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The Home Health Industry should address escalating Referral Rejection Rates

Referral Rejections

Introduction

A startling 75 percent of Americans over 65 live with multiple chronic health conditions, ranging from diabetes to dementia. Predominantly, hospitals have been able to refer patients to their network of home health agencies with the confidence of being absorbed by them until recently. The trends show that post-COVID 19, more and more patients opted for home health care where they get treated in the secure environment of their homes instead of visiting hospitals or nursing homes. Hence, The demand for home and community-based care has skyrocketed, unlike the supply creating high referral rejection rate than ever. 

According to an analysis by CarePort based on 1,000 home health Agencies

Reason for the high rejection rates

The Challenges of Health Care Costing

Accurate cost measurement in health care is challenging, mainly due to the complexity of its delivery. The patient enrolled with the health care agency is treated by various medical professionals and resources, each with different capabilities and costs. The patients go through clinical consultations, treatments, and administrative processes until the care is completed depending on their medical condition. Patients with the same conditions are often treated differently depending on their response, age, and current physical condition. Lack of standardization systems to some extent from the artisanal nature of medical practice makes it challenging to calculate and recover costs.

Shortage of skilled staff

It is challenging for HHAs to work on improving wages, training and recruiting, and retention efforts of the health care workers without proper funding from the government. The home health agencies will face an extreme shortage of millions of caregivers by the end of the decade, and they will be unable to compete with a much larger number of patients with each passing year.

Shortage of staff due to low wages

For a few years, the health care staff have seen no or very little growth in their wages in the past few years. The stagnation is blamed on the government’s health care policies. Instead of spending their well-earned money on themselves, the healthcare providers pay for higher health insurance premiums, deductibles, copays, and co-insurance. They get paid less as their efforts are also cashed by the doctors, hospitals, Pharma, device companies, and insurers. With low wages and stressful work, clinicians working for home health agencies seek different career options for monetary growth. New professionals who want to join the industry are discouraged due to lower wages and appreciation. 

Shortage of staff due to the booming elderly population

Ten thousand baby boomers in the United States turn 65 every day; the ageing population is expected to double in 20 years and swell to 88 million by 2050. The alarming growth of patients is unmatched, with projected figures of 41 % growth from 2016 to 2026, translating to 7.8 million job openings. 

Government policies (PDGM) and budgets

The most crucial area important for HHA is cost control while managing each patient’s care plan. The government’s PGDM policy has dramatically changed home health reimbursement since January 2020. The change has initiated a shift in CMSs; hence, care leaders are keen to evolve their organizations into value-driven and client / patient-centred providers. The HHAs only get paid 60 days after the approval of their reimbursement. The lack of a consistent national policy is a major overarching problem for home care that affects paid providers, care recipients, and their families daily. 

Inadequate health policies by Trump govt

The federal government and households were the most significant sponsors, contributing 28% to the total spending before the Trump Administration. The cost of health as a share of the economy decreased 0.2 points to 17.7% in 2018. Increased net costs drove up private health insurance spending by 5.8% to $1.2 trillion in 2018, faster than the 4.9% growth in the year before. Consumers also paid more out-of-pocket for retail prescription drugs, medical equipment, and dental services, offsetting a fall in hospital care expenses.

Impact on the Home Health Industry

Overworked and frustrated clinicians

Due to the extra work influx, every party involved started getting increased acuity. Labor crisis leads to prioritization, which works against the low acuity clients. This also results in a drop in the efficiency of patient care. 

Loss of new work hinders the growth of the agency

Declining new referrals has hindered home health providers’ ability to grow. Small Home Health Care agencies are feared to shut down due to a complete lack of staff, leading to further unemployment of the admin and office staff.

Sales and marketing strategy

Together with instantly impacting volumes and suppliers’ skills to develop, capability challenges have also impacted gross sales and advertising and marketing methods. Equally, they’ve influenced how operators handle their referral-source relationships. It is challenging to contact referral companions, have a wholesome combine, and serve the communities broadly.

Unfortunately, Home Care remains poorly understood, sometimes mistrusted, despite many stakeholders, caregivers, paid workers of various kinds and skill levels, employers, and communities in a broad sense. They collectively are trying to provide the best services with limited resources. Well-laid laws and procedures can prove like a shot-in-the-arm to the overburdened Home Health Care Industry.

How to combat referral rejection with technology provided by HHN

Eliminate unnecessary processes

Research shows that although inputs are more expensive in the United States, the higher cost in U.S. facilities is mainly due to lower resource productivity. HOME HEALTH NOTIFY APP (HHN) significantly improves productivity in the organization, improving staff performance. Home Health Notify gives you more time to work harder on what matters most.

Communication in Real-Time

Advances in IT and the introduction of online Apps have made communication extraordinarily swift and accurate. Communication Apps have specific features that cover the entire team working on a patient to get immediate information on them at the click of a button. This is a boon during times of emergencies.

Map-routing

The caregivers who are visiting houses of various patients in a day are well informed about the details of the patients and any alterations in the plan or situation in Real-Time. Technology also supports them with mapping the patients’ houses to save time on the road.

Recognition of intelligent patient clusters

Like route mapping, the HHN APP is a function where the caregiver can assign patients to the same area after choosing their first appointment. This way, clinicians do not need to ride across the city to visit patients. This practice saves a lot of time and effort, which can be utilized in acquiring and tending a few other patients. It proves to be a win-win situation for all the agency, clinicians, and patients, especially in the wake of high referral rejections. 

Adopt Home Health Notify (HHN), which works with all EMRs, takes a giant leap towards digitization and prompt communication, time-saving and cost-effective solutions. The App promotes process-oriented work ethics, a well-defined work schedule with Hourly | Daily | Weekly Calendars, and a detailed Workflow of each process.

Schedule a Demo to get a FREE virtual tour for more information on Schedule a Demo – Home Health Notify.

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