Outpatient rehab therapy services have been available for many decades to help restore function to post-acute patients. However, the emergence of outpatient therapy in the home setting to help promote optimal function has changed the delivery of this valuable service. This article the first in a two-part series that takes a look at outpatient rehab therapy in patient homes.
Since its beginnings, the practice of rehabilitation therapy has continued to evolve from a solid foundation of science-backed evidence and it has survived by its ability to adjust to changing times with creativity and innovation. One of the industry’s growing developments is an updated way to provide traditional outpatient therapy services in the home setting.
A Look-Back: the Roots of Outpatient Rehab Therapy
The original concept for outpatient therapy intended that it be a service offered to people recovering from illness or injury who were not admitted to a hospital and did not require 24-hour nursing care. With hospitals historically being the primary setting in which healthcare services were rendered, outpatient therapy was likewise naturally housed primarily in hospitals as its own department.
Today, outpatient rehab therapy still has its place in major hospitals but now quite commonly exists in the form of freestanding private clinics. As our social and economic culture modernized, the number of entrepreneurs in outpatient rehab therapy grew in response to the opportunity to expand service delivery models and meet new customer demands for:
- Alternative provider options
- Better quality care
- Personalized attention
- More convenient locations
In-Home Outpatient Therapy Emerges Out of Convenience and Necessity
Private outpatient therapy practices in New York City offer similar services as those provided in a hospital outpatient rehab therapy department, though many also specialize in the treatment of specific conditions, utilizing a unique range of therapeutic techniques.
When the nation began to see the incidence of chronic disease rise amongst baby boomers, as well as a greater prevalence of baby boomers’ functional decline because of it, we now had a generation of people who were less and less able to enjoy the original luxuries of the private outpatient clinic. Provider options remained but baby boomers’ physical decline kept at bay the benefit of traveling to a nearby location for therapy.
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Geographic convenience no longer mattered for many who regularly found it taxing to leave their home. This became particularly true for older adults in New York City who were uniquely challenged with the difficulty of safely managing walking in harsh weather conditions and navigating bus and subway stairs, uneven roads, and other street and public transportation hazards.
What naturally resulted was a growing number of older adults throughout the city who began to be overlooked as individuals needing outpatient therapy but unable to travel to a clinic for services. Despite the availability of senior transportation options, many older adults were increasingly finding it physically difficult to leave their apartments. This became a situation ripe for welcoming an answer to this new problem, and the concept of mobile, in-home outpatient rehab therapy entered the landscape.
During this time, New York City saw the emergence of private outpatient therapy practices offering in-home therapy. This new service delivery model joined the ranks of traditional outpatient practice settings, providing similar services as hospitals outpatient therapy departments and private clinics. As the service array for the in-home model remained the same what made the at-home feature stand out was how it spoke immediately to customer convenience. This was true not only for those patients for whom travel was infeasible but included everyone who simply wanted therapy services with the ease of foregoing travel and the comfort of home.
A Bold New Move: the Expansion of In-Home Outpatient Therapy Services
Under Medicare Part A coverage, the home health sector had already long-included rehab therapy in this service setting, so the idea of providing in-home rehab therapy was not new. However, rehab therapy under Medicare Part A is not considered an outpatient level of care and is intended for post-acute care upon an individual’s discharge to home following an inpatient facility stay; rehab goals at this point in the continuum of care focus on shorter-term therapy to ensure the patient’s safety and ability to function in the home environment and to ready them to tolerate an outpatient level of rehab care if needed. When baby boomers began to age, this was the typical route through which outpatient rehab therapy services were accessed. The in-home service delivery model, however, changed this.
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In contrast to Part A coverage for only post-acute rehab therapy, Medicare Part B helps cover medically necessary or preventative outpatient services – which includes outpatient rehab therapy. Part B beneficiaries can access physical, occupational, and/or speech therapy services as they’re deemed medically necessary. And this is what makes the current in-home outpatient therapy service delivery model attractive, innovative, and relevant to the times. In addition to reaching patients with difficulty traveling to a clinic, private in-home outpatient therapy practices today identify individuals who need outpatient therapy but are more difficult to identify if they’re not receiving Medicare Part A home health services.
This ability to reach out and identify individuals in the community who could benefit from outpatient rehab therapy has become pivotal in providing better care for people (ensuring fewer people fall through the cracks) and is pushing forward the current national healthcare focus on preventive care. Further, reaching out to a greater number of people with a functional decline who may otherwise be unidentifiable facilitates greater self-agency when it comes to individuals making more informed healthcare decisions. With reaching outcomes patient education, and when individuals become aware of their Medicare Part B therapy benefits, they have the power to take better care of their present and future health and to take this initiative. Where patients have often been passive receivers of health services, they now have more of an opportunity to be active drivers of their care.
I like what you said about different therapy services specializing in the treatment of specific conditions. I would say that outpatient therapy is vital to the proper recovery of any physical ailment. If I experienced any form of injury that required therapy, I will be sure to find the best outpatient therapy service in my area.