5 Home Care Trends to Watch Out for in 2016

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Karen Utterback By Karen Utterback 
Former Vice President, Product Marketing and Strategy, McKesson (Retired)
Nurse talking to elderly patient

As the holiday season comes to a close, our thoughts naturally turn to what the new year will bring. Over the past few years, changes to the home care industry – like all facets of healthcare delivery – have been fast and furious.

If you’re hoping for a well-deserved respite in 2016, you likely will be disappointed. But if you’re looking for new opportunities to show the value of home care to patients, providers and referral partners, you’re in luck. These five trends bear close watching in 2016.

Continuing transition from volume to value. You’re likely aware of several projects from the Centers for Medicare & Medicaid Services (CMS) that support the agency’s move toward value-based payments. Home health organizations in nine states are participating in the Home Health Value-Based Purchasing Model, which puts additional quality and performance metrics in place that will affect reimbursement (positively or negatively) by amounts up to 8% by 2021. We’re watching this issue closely on behalf of our customers.

The Comprehensive Care for Joint Replacement (CJR) model bundles payments for hip and knee replacement among Medicare recipients. This payment model likely will create contracts between health systems where the surgeries are performed and home health organizations to provide post-acute care services. The program is being implemented in 67 geographic areas around the country.

Sharing more patient information electronically. The key to improved care coordination across settings, including transitions of care, is the exchange of relevant information. For hospitals, physicians and other eligible providers, achieving Stage 2 Meaningful Use and earning their incentive dollars requires a greater reliance on electronic recordkeeping and information sharing. As adoption and meaningful use of their electronic health records increases, they will be looking for home care partners who can communicate and share valuable clinical data electronically. To accomplish this, home care organizations must have a robust clinical management software solution, one that supports the electronic sharing of clinical information.

Changes to hospice documentation and payment. The 2016 Hospice Final Rule began on January 1, with a higher reimbursement rate for routine care days during the first 60 days of enrollment as compared to routine care days 61 and greater. A higher rate is also possible during the last seven days of hospice care if certain criteria are met. This criteria qualifies the patient for a ‘service intensity add-on’ of up to four hours per day for nursing or social work services. Other changes included additional claim documentation requirements. For more details on the contents of the Hospice Final Rule, you can download our white paper on the topic.

The Medicare Care Choices Model. More than 140 hospice organizations are participating in the Medicare Care Choices Model, which allows Medicare patients to receive both palliative and curative care services at the same time. Participation is limited to patients with advanced cancer, chronic obstructive pulmonary disease, congestive heart failure and HIV/AIDS. CMS will investigate whether the model results in higher quality of life and quality of care, higher patient satisfaction and reduced costs.

Continuing emphasis on patient experience. The Consumer Assessment of Healthcare Providers and Systems Home Health Care Survey (HHCAHPS) remains the most visible effort to increase patient satisfaction. But many of the other programs we’re watching during 2016 rightly place a high value on the patient’s perception of the care they receive. It’s no longer enough to provide quality care – your clinicians, therapists and aides must do a better job communicating about the care they are providing to patients. This might be an area where additional training is required.

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