Abstract
There is a high prevalence of depression among the general elderly population. There is an even higher prevalence among elderly receiving home health care, with a conservative estimate of 13.5% having clinically defined major depression. The Medicare Home Health Benefit provides limited coverage, eligibility, and payment for mental health services, and the national Outcome Assessment and Information Set (OASIS) assessment instrument has had limited requirements on assessing, diagnosing, and treating depression. However, the new OASIS-C significantly increases the depression-related requirements, though still not requiring assessments and not adding prospective payment reimbursement for patients with depression. The new OASIS-C requirements provide a gateway to home care providers seeking to expand depression care, especially combined with evidence-based models of primary care—based collaborative depression management programs such as the Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) program. The article explains IMPACT, explores its cost savings and care improvement outcomes, and explores how Medicare and private duty home care providers might use IMPACT-type models to improve their patient care and agency fiscal health.
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