It is the clinical ability of the home care agency that will determine the level of success and its prospects for the future. This capability does not only include in assessing the condition of the patients but also assessing the environment in which the patient is living. In addition to that, the ability also involves:
- The type of care that is needed to provide to the patient
- The feasibility of the expectations of the patients as well as their families
- The chances of infection and spreading of it in case there is a wound to heal and much more.
Most importantly, they should also focus on the diseases by APMs. This is because some of the APMs require a specific consideration on population health, for example the ACOs. On the other hand, there may be some that will need the home health care agencies such as Myallamericancare and other reliable ones to focus on ways in which they can develop and increased clinical capability to address specific conditions.
For example, the CJR model indicates the increased requirement of focus on the caring process for joint replacement patients. However, the HRRP currently needs to focus most of the caring process on other significant diseases and medical conditions including:
- Heart failure
- Acute myocardial infarction
- COPD and
- Total hip or knee replacements.
The home health care agencies would therefore need to develop their key capabilities in all possible areas so that they not only manage the patient care in a much better way across a wide range and diverse population of patients but also are able to handle the patients that has specific needs or suffer from specific and severe conditions.
Improvement in operational capabilities
There is no doubt that the home health care agencies overall will have to develop better care processes and new capabilities. This will allow them to easily keep up with the continuously changing environment of the health care sector which has also affected and brought about significant changes in the home health care sector as well.
- Most of these new capabilities need the home health agencies to provide a whole range of new and better services.
- They also need to interact with a bigger range of care providers and healthcare professionals as well.
However, beyond these new capabilities that is typically based on care delivery, the home health agencies now also need to make some operational changes as well to align their health care systems and processes with the current health care environment and needs of the patients.
For example, the home health care agencies will now need to develop relationships with their existing staff or otherwise hire new staff that may include:
- Medical directors
- Home care nurses
- Home health aides
- Pharmacists and
- Other healthcare professionals.
With an improved relationship with their staff, they will find it easy to link their home health care processes and types of services with those specific services that are offered by other home care service providers or any other emergency medical technicians. That means they will need to provide rapid responses if in case there is an acute event.
In order to improve their operational capabilities, the home health care agencies should try the following steps:
- Training their current staff so that they can handle functions and take on new responsibilities
- Making the most use of information technology and
- Developing and following more patient centered home health care plans.
Similarly, they may also need to make a few significant changes in their financial or accounting practices as well as and when the home health care providers become more eligible and adept to accept the risks under the APMs and they become a greater care partner.
This will help them to accept more risk-based payments as well as ensure an accurate revenue recognition. They will also be able to handle the bonus payments and have adequate reserves to deal with the potential losses.
Focusing on long-term care
The ability to provide long-term care is another factor that will determine the success of the home health care agencies. With that said, they are required to hold discussions related to the preferences of the patients as well as the appropriateness of each care that they have designed for a particular patient.
During the discussion they must focus on a few specific aspects that may include:
- Speaking more broadly about the clinical imperative
- Addressing the full range of needs of the patients
- Going over and beyond Medicare home health benefits.
When discussions are so thorough, it will make easier for them to provide long-term care in a much better way in order to meet with the specific needs of the patients. These needs can be varied and include:
- Their functional capacity
- The care transitions
- Proper care coordination and
- Support for caregivers as well.
That means they must not restrict their focus to the medical aspects only.
- This will not only ensure that they provide the best long-term care to the patient but it will also help them to make sure that the quality of the life of the patient is highly improved.
- They, with their care processes, will be able to make more meaningful impacts on the ability of the patient to maintain their health as well as remain in the community more safely, happily and independently.
However, there has been a growing concern over the excessive use of the home health episodes that are based on and referred to the community. Stakeholders such as Med PAC, have already showed their concern over this “Part B” of home health care episodes suggesting that it may be an indication of the fact that the Medicare home health is being used as long-term care.
To end up with a summary of the matter, it can be said that current most of the nations of the world experiences the need of a long-term care that has been till now unmet. This is primarily due to a very weak and disjointed benefit system. Therefore, it is important to have a much broader long-term care discussion.