LHC Group Invests in Quality Improvement Push

One of the nation’s biggest home health care providers has been investing in tools to improve its rankings as a premier care company. For Lafayette, Louisiana-based LHC Group (NASDAQ: LHCG), its efforts are paying off, if the latest star ratings from the Centers for Medicare & Medicaid Services (CMS) are any indication.

Many home health agencies strive to achieve five-star ratings by CMS, among them LHC Group, who was able to attain a five-star distinction for 35 of its home health locations in the second quarter of the year. Further, 209 of the company’s locations received a four-star status or better in each category, while another 63 locations earned four stars in at least one category. LHC operates more than 400 locations across 26 states.

This achievement marks the fifth consecutive quarter the company has been recognized on CMS’ Five-Star Quality Rating System. This distinction “goes to the core” of LHC and stands as its “greatest differentiator” among competitors, LHC Group CEO Keith Meyers told Home Health Care News.

“LHC is very much a clinically-driven organization and these quality scores that we’re seeing now are the result of [improved] clinical processes,” he said.

Efforts in improvement

For Angie Begnaud, executive vice president and chief clinical officer at LHC Group, these recent star-ratings results highlights the company’s overall focus on improving quality.

“With all of our growth, we’ve never really lost sight of quality and patient satisfaction,” Begnaud told HHCN.

She acknowledged the organization’s Joint Commission accreditation as evidence of this, as well as its efforts in developing tools to ensure quality clinician and patient outcomes.

“We’ve been very fortunate to be able to develop some proprietary tools in order for us to assist us in looking at our clinicians and how well they’re doing as far as documentation and Outcome and Assessment Information Set (OASIS) accuracy, and also tools that allow us to concurrently manage our patients and their outcomes,” said Begnaud.

OASIS reporting has been an area of focus for the company in recent years. Begnaud stressed the importance of the role education and training has played in ensuring accuracy in clinicians’ OASIS reports.

“We’ve focused on OASIS training to make sure that our clinicians are answering our OASIS assessments accurately and we’re able track how our clinicians do individually,” said Begnaud. “And, if needed, we’ll do remediation training with individual clinicians on, say, a certain subset of questions that they may be having trouble understanding.”

Volume boosts

The company’s investment over the past two years in refining its education programs for clinicians has not only improved patient outcomes, it has also positively impacted the reputation the company has built for itself, according to Myers.

The success from the company’s star ratings “come at a cost,” he explained.

“The amount of dollars that go to direct patient care for LHC is higher than our peer group, and the administrative cost in LHC is lower,” said Meyers. “But the way it’s benefited us is our volume of referrals has grown and also our pipeline of hospital and health system partners that have been coming to us.”

These hospital and health system partnerships in the pipeline are due to the company’s long-standing relationships with hospital joint ventures, as well as the group’s quality outcomes, Meyers explained.

“We’re able to grow the company in revenue even though our margin as a percentage of revenue might be lower, our volume is improving the bottom line,” said Myers.

Thinking forward

For Myers, resting on the laurels of their recent CMS star-ratings success is no option. Looking ahead, the company aims to foster its relationship with managed care companies and value-based purchasing models, he explained.

“LHC and the industry at large have enormous potential to bend the cost curve by caring for patients in the home setting, as opposed to more costly inpatient alternatives,” said Myers. “Not every patient can be cared for at home but a very significant percentage of those in inpatient settings today could be cared for at home.”

The barrier to this scenario is reimbursement, particularly as managed care companies can be prone to reimburse home health operators for a low cost, explained Myers.

“There’s a huge opportunity to care for more of those patients and deliver value, but we have to find a way to prove that value and get paid fairly for it,” said Myers. “And if we do, there’s just this real win-win opportunity in all value-based purchasing models.”

Begnaud also mentioned that the company is working to improve the ratings for its other service lines, including hospice, and making sure that they are in line with their home care outcomes.

Further, LHC rolled out a program this year utilizing nurse practitioners in visiting patients who are not able to see a physician within seven days of being discharged from a hospital, explained Begnaud. This practice is integral, especially considering the acuity of patients in home health care, she said.

“We are getting sicker patients in home [health] care, so we have to make sure that our clinicians are ready to take care of those patients and that we have the care models in place and care coordination for those patients so that we can can continue to have the same, if not better, outcomes, quality-wise,” said Begnaud.

Written by Carlo Calma

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