People’s homes may well become the center of the U.S. health care system in the future. That’s because home health care is well-positioned to be a linchpin in efforts to meet the “triple aim” goals underlying Affordable Care Act reforms: improving patients’ care experience, improving the health of populations, and reducing costs.
However, for home health agencies to fulfill their promise and move into this central position, they need to recognize the current opportunities and develop needed capabilities. This was a take-home message of experts who spoke last week at an Alliance for Home Health Quality and Innovation (The Alliance) panel.
A nonprofit consortium of home health providers and other organizations, The Alliance has spearheaded a project known as the Future of Home Health Care. With research from Avalere Health and input gleaned from symposia that took place throughout 2015, the project has developed a framework that policymakers, providers, and other stakeholders can refer to, to help home health fulfill its potential in the evolving health care system.
While the complete framework is forthcoming in research to be published later this year, leaders of the effort shared some top-line principles at last week’s panel in Washington, D.C. Among the ideas under discussion was the “home health agency of the future.” These are some of the characteristics of a next-generation home health agency, according to Alliance board vice chairman and VNA Health Group President and CEO Steve Landers, M.D.:
1. Patient-centered. The home health agency of the future will put the patient and his or her needs and goals foremost, developing care plans accordingly.
2. Connected. Health care reform has created accountable care organizations (ACOs), bundled payment programs, and other new payment frameworks to encourage and incentivize different types of providers to collaborate more closely. As a result home health agencies already are connecting in new ways with hospitals, physicians, skilled nursing facilities, and others, be it through the new payment models, joint ventures, preferred provider agreements or other business arrangements.
“We see that connectivity happening to make it less wasteful, and a better, less fragmented experience [for the patient],” Landers said.
3. High quality. As health care providers across the continuum are forging these new connections, they want to partner only with other best-in-class organizations. This will winnow the field, meaning that home health agencies need to focus on quality to be successful in the future. This means adhering to evidence-based best practices, and leveraging all the data and analytics capabilities that are becoming increasingly available and sophisticated, to drive continuous quality improvement.
4. Tech-enabled. Technology will undergird efforts in nearly every realm of home health in the future. Connections with other providers will be facilitated with health information exchange and care coordination supported by mobile and digital tech. A particular priority should be using technology to fill the “white space” between home health in-person encounters with education, messaging, video encounters, and the like, Landers said.
A home health agency with these characteristics will be well-suited not only to provide high quality patient care, but to fulfill the more varied functions that home health likely will be called upon for, said Sally Rodriguez, director at Avalere Health.
These functions likely will include being more of a care manager, making the call as to what setting is most appropriate for a given patient at a particular time, as well as more diverse types of care, Rodriguez said. For instance, hospital-at-home programs already are bringing acute care into this setting, and home-based primary care also is on the rise.
Not every agency has to do all these things, but as an industry, the focus should be on expanding home health to encompass all these different dimensions, she said.
Agencies have work to do to build up these capabilities needed for the future, but for home health to fulfill its potential, policymakers also will have to step up, the panelists emphasized. One area policymakers should focus on, they said, is making it easier to activate Medicare’s home health benefit and providing more flexibility in what services it covers.
“Policymakers should think about ways to provide flexibility, especially in alternative payment models, maybe giving flexibility to the home health provider, or if not that, then the hospital or ACO,” Rodriguez said. “A key message is that we think there’s some meeting in the middle to happen.”
Written by Tim Mullaney