Resources, Regulations Holding Back Care Coordination

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.”

Regulation Stressors

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