The home health landscape is undoubtedly an evolving sector, and CMS continues to enhance the reimbursement rates and rules affecting how and when agencies get paid. Recent data shows that Medicare’s readmission penalties have reached a new high. More than half of all hospitals in the United States will be hit with fines, withholding $528 million in funding. Home health agencies have been forced to step back and think about how they can be more operationally efficient and enhance patient care. I frequently talk to customers about market challenges and how we can help them achieve their goals. What I consistently hear is that they need solutions that contribute to the productivity of their staff, enhance their bottom lines, improve patient outcomes and help them earn more referrals from their health systems and other sources. In order to grow, it is essential for home health agencies to invest in technology that will collect, track and report large volumes of data to referral partners.
The industry has become almost exclusively outcomes-driven, making patient activity reporting critical to an agency’s success. Knowing this, our company created a portfolio of technology solutions to help providers achieve their quality goals. SMARTAUDIT is a web-based solution that helps agencies prepare for audits. For those needing help with analyzing supply-use costs, or interested in comparing clinical and financial performance with industry benchmarks, SmartSupply is another relevant tool. SmartCare Home Health is a cost-efficient tool for helping agencies stay connected with their patients. The system provides individualized concierge service with 24/7 patient care through a wireless device.
To help explain the role technology can play in growing a home health agency, I recently spoke with Nancy Gillette, VP of sales and business development of Arizona-based Team Select Home Care, and Patti Brown, RN, BSN, community liaison for Virginia-based Valley Health Home Health.
What are some challenges your agency has faced that led to an increased interest in technology utilization?
Gillette: With locations in Arizona, Colorado and Oklahoma, Team Select Home Care currently works with nearly 1,000 patients. With three service divisions, including home health care, long-term pediatric home health and mobile therapy, we have struggled in the past with understanding our ordering patterns—what products were being ordered and how many. Often, one division will pull products from another, making it challenging to track each division’s spending.
Brown: In the state of Virginia, the average readmissions rate is around 18 percent. We work with nearly 450 patients per month and have referral partnerships with nearly 20 hospitals in Virginia and West Virginia. When the CMS Readmissions Reduction Program was introduced in 2012, we started thinking about strategic initiatives that could help us form strategic partnerships with hospitals in the markets we serve.
There are currently five conditions eligible for readmission penalties under CMS. As the list continues to expand, we are evaluating our role in helping hospitals manage these challenges.
What kind of technology has your agency implemented into its day-to-day operations?
Gillette: To simplify how we ordered products for patients, we integrated a supply ordering system into our EMR platform. This allows our nurses to document patient information and order products from the field. Through the platform, we can also receive real-time data to track the number of supplies our nurses have on hand and cost-per-patient so we can maximize our Medicare reimbursement.
Under the bundled payment initiative for orthopedics and comprehensive joint replacement in Colorado, we are responsible for making sure patients don’t return to the hospital for 60 to 90 days post-discharge. We offer a concierge-style program so we can maintain communication with the patient longer.
Overall, introducing comprehensive technology solutions has been a game changer in being able to provide quality data to our referral sources. Hospitals may love their homecare liaison, but in order to keep the referral partnership healthy, agencies must be able to provide proof points that support their clinical outcomes.
Two years ago we introduced an online education platform to help nurses keep up with their CE credits and stay abreast of hot topics such as wound care, quality improvement and safety. Because the classes are available online, they can take the classes at a time most convenient to their schedules.
Brown: We are currently the only home health agency in our territory that offers both a 24/7 personal care assistance program and a telehealth program that monitors patient vital signs and transmits the information to a nurse at our home base. To help bring concierge-style care to the home, we made the conscious decision to implement SmartCare in 2013. With the push of a button from a handheld device, the patient connects to a dedicated personal care assistant who can virtually assist the patient with such tasks as arranging transportation to doctor’s appointments, speaking to their primary care physician or pharmacist on their behalf and addressing any social issues. We’ve also found that some patients are lonely and simply want a listening ear.
Offering a personal care program has helped to promote staff productivity. Prior to offering a patient monitoring program, our nurses were responsible for coordinating appointments for patients. Now, they can stay focused on clinically related tasks because care center representatives answer the initial call. Additionally, about 90 percent of the calls have been resolved by the care center rep, reducing the need for an ambulance to take the patient to the hospital. Since implementing SmartCare three years ago, we’ve avoided nearly 50 readmissions, saving us nearly $500,000 in health care costs.
What should home health agencies look for in a technology vendor partnership?
Gillette: Our hospital referral partners expect to see our results. A platform should have accurate reporting capabilities and be easy to use so we can make sound business decisions. Also, consider software that encompasses the key areas of your business so that every facet can be easily tracked and reported. Finally, a technology partner should always comply with HIPAA to maintain a patient’s security.
Brown: Knowing that learning new technology can be challenging, consider looking into the vendor’s customer service team. Ask yourself what the initial training is
like. How will they accommodate staff members who are on-the-go and don’t spend much time in the office? Does the vendor offer online tutorials that are easily accessible?
