Adult Day Health Costs Compared to Other Masshealth Services

ADH Is the Lowest Cost Long Term Care Service Provided by Medicaid

According to Mass Home Care Association, “The Adult Day Health program is a critical component of the Commonwealth’s “Community First” strategy, and the Equal Choice mission for MassHealth of keeping people living in the least restrictive setting appropriate to their needs. ADH is helping over 8,800 MassHealth members and a total of 17,000 elders and disabled individuals to remain living in the community, saving state and federal taxpayers millions of dollars annually.” (MADSA notes the information in the chart is from 2011 and the dollar costs listed have risen a little.)

How Do ADH Reimbursement Rates Compare
with Other Services Funded by Medicaid?

Adult Day Health:$58.83/day
(Basic Level 6–8hrs.)
(Complex Level 6–8hrs.)
Visiting Nurse RN $86.99/visit(1 hr. avg.)
Home Health Aide$25/hr.
Nursing Home$209/day

Adult Day Health programs make the critical difference for elders, disabled adults and family members seeking lower cost community-based care rather than institutional care. Patients attend the programs during the day and receive multiple services including skilled nursing care, daily health care assessments and monitoring, chronic disease management, medication administration and monitoring, physical, occupational and speech stabilization therapy, social services, assistance with activities of daily living, exercise programs and two meals all for just $59 per day*! Simply put, the economies of scale made available by bringing frail elders to one location where they receive multiple services are a cost-effective use of Medicaid’s limited resources.

Family members also depend on ADH to provide care for their loved ones so they can continue to work. Without ADH services, family caregivers would be forced to give up their jobs, or make the difficult choice to transfer their loved one to a nursing home.