title: Integrating mental health parity for homebound older adults under the medicare home health care benefit.
abstract: Despite high rates of mental illness, very few homebound older adults receive treatment. Comorbid mental illness exacerbates physical health conditions, reduces treatment adherence, and increases dependency and medical costs. Although effective treatments exist, many home health agencies lack capacity to effectively detect and treat mental illness. This article critically analyzes barriers within the Medicare home health benefit that impede access to mental health treatment. Policy, practice, and research recommendations are made to integrate mental health parity in home health care. In particular, creative use of medical social work can improve detection and treatment of mental illness for homebound older adults.
authors.affiliation: School of Social Policy & Practice; and New Courtland Center for Transitions and Health, University of Pennsylvania, Philadelphia, PA 19104, USA. jdavitt@sp2.upenn.edu
authors.forename: Joan K
authors.initials: JK
authors.lastname: Davitt
authors.forename: Zvi D
authors.initials: ZD
authors.lastname: Gellis
mesh_terms: D000368:Aged; D015897:Comorbidity; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration; D006291:Health Policy; D018574:Home Care Agencies / Q000592:standards*; D006699:Home Care Services / Q000592:standards*; D018577:Homebound Persons; D006801:Humans; D006278:Medicare / Q000592:standards*; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D008603:Mental Health; D005791:Patient Care / Q000379:methods / Q000592:standards; D010346:Patient Care Management / Q000379:methods / Q000458:organization & administration; D010349:Patient Compliance; D012949:Social Work, Psychiatric / Q000592:standards*; D014481:United States