New Care Models a Boon for Home Health

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Karen Utterback By Karen Utterback 
Former Vice President, Product Marketing and Strategy, McKesson (Retired)

Team of doctors.An increased focus on care quality is bringing opportunities for home care agencies, according to speakers at a recent McKesson webinar on accountable care.

“Health systems don’t have the tools to help patients pre-admission and post-discharge,” says Brent T. Feorene, president of Colonnade Healthcare Solutions. This has negative potential for hospitals, says Feorene, who notes that 50% of health system revenues come from ever-dwindling Medicare funds and that hospitals face penalties for adverse outcomes and avoidable readmissions.

Home health agencies are ideally suited to partner with hospitals to provide traditional home care services, in addition to such services as transitional care, telehealth, geriatric assessments, palliative care, hospice and programs designed around specific morbidities such as diabetes, congestive heart failure or COPD.

A key question that agency executives must ask is whether their agencies are solutions providers or merely vendors, says Chip Measells, managing partner at Wyatt Matas. A solutions provider must be willing to:

  • Manage high-cost patients
  • Sell solutions to managed care organizations and employer groups
  • Have the sophistication to take and manage risk
  • Focus operational strategies on building care coordination infrastructure

The ability to become a solutions provider can help agencies cope with declining reimbursements that show no signs of letting up. Formal accountable care organization pilot projects, patient-centered medical homes and other emerging care models all have a home health component. Smaller agencies especially have the opportunity to expand, diversifying payer sources, serving managed care organizations and dual-eligible populations and leveraging niche services by teaming up with physicians or larger home health agencies.

But agencies must be able to demonstrate their value to potential partners to help reduce readmissions and empower patients to better care for themselves, says Dr. David Nace, medical director at McKesson Corp. This is an area where technology can help.

Just 50% of patients receive evidence-based care, according to a study from the Rand Corp. To be successful participating in accountable care models, provider partners must have:

  • Connectivity, to actively engage patients in their care, provide self-help tools and enable care coordination
  • Care Management, to leverage evidence-based care, support care across the continuum and manage cost/quality
  • Analytics, to support reporting demands, identify/fix care gaps, understand/optimize provider performance and drill down to particular patient populations or conditions
  • Payment Mechanics, to manage payments in multiple care models and oversee contracts

“I cannot underestimate the role of technology to improving care,” Nace says. “Data is a critical asset, as are standard (treatment) protocols and bringing financial and clinical data together in one place so you can evaluate your efforts.”

“Accountable Care: Addressing the Triple Aim” was the second in a webinar series on accountable care. To listen to this and the other two webinars in the ACO series, click here.

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