The Senate Committee on Aging brought witnesses in Wednesday for a hearing on technology for helping older Americans stay in their homes as long as possible, while using as little expensive medical care as possible.

Sen. Claire McCaskill, D-Mo. said in her opening remarks that achieving that goal is critical to getting U.S. government spending under control.

To keep Medicaid nursing home spending from skyrocketing, the country needs to maximize the length of time the baby boomers can live on their own, McCaskill said at the hearing, which was streamed live on the Web.

“If we can figure this out, the implications of the cost savings are dramatic,” McCaskill said.

Marjorie Skubic, an electrical engineering professor at the University of Missouri, talked about efforts to develop specific home care support systems, such as fall detectors and a passive hydraulic bed sensor.

Dr. Maureen McCarthy, a Veterans Health Administration (VHA) official, talked about the VHA’s telehealth services program, which provided care for about 13 percent of the VHA’s enrolled veterans in 2014. The VHA telehealth program cut VHA bed days of care by 54 percent, and hospital admissions by 32 percent, McCarthy said.

“That translates into a significant cost savings,” McCarthy said.

Charles Strickler, a caregiver with a mother-in-law who is suffering from dementia, said his family worked with a home security company to develop a system for monitoring his mother-in-law while she continued to live in a home of her own.

The system has cost about $4,000 for equipment and monitoring services over a 30-month period. The Strickler family still uses some professional in-home care, but the security system has helped the family avoid about $200,000 in nursing home bills, Strickler testified. 

Sen. Susan Collins, R-Maine, the chairman of the Aging Committee, said policymakers need to come up with ways to promote use of independence-protecting technology, and help families pay for the technology, without leading to the kind of fraud and abuse that has plagued the mobility scooter market. “We want to make sure we’re not opening a whole new avenue for con artists,” Collins said.

For a look at some of witnesses’ and lawmakers’ ideas about how to expand appropriate use of home care technology, read on.

Vermont

1. Help get better Internet service out to older people’s homes, and help older people find affordable cellular telephone and Internet service.

Collins and another member of the committee, Sen. David Perdue, R-Ga., said poor Internet service in rural areas hampers efforts to offer home monitoring services and telehealth services to many of their constituents.

Laurie Orlov, founder of Aging in Place Technology Watch, estimated that cell phone service costs an average of about $60 per month, and that high-speed Internet service costs an average of about $60 per month.

Paying $120 per month for the combination of cell phone service and Internet services needed to use many home monitoring and health care communication systems “is beyond the means of low-income people,’ Orlov said. 

Hospice

2. Overcome the current bias in favor of brick-and-mortar services.

Skubic said the countries with the most successful telehealth programs tend to be the countries with too few hospitals. 

One of the biggest barriers to telehealth is dealing with all of the many procedures and requirements tied to the assumption that older people will get their care from brick-and-mortar facilities, Skubic said.

See also: Texas regulators threaten telemedicine

Piggy banks

3. Make sure insurance plans pay for appropriate use of appropriate telehealth systems and services.

Collins said Congress should work with the Obama administration to make sure Medicare and Medicaid pay for the kinds of technology products and services that let older people stay in their homes.

Today, she said, “we’ll pay for the consequences of unchecked diabetes, but we won’t pay for the ongoing consultation that prevents the person from having complications.”

The lack of spending on home monitoring services and telehealth services is part of that problem, Collins said.

See also: 5 ways to increase use of telehealth