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151 views2 pages

Home Health

study

Uploaded by

b_lamine
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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C-Suite Cheat

Health Care Industry Committee


Sheet Series

Home Health Agencies


Educational Briefing for Suppliers and Service Providers

Executive Summary
Home Health Agencies (HHAs) provide skilled nursing, therapy, and personal
care services to patients in their private homes. HHAs are sometimes also HHA Patient Complexity
known as Visiting Nurse Associations (VNAs). Though the name may differ,
licensure for both types of organizations is the same.

What are HHAs? 70% Percentage of Home


Health patients over the
age of 65
What types of patients do HHAs serve?
Average number of chronic
HHAs provide care for patients who can safely live at home. For CMS to cover a
patient’s HHA care, a physician must certify that a patient requires intermittent
4 illnesses for HHA patients
nursing or therapy care and is home bound. HHAs are often designed to serve
patients who require additional medical support after a hospital stay. More than a
third of patients discharged to post-acute settings are discharged to an HHA.
However, HHAs may also serve patients that have been referred from other types of
post-acute settings or their primary care physicians.

What services do HHAs offer?


HHAs deliver a wide variety of services. These may range from professional nursing to supportive services, or even physical therapy.
Some HHAs provide durable medical equipment (DME) or nutritional services. An individual patient may receive just one service, or a
combination of many. HHAs are using telehealth more frequently to monitor patients in the home remotely. This helps lower costs by
reducing the frequency of nursing visits and allows the HHA to provide more frequent care to high risk patients. However, the cost of
purchasing equipment and software to provide telehealth remains a barrier, as reimbursement for remote services can be a challenge.

What is the role of a HHA in a value-based delivery system?


As health systems strive to keep services in less costly settings, and Medicaid and Medicare push for more services to be delivered in
a patient’s home, the role of HHAs across the care continuum is growing. As a result, HHAs are building upon their core skills to
enhance care planning and delivery for more complex patient groups. HHAs are offering new transitions of care programs to meet the
demands of health systems that are focused on reducing readmissions. This makes them an attractive partner for hospitals as they
migrate away from fee-for-service to new value-based delivery models. It also allows HHAs to tap into new patient populations.

Core HHA Skills for Complex Patients

Care Coordination Self-Management Education Connection to Community Supports


Experience managing patients Trained to provide disease Able to link patients with needed
with multiple care providers self-management direction community social supports

Conversation Starters with the HHA C-Suite


1 How is your HHA preparing for more complex patients?
2 What steps has your organization taken to coordinate care with health systems engaged in value-based care?
3 What is your biggest challenge coordinating care across the continuum?

January 2015 Source: Advisory Board Research and Analysis

This report does not constitute professional legal advice. The Advisory Board Company strongly recommends consulting legal counsel before implementing any of the practices contained in this
report or making any contractual decisions regarding suppliers and providers.
©2014 The Advisory Board Company 1 advisory.com
What are the key priorities and opportunities for HHAs?
Clinical
HHAs have the experience and capability to provide care coordination and navigation services for high-risk patients. As a result, they
can forge a key role as care planning partners with primary care providers. This arrangement enables HHAs to move from being an
episodic vendor to an ongoing partner that other types of providers consult before an acute episode.

Home Health’s Role in the Patient Care Cycle

Healthy
State
Post-Acute Care Positioning as a resource Preventive Care
(Traditional HHA before acute episodes (Emerging HHA
Involvement) allows HHAs to expand Involvement)
their role

Acute Episode
Financial
Medicare Part A payments to HHAs are given in episodic payments, with each episode of care lasting 60 days. Because of this
episodic payment structure, HHAs are perennially focused on reducing travel time and the associated costs for their staff, as these
often eat into their margins.

Despite these challenges, they may see an increase in volumes. Both Medicare and Medicaid are trying to shift services to lower-
acuity settings with the goal of reducing total health care spending, including more community-integrated settings like the home.
Medicaid Managed Care programs are leading the charge by offering incentives to payers whose members are served in the home.

What are the challenges HHAs face?


HHAs have traditionally provided care after a patient leaves the acute setting. HHAs will need to further develop care transitions
programs and preventive services to meet the demands of new, value-based hospitals that they rely on for referrals.

How are supplier sales relationships with HHAs changing?


In response to a value-based market, HHAs are beginning to offer more preventive services and greater levels of coordination.
Suppliers and service providers should take note of their challenges and support them in redefining their role.

Facilitate the IT infrastructure for care coordination


• HHAs will need support integrating their IT and electronic medical record (EMR) systems with other providers to promote better
patient management. HHAs may also require additional tools to provide remote patient monitoring.

Support improved medication adherence or reconciliation


• As HHAs become more involved in preventive care and longer-term patient management, medication adherence and reconciliation
are critical competencies. Companies can support HHAs in these endeavors by promoting patient engagement in medication
adherence or providing innovative ways to manage complicated drug regimens.

Support referral monitoring


• Because HHAs pay close attention to referral patterns, IT vendors should consider their ability to track referrals, particularly at the
individual level.
Additional Advisory Board research and support is available
If you would like more information on HHAs, please contact your institution’s Dedicated Advisor. To see how HHAs are
preparing to become complex patient managers, please view Home Health’s Next Frontier: Complex Patient Management.
Source: Advisory Board Research and Analysis

©2014 The Advisory Board Company 2 advisory.com

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