Whole-Person Care: How OT and PT Home Assessments Are Transforming Medicare and Medicare Outcomes

Whole-Person Care is an approach that focuses on treating individuals holistically, considering their physical, emotional, social, and environmental needs. This model is particularly significant for dual eligibles—individuals who qualify for both Medicare and Medicaid. Dual eligibles often require long-term services and supports (LTSS), making a comprehensive care strategy essential. Potential changes may seem costly or impossible, but this article highlights how action can be taken in a cost and time effective manner.

What Can Insurance Plans Do to Better Address Member’s Health at Home?

With the growing complexity of the aging in place population, the focus on whole person care becomes paramount. Skilled healthcare professionals, especially Occupational and Physical Therapists, are playing a larger role in the goals within Long Term Services and Supports plans. In addition to the need for greater focus on the expertise that OTs and PTs provide, the home is increasingly becoming a bigger factor too now that aging in place statistics cite the increasing desire of individuals to stay home versus in medical facilities.

Occupational therapy and physical therapy evaluations are instrumental in enhancing care outcomes for dual eligibles. These evaluations involve a thorough assessment of an individual's home environment and most importantly - the interactions within it. It’s not enough to simply assess a home. The key separator between a home assessment and a medically focused home assessment is the understanding of the medical diagnosis and the assessment of the patient’s performance of tasks within the home.

By identifying potential hazards and recommending targeted interventions, OTs and PTs can help create safer living conditions. Incorporating occupational therapy into Whole-Person Care strategies not only addresses immediate health concerns but also promotes aging in place, allowing individuals to maintain their independence and quality of life. And enhanced safety and personalized interventions will lead to improved health outcomes.

Understanding Whole-Person Care and The Role of OTs and PTs In Home Evaluations

According to https://www.nccih.nih.gov/health/whole-person-health-what-you-need-to-know, Whole-Person Care is an approach that treats individuals by addressing their comprehensive needs. This care model focuses on various dimensions of health, including physical, emotional, social, and environmental factors. Instead of isolating medical conditions, Whole-Person Care looks at the broader context in which these issues arise. In addition, the current patient is more medically complex than ever before!

Occupational therapy evaluations are an essential part of Whole-Person Care and are needed to address these medically complex issues. These evaluations, conducted by licensed occupational therapists, aim to understand the specific needs and abilities of dual eligibles, particularly those who require Long-Term Services and Supports (LTSS).

The evaluation process begins with a comprehensive assessment conducted in the individual's home environment. Licensed therapists carefully examine how clients interact with their living spaces to identify potential safety risks.

Incorporating occupational therapy evaluations into Whole-Person Care leads to better health results through personalized care plans. This method emphasizes the significance of addressing environmental aspects to encourage safer and more self-sufficient living conditions for individuals receiving LTSS.

Here are the key areas they assess:

• 1. Mobility and Accessibility: How well the individual can move around their home, including navigating stairs, hallways, and doorways.
• 2. Daily Living Activities: The ability to perform activities such as bathing, dressing, cooking, and cleaning.
• 3. Fall Risks: Identifying tripping hazards like loose rugs, cluttered pathways, or inadequate lighting.

Whole-Person Care OT and PT Principles - The Secret Sauce to Improved Outcomes

Whole-Person Care is guided by several key principles:

• Holistic Approach: Emphasizes treating the individual as a whole.
• Integrated Services: Coordination across multiple healthcare services.
• Personalized Care: Tailoring interventions to meet unique needs.

By utilizing OTs and PTs certified in home modifications, these factors can be addressed and lead to better health outcomes. Home assessment’s are not limited to grab bars and ramps, but through the eyes of an OT or PT, these social factors as well as environmental factors are acknowledged within the assessment and recommendations.

What are the Social and Emotional Factors Assessed?

Addressing social and emotional factors is crucial for effective care and is a determinant of whole person care and health outcomes. Many dual eligibles face challenges such as social isolation, mental health issues, and limited access to community resources. Ignoring these aspects can impede recovery and well-being.

OT and PT home evals focus on the Social Support, the Emotional Well-being, and the Resource Accessibility when performing their home evaluations.

Case Studies Further Demonstrate the Significance of The Evaluation And Healthcare Costs/Needs

Case studies have demonstrated that there is statical evidence to prove that using home modifications recommended by OTs and PTs can result in significant outcomes.

The below graph illustrates a reduction of 6 hours of home care hours per week post home assessment in a 2019 study.

Carnemolla P, Bridge C. Housing Design and Community Care: How Home Modifications Reduce Care Needs of Older People and People with Disability. Int J Environ Res Public Health. 2019 Jun 1;16(11):1951. doi: 10.3390/ijerph16111951. PMID: 31159396; PMCID: PMC6604004.​

Another study by Szanton et al. also found improvements in the ability to provide self-care following home modifications, citing a reduction in disability outcomes, increased mobility outcomes, increased quality of life, increased environmental safety, and reduced hospitalization, admission costs and emergency room visits.

• Szanton S., Wolff J., Leff B., Thorpe R., Tanner E., Boyd C., Gitlin L. CAPABLE trial: A randomized controlled trial of nurse, occupational therapist and handyman to reduce disability among older adults: Rationale and design. Contemp. Clin. Trials. 2014;38:102–112. doi: 10.1016/j.cct.2014.03.005​

This is why Rosarium Health trains and works with PTs and OTs to overcome the barriers to accessible housing. They allow for a nationwide impact on LTSS outcomes and the overall wellbeing of the person through their skilled home assessments.

Collaborative Approaches to Whole-Person Care: The Role of Physical Therapists

Collaboration between occupational therapists and physical therapists is essential for delivering comprehensive care solutions for dual eligibles. By working together, these professionals can address both the functional and physical aspects of patient care, ensuring a holistic approach that considers all facets of an individual's health and well-being. This is another reason why Rosarium Health contracts OTs and PTs.

Joint interventions between occupational and physical therapists have shown significant benefits. For example:

• Mobility enhancement programs: Physical therapists may design exercises to improve strength and balance, while occupational therapists focus on integrating these exercises into daily activities to promote independence.
• Fall prevention strategies: Occupational therapists can identify environmental hazards in the home, while physical therapists provide training on safe movement techniques, reducing fall risk.
• Pain management plans: Physical therapists may employ manual therapy and exercise regimens to alleviate discomfort, whereas occupational therapists offer strategies to manage pain during everyday tasks.

This interdisciplinary teamwork not only enhances patient outcomes but also streamlines the care process, making it more efficient and effective. By collaborating closely, occupational and physical therapists ensure that dual eligibles receive tailored interventions that address their unique needs comprehensively.

Rosarium Health's Innovative Practices in Implementing Whole-Person Care for Dual Eligibles with LTSS Needs

Rosarium Health has developed a pioneering model for Whole-Person Care specifically tailored to meet the unique needs of dual eligibles who require Long-Term Services and Supports (LTSS). This model focuses on delivering patient-centered care through a comprehensive and integrated approach.

Key Components of Rosarium Health's Model:

• Occupational and Physical Therapy Home Evaluations: At the core of Rosarium Health's strategy are thorough OT or PT evaluations. These assessments dive deep into the individual's daily routines, physical capabilities, and environmental interactions to identify areas requiring intervention.
• Personalized Care Plans: Based on the OT evaluations, personalized safety plans and home modifications are crafted. These plans aim to mitigate risks like falls and improve accessibility within the home.
• Collaborative Care Teams: Their model emphasizes a collaborative approach involving occupational therapists, physical therapists, social workers, and primary care providers. This team works cohesively to address all facets of a patient's well-being.
• Skilled Home Safety Trained Contractors: In addition to having mindful OTs and PTs, contractors play a very specific role. Their understanding of the structural engineering allows for these modifications to happen. Often contractors and therapists are separate, but by having a collaborative approach under one house is the key to also fully understand the possibility of modifications.

Innovative Practices:

• Whole Home Assessments: A distinctive feature is their "Whole Home" initiative. By evaluating every aspect of the living environment, from furniture layout to lighting, they ensure that all potential hazards are addressed.
• Assistive Technology Integration: Incorporating advanced assistive devices such as grab bars, stairlifts, and smart home technologies to enhance safety and independence.
• Patient Education Programs: Empowering patients through education on safe practices and how to effectively use assistive devices within their homes.

The impact of these innovative practices is evident in improved patient outcomes. There have been significant reductions in fall incidents among dual eligibles under Rosarium Health's care, leading to enhanced independence and quality of life.

By adopting these innovative approaches, Rosarium Health exemplifies how comprehensive OT and PT evaluations can lead to better outcomes for dual eligibles with LTSS needs.

Conclusion

Adopting holistic approaches like Whole-Person Care transforms the lives of those using Medicare, promoting empowered living through sustainable care solutions. By integrating occupational therapy evaluations and leveraging the insights from physical therapists, the goal is to enhance safety, independence, and overall quality of life. This approach underscores the principle that addressing every aspect of an individual's life leads to better outcomes, aligning perfectly with the vision of Rosarium Health.

If you are a health plan interested in integrating occupational and physical therapists into your care strategy, Rosarium Health is excited to work directly with your plan. Please reach out to us at support@rosariumhealth.com or (855)- 650-0632.