Does Your Organization Stack Up on Care, Integration Metrics?
Posted On: July 26th, 2016
Director of Product Management, Change Healthcare
Bundled payments and accountable care represent two emerging concepts in healthcare that show no sign of going away. Regardless of whether your home health organization is part of a health system or is standalone, you likely already are partnering with hospitals and other providers to coordinate patient care across the care spectrum where, previously, clear boundaries existed.
But as the delivery of healthcare changes and hospitals are being held financially liable for downstream care, being the local provider or having a good working relationship with hospital management isn’t enough to earn a hospital’s business. You must be able to show the value your organization can bring to patients and to the care process.
A recent article in Hospitals & Health Networks focused on key questions hospitals are asking post-acute providers when vetting potential partners. Although it’s clear the article was targeting care facilities rather than home health, the general questions are pertinent as hospitals scrutinize all post-acute care providers. How does your organization stack up?
What are Your Quality Metrics?
It’s likely that you’re already providing readmissions data to the hospitals you work with. But do you understand what the numbers mean and are you working to improve them? Teasing out care quality information can be difficult, but your clinical software is a good place to start.
Hospitals in the 67 geographic regions covered by the Medicare Comprehensive Care for Joint Replacement (CJR) payment model are working with post-acute care providers to help with rehabilitation. A recent study commissioned by the Alliance for Home Health Quality and Innovation showed that Medicare beneficiaries from 2011-2014 who underwent major joint replacement without major complication or comorbidity (MS-DRG 470) received “cost effective care and lower readmission rates.”
How Easy Is Your Organization to Work With?
I like to think this question refers to your people, your processes and your technology. When a patient is ready for discharge, are you prepared to set up and complete the evaluation visit the next day? Quick turnaround requires cooperation from the intake staff, schedulers and clinicians, working within management guidelines.
And when making the referral, can your organization accept electronic documents? Being easy to work with is more than expressing a willingness. That willingness has to be backed by a properly trained staff that recognizes the importance of referrals, processes to smooth care transitions and the right technology that can speed the scheduling and delivery of care.
Can Your Deliver Integrated Care?
Integrated care is more than managing care transitions. As hospitals continue to incur readmission penalties and receive bundled payments for care outside their facilities, collaboration must go beyond the individual patient. It must extend into shared accountability to standard clinical practices, transparency to outcomes and joint performance improvement efforts. How do your care processes line up with the hospital’s? How are you sharing data and performance metrics with your referral partners? Care partners should be meeting periodically to monitor performance and progress against care and payment metrics.
What are Your Per-Episode and Per-Visit Costs?
There’s no question that your home health organization must know not only your per-episode and per-visit costs, but also how those numbers stack up against peer organizations in your service area, your region and nationally. Especially in bundled payment scenarios, hospitals want to know that you can deliver quality outcomes at a price that fits the model.
This definitely is not about cheapening what you do to fit the terms of a contract. Rather, it’s a chance to take a critical look at your staff, your technology and your processes to determine your efficiency against others.
Your organization is already doing this, isn’t it? If not, it should be.