In the future, 2020-21 will stand out as the year that homecare truly shined out. From taking the burden off overtaxed hospital intensive care units by providing around-the-clock clinical care at home, to supporting seniors facing isolation. There have been countless instances over the past year when, care coordination helped optimized resources which resulted in better outcomes as a whole. This proved that, Home Health care services are crucial to bridging these widening gaps between hospitals and patients. Propelled by home health care’s participation at the forefront of the COVID-19 response, is a shot in the arm for providers to continue make quality health care accessible to our communities’ most vulnerable.

Role of HHAs during the Pandemic

Older adults and individuals with underlying chronic health conditions are at greater risk for complications and death from COVID-19, the very population served by Medicare’s home health benefit. This calls for more trained nurses and practitioners to visit patients’ homes, their demand is constantly escalating with passing days. Pandemic has changed home health care forever.

As we are aware, visiting hospitals during the Pandemic days is not a practical solution for senior citizens suffering from different ailments. Patients at home are anxious visiting hospitals due to the situation, and are seeking for Medical aid at the comfort and safety of their homes. Moreover, the Individuals who are just out of hospitals after the COVID-19 treatment are in immediate attention of Home Health care.  Home health industry has a big role to play, in caring for the ones out of hospital and for the ones preventing hospitalisation.

Moreover, the agency is concerned about protecting their workforce. During the pandemic, HHAs experienced new, substantial challenges in order to maintain services while keeping clients and aides safe from COVID-19. Specific needs to improve future pandemic resilience include more complete information on the infection status of clients; ready access to affordable PPE; and guidance, tools, and training from government and research agencies that are tailored for the industry and its workforce. The impacts of COVID-19 found in this study highlight the need to incorporate HHAs more fully into future healthcare and public health pandemic planning.

Meeting the Demand

Home health care is becoming one of the leading sources of medical care in these troubled times, with the eminent need to keep the elderly patients out of hospitals, or caring for the ones out of it. The medical attention and care given through Home Health staff is more preferred by the family of patients, as it is, more personal, peaceful and slow paced. This also gives the staff opportunity to connect with the patients personally and comfort them in these difficult times. They need medical attention to keep them afloat. This causes for a significant demand for trained nurses and practitioners across the country. 

Unfortunately, the demand is met with acute shortage of CNAs, LPS’s, and RNs in this space is witnessed which is alarming due to immense need during these troubled times. The turnover of patients handle by staff has become much higher in number. It leaves no time and zero personal life for overworked and tired and staff of clinicians. The pandemic highlights licensing barriers that predate COVID-19, but many believe it can serve as a wake-up call for state legislatures to address the issue for this crisis and beyond. Already, five states — Colorado, Massachusetts, Nevada, New Jersey and New York — have adapted their licensing guidelines to allow foreign-trained health care workers to lend their lifesaving skills amid pandemic-induced staff shortages.

Here are a few steps necessary for a Home Health agency to follow:

• Maintaining appropriate staffing in healthcare facilities is essential to providing a safe work environment for healthcare personnel (HCP) and safe patient care. As the COVID-19 pandemic progresses, staffing shortages will likely occur due to HCP exposures, illness, or need to care for family members at home.
• Healthcare facilities must be prepared for potential staffing shortages and have plans and processes in place to mitigate these, including communicating with HCP about actions
• Be in communication with local healthcare coalitions, federal, state, and local public health partners (e.g., public health emergency preparedness and response staff) to identify additional HCP (e.g., hiring additional HCP, recruiting retired HCP, using students or volunteers), when needed.

Overview

Over the past few years, there has been a steady uptick in the requests for home health care services. As the number of seniors, the number of chronic conditions to be managed, and life expectancy increase, so does the desire to safely age in place. Both the health care industry and the federal and state agencies that oversee the industry’s many moving parts need to recognize the home health care community for what it is: an indispensable service that will make health care as a whole stronger and more resilient.

As we enter our new normal, many Home Health agencies are being praised for their hard-work and determination during this difficult time. Many of them are being rewarded by their local towns, peers, and employers for their commitment with their patients. This sends a message to the medical industry that, becoming a home health care staff has similar recognition to the hospital staff, and probably on a greater level.

The core shift for home health organizations is visible in the overall healthcare industry. Organizations need to move from producing volume to creating value. Across the country, all healthcare disciplines are moving towards value-based care. Home Health caregiver’s appreciation and demand can be, foot in the door to help the shortage of home care nurses nationwide.

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We are keen to understand the challenges during these difficult times, and see if our platform can help progress your agency.

The healthcare landscape has changed dramatically over the past two decades due to advancing digital technology, population changes and evolving federal policy. For the home health industry in particular, Medicare’s payment policy has moved away from Fee-for-Service (FFS) to Managed Care. This shift has initiated Home Health agencies to adapt and change their business model towards more efficient and effective care providers. It has also fundamentally transformed how agencies present themselves to physicians and get referrals. 

Work culture at HHAs, Circa 2006 

Let’s quickly remind ourselves what Home Health marketing looked like circa 2006. The physicians’ selection criteria for a HHA were simple. HHA’s team routinely visited physicians’ offices and presented strategy alongside an elaborate luncheon. For selection of the agency, physicians relied on their “gut” feeling along with a few questions: “Can I trust these people?”, “Will they take care of my patients?”, and “Did I like their presentation.” If the presentation and food impressed the Physicians, agency was assured to see a few patients trickle in from their office. The referrals were based on a one-on-one, trust-based relationship. Once the right equation was in place concerning quality of work and trust, the relationship grew with more referrals and increased patient census.  

Back then, Medicare’s payment system, FFS, was simple. Home Health Care agencies got paid hefty money per visit. However, this system did not always incentivize the right behaviours from healthcare providers and was often abused by agencies. By 2011, the system was in need of some big change. 

Introduction of PO and ACO in healthcare  

Around 2011, new legislation was passed to substantially improve care and reduce costs, Medicare brought in big changes. The new legislation was centred around three goals: 

• Improve patient care 
• Improve patient outcomes 
• Reduce costs 

In order to achieve goals, the legislation pushed physicians to join Physician Organizations (POs) and Accountable Care Organizations (ACOs). Under the new law, these organizations aimed to attain huge cost savings while alongside the defined key goals.

The POs were not keen to deal with many home health agencies. they wanted to build a preferred network of few providers they could trust. Main objective was excellent care with reduced costs and reduced hospitalization of patients.  The writing was on the wall; getting referrals and strong relationships with individual physicians could no longer sustain a growing agency. 

Preferred Networks 

To get patients and referrals agencies needed to invest in marketing to the newly formed POs and Accountable Care Organizations (ACOs). Livelihood of POs’ and ACOs’ depended on keeping patient costs low, their selection criteria were entirely on statics. They required evidence to join hands hand with your HHA, and assurance of lower  cost of medical care. HHAs were carefully scrutinized regarding their processes and procedures, to ensure highest quality of patient care.  

Guidelines for a successful HHA

I am eager to briefly share some tips to reach-out the POs and ACOs and ensure that your agency not only survives, but thrives under the new paradigm. 

1. Home Health Compare: Home Health Compare is Medicare’s repository of information on health care providers. The website displays your star rating. It is the first thing any organization looking to partner with you, will evaluate. Get to know this tool, and make sure your numbers reflect the standard of care you provide. 
2. Documented Processes and Procedures: 50% of healthcare costs comes from 5% of the patients, so you must show POs, your process to identify that 5% at mitigated the patient risks. Also show the organizations what your agency does to manage high-risk patients.
3. Involve the physician: Doctors need to have visibility into the care of their patients. Show them your process of regular updates, and how this helps prevent hospitalizations through fast, effective intervention. At our agency, we use HOME HEALTH NOTIFY to keep our physicians up-to-date in real-time. 

Field staff is the life-line of your organization, make sure they are of the superior quality. At TONE HOME HEALTHCARE SERVICES, we only use the highest level of clinicians, no LPNs or PTAs. They communicate with patients, physicians and represent your company in every interaction. Ensure, that they have the right resources and training to accomplish their job. Educate your staff on Medicare policy, else there will always be struggle during execution no matter the best of intentions. 

Execution 

Smooth marketing may get you into a preferred network, but only great performance will keep you inside one. If you want a sustainable stream of referrals from your partners, you must perform and your HHC numbers will reflect that Make sure you have effective and efficient staff, processes, and tools to follow through your promises made to the POs and ACOs.  

We wish you all the best in your Home Health adventure. Please reach out to us with any questions or comments!

TRY A FREE VIRTUAL TOUR OF HOME HEALTH NOTIFY

We are keen to understand the challenges, and see if our platform can help progress your agency.

Improved patient care is the ultimate goal for every agency. Agencies should focus on improved patient care through efficient processes.  It is important to infuse a culture of accountability and efficiency throughout the company for improved care coordination. The golden formula that works for efficient Home Health Agencies towards improved patients’ outcome is:

EARLY DETECTION + EFFECTIVE INTERVENTION => IMPROVED PATIENT OUTCOMES

Patient issues should be detected and diagnosed quickly, and should be provided immediate and appropriate treatment. For a budding home health agency with less than 20 patients, this formula is all they need to remember.  That’s the responsibility that we take on as a Home Health Agency and a promise we make to our patients and physicians.

But in order to scale this formula to hundreds and thousands of patients, we need to make some tweaks. As your agency grows, you have to ensure that you must apply the formula to every single patient that your agency takes on. How can you achieve that?

In chemistry, in order to accelerate and tune a reaction, we use catalysts! Catalysts dramatically speed up actions, while ensuring that they materialize reliably.  The Catalyst for a bigger Home Health Agency is REAL-TIME COMMUNICATION. This is the catalyst that connects your clinicians, patients, and physicians so that they can work as a team, anywhere, anytime to produce improved and accelerated outcomes.

Let’s explore some examples so we can understand this catalyst’s “mechanism”.

Facilitating Early Detection

It is extremely difficult to closely track each patient’s status, make sure there are no gaps in care, and keep everyone on the same page. Using a real-time communication app builds a culture of teamwork and accountability especially when managing a remote team with remote patients. 

Every time, when a visit is made, the clinicians can notify about it via our communication app, Home Health Notify (HHN). It only takes 30 seconds for them to check-in with the office.  This ensures that our agency is on top of the patient’s care. On the flip side if the clinician has not made the Start-of-Care or Eval visits of the patient, we can quickly resolve that.

Routine visits are the key to early detection.  HHN ensures that we are checking up on our patients all the time as a routine, and can catch issues at their onset and treat them instantly. Home Health Notify makes this easier by making your patient’s care completely transparent to all the parties involved.

Facilitating Effective Intervention

Once the medical issue has been noticed, the agency has to ensure that the care team makes an effective intervention, the clinicians can make relevant messages visible to the physician, resulting in real-time involvement. This enables physicians to provide timely and optimal care for your patients. Home Health Notify, works as a catalyst for an effective intervention.

Efficient and real-time communication is also very important while the patient is showing effective progress during the treatment. The follow-ups are as important as the initial visits. In short, communication is essential throughout. There are several options available for real-time communication platforms that are HIPAA compliant. 

Home Health Notify is tailor built for the home health industry by a Home Health agency. It improves patient outcomes and prevents hospitalizations by early detection and immediate intervention. The App will prove to be the Catalyst you have been seeking to improve the work efficiency of your staff and instil a culture of accountability. 

Reach out to us for more information on how you can “catalyze” your patient outcomes and business growth!

Book a free demonstration and virtual tour of Home Health Notify.