Last time in our home health experts series, National Association for Home Care and Hospice President Bill Dombi took a high-level approach toward home health’s impact on healthcare as a whole. Today, Arnie Cisneros and Kimberly McCormick from Home Health Strategic Management talk about making the shift from a high amount to a high quality of care.

Embrace the “Volume to Value” Transition

Healthcare reforms have been slated towards improving the value of care costs for a number of years, and home health is confronting the “volume to value” transition as we head into 2018. For home health providers seeking success as they follow their care path into the future, the best idea is to develop a value platform in their agency that addresses the goals of the reforms. This value platform will allow for home health providers to create efficient outcomes for patients through programs totally unrelated to the volume history in home care. Through this approach, centered around a clinical focus on rapid outcomes under the guidance of Chapter 7 of the Medicare Guidance Manual, Home health care programs can be rewired for success under value-based care, Home Health Groupings Model and post-acute prospective payment system; all of these alternative payment models are slated to begin within two to three years.

Home health agencies seeking a successful “volume to value” transition should take the lead of Medicare providers outside of home care; when presented with similar value-based reforms, they assumed total care control through the use of a utilization review (UR) management model. By assuring timely and focused clinical content from admission to discharge, agencies can develop and deliver value-based patient programs free from the volume legacy of the home health model. From intake to scheduling, Outcome and Assessment Information Set (OASIS) to plan of care, evaluations to in-episode management, clinical outcomes to Home Health Care Consumer Assessment of Healthcare Providers and Systems (HHCAPS); all elements of a value-based care model are brought in-house where they can be managed in terms of value outcomes. Home health providers willing to install this quality UR model will produce improved margins and clinical outcomes (> 25 percent) under future value reforms than under the current home health model.

Coming up next in Part V: OperaCare President Michael McGowan addresses how new regulation and requirements call for a new approach to patient care.