Home care agencies were scrambling this week to meet a filing deadline to receive tax credits through a program that has saved some providers hundreds of thousands of dollars.
Wednesday was the deadline set by the Internal Revenue Service (IRS) for some Work Opportunity Tax Credit (WOTC) filings. WOTC offers employers federal tax credits ranging between $2,400 and $9,600 who hire individuals from eligible target groups.
The WOTC program was initiated in 1996 and has since been extended and modified. The program recently was extended through the end of 2019, under the Protecting Americans from Tax Hikes (PATH) Act of 2015. After that law was passed, the IRS announced that any employer who hired a qualified new worker between Jan. 1, 2015, and Aug. 31, 2016, had until Sept. 28 to submit the necessary forms for WOTC. After that, employers would have the customary timeframe to file the needed forms: 28 days from a new hire’s first day of work.
As the IRS extension came to a close, home care agencies went into high gear, said Michael Markowitz, executive vice president with TC Services USA, Inc., a technology-forward tax credit screening firm. The company heard from hundreds of its home care clients in the lead-up to Wednesday’s deadline, Markowitz told Home Health Care News.
The bad news is that some agencies have missed out on the chance to apply for tax credits for new hires dating back to 2015—but the good news is that the WOTC program still is ongoing and a way for home care providers to give a boost to their bottom line.
Some agencies dismiss the idea that they can boost their revenue through WOTC because they don’t think they hire enough qualified individuals, but this likely is not true, said Derek Jones, vice president of marketing for home care technology company ClearCare, at this week’s Home Care Association of America Leadership Conference in Anaheim, California.
“About 20% of caregivers qualify, on average,” Jones said. That figure was corroborated by Markowitz and Les Wasser, controller of Any-Time Home Care Inc., which has eight branch offices in New York state.
Any-Time has received tax credits in the six figures over the course of about the last two years, Wasser told HHCN.
“It’s a win-win situation, you have nothing to lose,” Wasser said of home care companies filing for the credits. “You’re talking about tax credits, so it’s dollar-for-dollar in the owner’s pockets.”
Applying for the credits is not burdensome, he said. The company has new workers fill out the requisite forms during hiring process at the local branch, after which the forms go to Wasser, who adds the date of hire. Any-Time is a client of TC Services, so Wasser then sends the forms along to that company, usually once a week, Wasser said. TC Services receives a percentage of what Any-Time saves through its credits.
The typical WOTC tax credit that a home care agency receives for an eligible employee is about $2,400 according to Markowitz. However, it can be as much as the maximum of $9,600.
WOTC is not the only tax credit program that home care agencies can benefit from, and provider associations have begun to more actively evangelize to their members about tapping into these funds. For instance, the HCAOA, the Pennsylvania Homecare Association (PHA), and Home Care Association of Florida (HCAF) have partnered with TC Services to promote the value of tax credits.
If the experience of Any-Time is an indication, it’s a message that providers will be happy to hear—as Wasser put it, “It’s free money.”
Written by Tim Mullaney
A bill introduced in Congress this week would put a pause on the Pre-Claim Review Demonstration from the Centers for Medicare & Medicaid Services (CMS) with a one-year moratorium on the program.
The legislation, introduced by Representatives Tom Price (R-GA-6) and James McGovern (D-MA-2), comes after the home health industry has pushed back hard against the program, citing numerous problems in its roll out in Illinois. The bill, named the Pre-Claim Undermines Seniors’ Health (PUSH) Act, was introduced on September 28. The PUSH ACT is co-sponsored by Reps. Kenny Marchant (R-TX-24) and Mac Thornberry (R-TX-13).
The bill will delay the program one year after the enactment date within each of the five states. In addition, the bill requires the Secretary of Health and Human Services to provide a report to Congress within a year that includes a “comprehensive description and analysis” of the program in any state it was enacted before passage of the bill. The report must also include a description of the resources used by agencies, physicians and the Department of Health and Human Services; a description of alternative measures to identify fraud; and detailed data on the number of claims submissions and resubmissions, including data on approval and disapproval rates.
Earlier this month, CMS announced it would delay the implementation of the demonstration in Florida, Massachusetts, Michigan and Texas, though it did not say for how long. The program was originally anticipated to roll out in Florida as soon as October 1, and Texas by the end of the year. The demonstration requires home health agencies to submit their claims much earlier in the care process before getting paid for their services.
Rep. Price wrote to Congressional members about the demonstration, saying it “is creating barriers to care and forcing providers to incur significant unnecessary burdens to support an overly broad, untargeted and ineffective demonstration,” the National Association for Home Care & Hospice (NAHC) reported.
Those sentiments mirror what Illinois providers have said about the pre-claim model, calling their situation “desperate” and reporting significant administrative burdens that slow down care. At least one home health agency in Illinois has already closed its doors as a result of the pre-claim, according to NAHC.
“PCR began in Illinois on August 3, 2016 and almost immediately created chaos in the state’s home health agencies and their patients,” NAHC wrote in an update of the legislation. “Problems included a 60% to 80% non-affirmed rate, burdensome and time-consuming paperwork, an inefficient electronic system that cannot process the documentation, physician unfamiliarity with what is needed for PCR due to poor education from CMS and their contractor and considerable cash flow problems at agencies.”
Multiple industry groups have spoken out in favor of the legislation, including the Visiting Nurse Association of America (VNAA), which thanked Congressional members for introducing the bill in a statement.
“The disastrous rollout of the program in Illinois has clearly established that the current Pre-Claim Review demonstration should be discontinued before it seriously impacts patient health,” said Tracey Moorhead, CEO and president of VNAA. “We’ve already received multiple reports from providers across the state citing serious technical failures and improper claims denials, which have resulted in delays to the delivery of timely clinical services.”
The organization was also supportive of the measure to require a report of the pre-claim data.
Additionally, the Partnership for Quality Home Healthcare supports the bill.
“The legislation offers the relief the Medicare home health community has been seeking,” Colin Roskey, executive vice president of the Partnership, said in a statement. “We look forward to working with lawmakers in Congress to see that this bill is enacted and with CMS to improve the pre-claim review processes for the benefit of Medicare contractors, physicians, home health agencies and, most importantly, patients.”
Written by Amy Baxter
While the home health industry cheered after learning the Pre-Claim Review Demonstration from the Centers for Medicare & Medicaid Services (CMS) would be delayed ahead of start dates in four other states, the program is still likely to roll out—and is still in effect in Illinois.
“This is just a delay. It does not mean it has been eliminated altogether,” Nick Seabrook, managing director at Blacktree Healthcare Consulting, said during a recent webinar on pre-claim. “Illinois still has to go through these rules.”
As CMS works to educate doctors, agencies and Medicare Administrative Contractors (MACs) on the demonstration and claims process, home health care agencies need to remain ready and could learn a thing or two from the disastrous roll out in Illinois.
The Burden of Time
One of the biggest missteps that has been discovered in the demonstration in Illinois is the actually amount of time it takes to submit pre-claims for approval. While CMS assured home health agencies that the process would not add any administrative burden, as agencies would be submitting the same paperwork in the pre-claim process versus the regular claims process, that has proven to be untrue, according to Craig Mandeville, CEO and founder of Forcura.
In Illinois specifically, the process takes nearly an hour, Seabrook described. By comparison, one MAC, Palmetto, estimated that the process would take just just five to 10 minutes. One home health agency, Illinois-based Residential Home Health, put CMS’ estimate to the test in a video that documented the process.
“There are horror stories that we’ve been hearing,” Seabrook said of the claims process during the webinar. “An agency in Illinois did a timed study and a video. Palmetto estimated a five to 10-minute process. The agency’s video walked through the whole process, and it shows the submission process from start to finish took 51 minutes.”
That grossly underestimated figure is per claim, according to Seabrook. While a lot of the pre-claim submissions are done online, the process is time-consuming, and there are issues specific to using an online portal, as well.
“You cannot save and come back later, or the website will time out,” Mandeville said. “You want the team members to be very dedicated and not interrupted to do the work and conduct their uploading process.”
Once pre-claims are submitted, agencies must wait up to 10 days before receiving an approval or being told to resubmit their claims. Resubmission responses can take up to 20 days. These response times, coupled with a very low reported affirmation rate in Illinois, is likely to lead to “significant delays,” Seabrook said.
“Some agencies have said they won’t admit any patients until they get affirmations back,” he said “They can’t take the risk of not getting reimbursed for those services.”
To facilitate the pre-claims process, some home health agencies have hired or are considering hiring additional help to focus on the submissions process. However, it’s essential that agencies know their documentation requirements before hiring additional staff.
“It’s the same requirements, but they must be organized in an articulate fashion and delivered as quickly as possible,” Matt Chamber, director of business development at Forcura, said of organizing the pre-claim paperwork. “The more effectively organized the packet, the more likely to have a positive outcome of a potential affirmation.”
That means that home health administrators need to be trained on how to package the claims.
Additionally, notifying partners can help an agency move the submission process along. CMS has stated it will step up its education outreach to physicians, in part because obtaining their signature on the care plan has potentially slowed down the submission process. However, home health agencies can take this step, too, by notifying their referring physicians about pre-claim.
“That clear line of communication can help get that better documentation on the front end,” Chamber said. “More information in a concise manner up front, as quickly as possible, will be more effective and efficient.”
Lastly, once pre-claims are submitted, it’s essential that agencies stay on top of their claims throughout the process by tracking their documents and corresponding numbers. In doing so, it’s also important to have a specific process in place for tracking and following up with resubmissions.
Written by Amy Baxter
ResCare Hires Kindred Executive as President, CEO
ResCare, a home health care provider based in Louisville and the nation’s largest private provider of services to people with disabilities, has named Jon Rousseau as its new president and CEO, replacing CEO Ralph Gronefiled, Jr., who is retiring. Rousseau is moving from Kindred Healthcare (NYSE: KND), one of the nation’s largest home health care providers, where he served as executive vice president and president of its rehabilitation services company. At Kindred, he also was head of its care management division and the company’s home health, hospice and home care business, Kindred At Home.
Prior to joining Kindred, Rousseau held leadership positions at Mylan and Medtronic. He also worked at private equity firm Friedman Fleischer & Lowe and Morgan Stanley.
“Jon Rousseau is a proven leader who brings a wealth of experience across health care sectors and disciplines,” Chairman of the ResCare board of directors James Bloem said in a statement. “In partnership with the company’s leadership team, local management and direct service providers and care professionals, he will advance ResCare’s mission to provide high quality and respectful care for the company’s clients and help them achieve their highest level of independence.”
Rousseau succeeds Gronefield, who dedicated 21 years at ResCare, and will serve as interim president of the residential services segment until June 30, 2017.
Hometeam Hires Elizabeth Berman as New Chief People Officer
Hometeam, a New York-based tech-forward home care company, hired Elizabeth Schepp-Berman as its first-ever chief people officer, in charge of the company’s human resources department. In her new role, she will be instrumental in nurturing Hometeam’s culture and supporting the company’s mission.
“The whole organization is excited about making Elizabeth the newest addition to our team,” Josh Bruno, CEO and founder of Hometeam, said in a statement. “Our employees and especially our caregivers are what we are all about. With Elizabeth’s expertise and people-first attitude, we are confident Hometeam will continue to cultivate the best talent and provide our care recipients and their families with the care and support they deserve.”
Schepp-Berman will oversee and expand the human resources department, as well as shape hiring strategy for the company as it continues to increase its footprint across the country. In its hiring strategy, Hometeam takes on caregivers in a W-2 model rather than on a contract basis, unlike a lot of the industry. Hometeam currently has offices in three states.
Schepp-Berman joins Hometeam after working as vice president of people strategy and operations at Vevo. She previously was executive director of human resources at Estee Lauder. She has also held human resources roles at Nike and Macy’s. She will report directly to Bruno.
Kyle Simon Joins Home Care Association of Florida
Kyle Simon has been named director of government affairs and communications at the Home Care Association of Florida, a statewide trade association representing the home care industry.
Simon joins the organization with more than six years of health care policy experience and has served as an adjunct faculty member at Valencia College since 2012. He joined the Home Care Association of Florida in early September. He holds master and bachelors degrees in political science from Florida State University.
Approved Home Health Care Hires New PR & Marketing Liaison
Approved Home Health Care, a Medicare-certified home health company in Texas, named Paula Baucum as its public relations & market liaison. Baucum, of PR Baucum & Associates, has worked with for-profit, non-profit and governmental agencies over the past nearly 20 years.
As liaison, Baucum will assist the company in developing programs and policies for public relations, collaborating with physicians and social agencies and creating goodwill programs at the community level. She recently served as board trustee for Baylor Medical Center in Waxachie, Texas, and served as co-chair fundraising steering committee for the New Baylor Scott & White Health Hospital, which raised $2.4 million, according to Waxachie-based Daily Light.
CEO of Effingham Health System Moves to Georgia Department of Community Health in Atlanta
Norma Jean Morgan, who served as the CEO of Effingham Health System, has been named the deputy chief of healthcare facilities for the Georgia Department of Community Health in Atlanta, Georgia. The department, under the Healthcare Facility Regulation Division (HFRD), completes the survey and certification process for 24 provider types in the state, including home health, home care, hospitals, rural health clinics, using homes, hospice, personal care homes and more.
Morgan served as CEO of Effingham Health System for years before making the career change. In her new role, she will be responsible for directing programs under the HFRD office, including management, oversight and leadership of the HFRD licensing section.
“Having been a provider for over 40 years, this was a great opportunity for me to lend that experience to the government side of trying to keep facilities certified, keep them in compliance of the many regulations that we are required to be in compliance with—not only on the state level, but on the federal level,” she told the Effingham Herald.
Written by Amy Baxter
It’s no secret that staffing presents a huge challenge for home care providers, with agencies across the country routinely seeing sky-high turnover rates. As of 2015, the median caregiver turnover rate was upward of 60%, according to survey data from Home Care Pulse.
“This is crazy high,” Georjean Sweis, director of operations for Visiting Angels/Living Assistance Services, said Tuesday at the annual Home Care Association of America (HCAOA) Leadership Conference in Anaheim.
There’s no silver bullet for bringing turnover down and improving recruitment, but home care providers can achieve notable improvements by being sure that they are following best practices throughout the hiring and onboarding process, Sweis said. Home care providers looking for a place to start may want to consider the following numbers, to see if their workforce strategies are adding up to success.
Hiring home caregivers is a “speed game,” Sweis emphasized. That’s because qualified candidates are in extremely high demand—caregiver shortages ranked as the top threat facing the industry, in Home Care Pulse’s 2016 Benchmarking study.
Therefore, agencies need to streamline their hiring process as much as possible to prevent losing prospective workers to competitors. So, if an agency intends to offer an applicant a second interview, don’t let that person walk out the door. Instead, ask the person to stay and conduct the second interview immediately, Sweis advised.
Checking references, doing background checks, and other due diligence is necessary, but if possible, she would even make a job offer on the spot, she said.
To have a maximally efficient recruitment process, it’s crucial to be measuring how many applicants make it through various stages of the hiring journey, such as a first interview, second interview and job offer. If too few applicants are viable, that means an agency needs to reevaluate its practices, said Sweis.
“I would say that if your numbers aren’t around 15% or 20%, you may want to look at where your folks are coming from to begin with,” she said. “If you’ve got a hundred applicants from Craigslist, but only one is a viable candidate, what does that tell you?”
Some agencies are hiring dedicated recruitment/retention coordinators to be responsible for maintaining an active, high-quality pipeline of candidates, and spearheading retention efforts. The savings achieved through lower turnover and the value-add of a more experienced workforce could well make the salary paid to this person well worth it, Sweis noted.
If it’s taking applicants longer than 20-30 minutes to fill out an application, that is a barrier that needs to be addressed, according to Sweis.
It should not only be easy for caregivers to apply for a position, but they should have various options for doing so, such as online versus in person, she added. And it’s always a good idea for agencies to have an attorney review the application if any changes are being made, to ensure it’s still compliant.
The onboarding process for new caregivers is a crucial part of setting them up for success. A four- or five-hour orientation is reasonable, Sweis said.
This time should be spent in a variety of ways to keep the new hires engaged, she advised. Having different people speak, mixing in a PowerPoint, and showing video are some options for different ways to convey information. But more outside-the-box approaches also can be effective. One agency, for instance, brings in a recipe for cookies and has the group prepare them.
Other suggestions for orientation include having the new workers affirm verbally that they are committed to being a part o the team and meeting the quality expectations that have been conveyed. Emphasizing customer service and the customer experience also can be powerful. For example, ask the new hires to imagine what a first-time home care client feels like half-an-hour before the first scheduled visit—the nerves and uncertainty—and then the positive feelings the client experiences when the caregiver arrives on time.
Coming out of orientation, agency managers should have a sense of the new caregivers’ strengths and some “stretches,” or areas for them to work on improving, Sweis said.
The first 90 days are crucial from a retention standpoint, Sweis stressed. So, agencies should devote extra time and attention to new caregivers in this period. That means having robust communication, accompanying them on ridealongs and providing a steady stream of feedback.
At the end of the first 90 days, or after a certain number of hours worked, do a performance review, Sweis recommended. What is said should come as no surprise, and should be related to the “stretches” identified at orientation and the feedback that has been given; rather, the review is a chance to reinforce a plan to keep the caregiver engaged and improving.
10% of Caregivers
Mentoring programs are catching on in home care, Sweis said, and they can provide a big retention boost. One approach is to identify the top 5% to 10% of caregivers on the payroll, provide them with some mentorship training and extra pay, and then pair them up with new hires. The mentor might accompany the new caregiver on his or her first case, and then provide ongoing guidance and support.
On the other hand, it’s also important for agencies to be tracking the lowest-performing 5% to 10% of caregivers. At weekly meetings, the management team can evaluate these workers and discuss strategies for improvement or, if need be, an exit. But to really reduce turnover, the focus also should be on the most troublesome 5% to 10% of clients—and separating from these clients also is a move that agencies need to be willing to make, Sweis said.
That’s because maintaining a positive working environment is crucial for high retention, and clients that are extremely difficult to work with can compromise this; and, in many cases, the manpower and other resources being devoted to these clients means that they’re not even profitable cases, Sweis said. It may be that the individuals simply are not good candidates for home care, and the agency needs to prioritize its workforce over these problem clients.
Written by Tim Mullaney
Soon, Uber may be a more common way for home health workers to reach their clients.
The popular ride sharing company recently partnered with Circulation, a Boston-based health care transportation platform that integrates with health care systems, as well as with Uber’s API. Right now, the goal of the partnership is to provide reliable non-emergency medical transportation in Uber-driven vehicles to patients traveling to and from the hospital. But the opportunity exists to use the platform to bring health care practitioners, like home health care workers, to patients in their homes, John Brownstein, Circulation’s co-founder, told Home Health Care News.
“That would be the next phase of this platform,” Brownstein said. Brownstein, a Harvard Medical School professor and a health care adviser to Uber, has also worked with Uber on its UberHEALTH vaccine delivery platform.
Currently, transportation coordinators at hospitals use Circulation to schedule and manage affordable, on-demand rides that are tailored to patients’ specific needs, including whether that patient has a wheelchair, sensory impairment or a service animal. The HIPAA-compliant platform automatically verifies a customer’s ride eligibility and health insurance, and customers’ health and contact information is auto-populated into the platform from their health records, according to a Circulation press release.
Patients and their caregivers can also receive ride reminders and real-time notifications through text, by email or by phone, and all billing and payment reconciliation with Uber and health care organizations is dealt with on the backend of Circulation’s system.
Circulation was “designed with seniors in mind,” Brownstein said. “There’s definitely an opportunity to use Circulation for on-demand home health services,” he explained, adding that the idea is being discussed.
Circulation’s service is currently being piloted at Boston Children’s Hospital; Nemours Children’s Health System in Wilmington, Delaware; three acute-care hospitals in the Mercy Health System and an all-inclusive care program for seniors in Pennsylvania. Circulation hopes to roll out in six more states in 2016, according to the press release.
Uber has designated Circulation “the preferred healthcare platform partner of the Uber Developer Platform,” according to Circulation’s press release.
Written by Mary Kate Nelson
Is your organization using the data you already have efficiently and effectively? Understanding key drivers and establishing a strong baseline of metrics is imperative to your agency.
During this webinar, you’ll hear from Vice President of Coding Services, Nick Dobrzelecki and Chief Nursing Officer of HCR, Laura Martini on:
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When: Monday, October 3
Time: 1:00 PM CST
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Addus Enters Home Care Partnership with CellTrak
National provider of home and community-based personal care services Addus HomeCare (Nasdaq: ADUS) has extended its nine-year contract with the provider of mobile health care delivery management solutions, CellTrak Technologies.
The revamped partnership will debut a new version of the CellTrak solution that enables home care providers to manage service delivery while meeting electronic visit verification (EVV) mandates.
The new version will incorporate mobile applications, interactive voice response capabilities, portals for office staff and the extended care team, and interfaces with EMRs, back office system and third parties, like other EVV providers. Real-time data from these sources will be available to care coordinators and operations management to help provide quicker responses to events happening in the field.
Addus will roll out the new version of the software in its entirety this fall.
Senior Helpers Boston Acquires Other Location
Part of the national in-home senior care provider franchise Senior Helpers, Senior Helpers Boston, has announced the acquisition of Senior Helpers South Shore. The acquisition will help Senior Helpers Boston deliver care to more than 75 communities in the greater Boston area.
The caregivers from the company throughout Boston are trained to offer the highest level of care possible using the company’s Senior Gems Alzheimer’s and dementia care program. The company will also be implementing a new Parkinson’s Care Program, which will include specialized training and a certification program for staff that was created by experts from the National Parkinson Foundation’s Center of Excellence.
To keep up with the expansion, Senior Helpers Boston will relocate its headquarters to Newtonville, Massachusetts, in October. The company will also open a third office, which will serve as a recruitment and training center, in the Wilmington/Woburn area at the end of the year.
OnCourse Learning Acquires Home Care Education Company
The Brookfield, Wisconsin-based OnCourse Learning, a company that offers licensure, regulatory and compliance education solutions to the health care, financial services and real estate industries, has announced the acquisition of the Vancouver, Washington-based e-learning company, Institute for Professional Care Education (IPCed).
“This acquisition allows us to build on our strong foundation in health care education by expanding our content catalog to meet the training needs of professionals across the provider landscape, in both acute and post-acute care settings,” Patrick Sheahan, president and CEO of OnCourse Learning, said in a press release.
IPCed will continue operating from its Vancouver headquarters and will still offer specialized certifications for caregivers. The company also offers training materials like DVDs and care checklists that include education in dementia care, Parkinson’s care, end-of-life care and diabetes care.
Wilpage Inc. to License CareTend Home Medical Equipment Software
A provider of comprehensive post-acute health care software, Mediware Information Systems announced that Wilpage Inc., a provider of home medical equipment, will license CareTend software for use in its business.
“When looking at CareTend’s model, we realized that switching from our current on-premise deployment would eliminate costly hardware maintenance and truly save hours each week in traditional manual data backups and updates,” Cy Abruzzo, vice president and CFO of Wilpage, said in a press release. “We will look forward to using CareTend’s cloud technology so that we can improve our data security and have peace of mind knowing that our software will be automatically updated with the latest enhancements.”
This is not the first time Wilpage has licensed Mediware’s software. Twenty years ago, the company licensed Mediware’s CPR+ software for its HME and DME service lines.
“Wilpage has been a loyal customer since 1996, and we truly appreciate that the company has chosen Mediware as its software vendor over the years,” said Paul O’Toole, vice president and general manager of the Home Care solutions division of Mediware. “We are thrilled to see how CareTend’s secure hosted deployment will reduce Wilpage’s overall IT costs and streamline technology so the team can have more time to run the business.”
Fazzi Associates Opens Office in Limerick Ireland
The Massachusetts-based coding company that serves U.S.-based home health care and hospice agencies, Fazzi Associates, has announced the opening of a new international location in Limerick, Ireland.
The company serves U.S. companies, but also launched coding services from locations in India in 2013. Now with a location in Ireland, Fazzi will be able to provide even greater capacity needed for increased demand.
“In addition to increasing our ability to serve our customers on a 365/24/7 basis; by operating out of multiple locations, we can provide business continuity and disaster recovery services for the mission critical coding process to our clients,” Dr. Robert Fazzi, founder and managing partner of Fazzi Associates. “The industry is realizing that this coverage is of growing importance due to things like climate change, natural disasters, terrorism and cyber security risks.”
Alliance Homecare Acquires Elder Care Alternatives
Alliance Homecare, a New York-based home health care company, announced the acquisition of Elder Care Alternatives, a care management company based in New York, New York.
Elder Care Alternatives will now be known as AllianceECA, and the company’s services will continue to be provided by its present team of care managers.
“Particularly as we mark our tenth year of providing exceptional service to our clients, we are thrilled about this new affiliation and the additional knowledge, skills and resources to which we have access,” Greg Solometo, co-founder and CEO of Alliance Homecare, said in a press release. “This new venture deepens and expands our care manager capabilities with a proven structure methodology, making our practice are even more robust. Together, we will continue to service the ever-changing care needs of clients and their families who are as important to us as our own.”
Written by Alana Stramowski
Care coordination is on the tips of tongues of care professionals these days, and home health agencies have a lot to gain within new payment models and care trends. From population health efforts to value-based purchasing, incentives pushing health care providers to collaborate across different settings is adding to the importance of home health and opening new channels for growth and revenue.
Surprisingly, the majority of home health agencies have stated that care coordination is a top priority, but not too many are actually allocating resources to facilitate this goal, according to a recent survey on care coordination, conducted by Digital Collaboration Solutions (DCS), which surveyed health care professionals that included home health care providers.
“It’s a universal understanding that improving the patient experience is the net focus of care coordination—did it work? Are you healthier? Did you have a better experience?” Tim Perkins, a partner at Digital Collaboration Solutions, which conducted the survey, told Home Health Care News.
Fewer than half of businesses said they had a dedicated budget for implementing care coordination.
“They are getting a lot of pressures from different places,” Perkins said. “They’ve got to do more with less—more reporting, more coordination, more volume. And they are getting paid less to do it. They are approaching it in an ad hoc and opportunistic manner. We know we need to improve, it’s important to improve, but we don’t have a budget or systematic way to do it.”
Even with proper budgets, there may be regulations getting in the way of true care coordination.
Currently, home health care services are finding themselves hung up on the requirement for a physician to sign off on the certificate of need for homebound status. Industry advocates argue this slows down the overall care coordination process, and a bill currently sitting in Congress would open up that ability to other health care professionals, including nurse practitioners.
While Perkins sees coordinated organizations that are partnered with providers in other health care settings as current “winners,” should the system shift to allow more flexibility outside the primary care physician when it comes to home health, more coordination could be streamlined.
“I think the winners in this are going to be the accountably care organizations (ACOs) that provide the full gamut [of care],” Perkins said. “And the center of the universe is currently the primary care doctor. Though, the center is shifting a little over to the nurse practitioner.”
Shifting the power over to non-physician parties could be good for home health, with some arguing that senior care providers are the organizations best suited for care coordination and should work to assume that role, cutting out the middleman.
Perkins concurs that even lacking resources, home health is honing its care coordination skills.
“Work is happening,” Perkins said. “The handoffs have gotten a lot better. There is now a whole coordination role [that exists]. Home health is really good at this process. We have to travel this path and learn these lessons, but technology and changes in workflow—it can be worked out.”
Written by Amy Baxter
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