
- Physical therapy
- Occupational therapy
- Speech therapy
- Wound care
The primary goal of home health is to help patients recover from medical events (e.g., surgery, illness, or injury) or to teach patients and their families how to manage ongoing medical needs. For example, a skilled nurse might visit a patient recovering from surgery to dress wounds or monitor vitals. Physical or occupational therapists may assist with mobility exercises to help the patient regain independence.
What Is Home Care?
Home care, on the other hand, is generally non-medical assistance that supports individuals with activities of daily living (ADLs). While medical care can sometimes be included, it is not the focus. Instead, home care emphasizes helping individuals maintain independence and quality of life.
Common Home Care Services Include:
- Bathing, dressing, and grooming assistance
- Meal preparation and feeding assistance
- Medication reminders
- Light housekeeping and laundry
- Transportation to appointments
- Companionship
Unlike home health, home care services are provided by non-licensed professional caregivers. They do not require a medical need to qualify, making these services a good fit for individuals who require long-term, consistent help with daily tasks.
Payment and Eligibility
Payment sources and eligibility requirements vary significantly between home health and home care:
Home Health:
- Covered by Medicare, Medicaid, and private insurance.
- Requires a physician’s order.
- Patients must have a limited ability to leave home and need significant assistance to do so.
- Care is typically part-time or intermittent, with visits lasting only a few hours per week.
Home Care:
- Paid for out-of-pocket, through Medicaid, or via long-term care insurance.
- Does not require a physician’s order in most cases.
- Services can be provided in the home or community and may range from a few hours to 24/7 care, depending on the client’s needs.
What About Pediatric Care in the Home?
Another area of at-home care is pediatric services, which often fall under the umbrella of home care rather than home health. Pediatric home care, particularly Pediatric Private Duty Nursing (PDN), involves long-term, skilled medical care provided in extended shifts, typically 12 hours or more.
Why Is This Considered Home Care?
- Pediatric care often involves round-the-clock nursing care for children transitioning from the hospital to home.
- While Medicare does not cover this type of care, Medicaid and private insurance are typically the primary payers.
- These services may be provided at home, school, or in the community, offering flexibility in location.
For example, a pediatric client recovering from a complex medical condition may require 24/7 skilled nursing care to monitor their condition and administer medications. As this care is long-term and extensive, it aligns more closely with the structure of home care than the intermittent model of home health.
Why the Distinction Matters
Understanding the differences between home care and home health can help families and providers navigate the complex world of at-home services more effectively. Whether you’re managing a loved one’s care or building a business in the at-home care industry, knowing the types of care available, payment sources, and eligibility requirements can simplify decision-making.
The Future of Care Is in the Home
Whether you own a home care organization looking to expand services or you’re new to the care-at-home industry, the demand for these services is rapidly growing. With more patients seeking care in the comfort of their homes, offering a full range of home care and home health services will be essential for meeting future needs.
Now is the time to invest in and adapt your programs to the changing landscape of healthcare. Both home care and home health play vital roles in supporting patients and their families, ensuring the best possible outcomes in the comfort of home.
