As the home health environment shifts toward value-based care, and Medicare Advantage enrollment rises among Medicare beneficiaries, so too does the importance of technology that can help in-home care providers adapt to this new landscape.
Yet technologies that simply serve a function, or even several functions, will be hard pressed to assist their users effectively unless they integrate with others — just as the health care settings that support each patient will be forced to operate in concert with one another.
“The ease of data flowing between systems and the need for different applications to house different key pieces of data for any provider is paramount and fundamental,” says Neil Grunberg, cofounder and vice-president of strategy and corporate development for Toronto, Canada-based AlayaCare.
Creating a space for interoperability
Data lies at the core of integrated care, as many players within a health network, or players among several health networks must communicate patient information including conditions, plans of care, and health record contents. This is true within Medicare Advantage networks, but also across non-MA networks that are facing rewards and penalties based on the outcomes they deliver.
As a result, technology platforms are making way for other platforms to integrate with them, allowing users to customize their approach.
“When we started AlayaCare, we knew we’d be hard pressed to find 10 providers that have the same ecosystem in place and wouldn’t want us to fill certain gaps only,” Grunberg says.
By offering a host of APIs — or application program interfaces — the platform, which hosts clinical and non-clinical data, as well as back-office functions, telehealth, a family communication portal and more, integrates with many other technology providers, such as electronic health records (EHRs), payment gateways, electronic billing, revenue cycle management and others.
“It could be anywhere from two to 20 technologies depending on the organization,” Grunberg says. “Human resources, applicant tracking, payroll application, billing and general ledger comprise the traditional layers regardless of ecosystem and regardless of vertical.”
The future of integrated care and technology
Enrollment in Medicare Advantage (MA) has nearly doubled over the past decade, according to the Kaiser Family Foundation, and as of 2019, roughly one third of all Medicare beneficiaries, or 22 million individuals, were enrolled in MA plans.
In some states, enrollment is even higher; for example in Oregon, Florida, Minnesota, Wisconsin and Pennsylvania, the proportion is more than 40%.
As more individuals opt into MA plans and care becomes more integrated, home health and in-home care providers will need to adopt platforms that allow them to eliminate data entry and focus on patient outcomes.
“By moving data between all the systems, they can focus more on operational excellence,” Grunberg says. “You could do it manually, but it’s prone to error and takes a massive amount of time.”
Further, with rising pockets of Medicare Advantage enrollees, providers will need to focus their efforts on delivering outcomes in those growth areas.
“For providers to hone their care and race to find the pockets of MA clients, they will need to find those pockets, address them, provide tremendous service and report on it,” Grunberg says. “If interdisciplinary care is required, the ability to manage it becomes really powerful. Being able to move the data into the interdisciplinary side of things is becoming really exciting.”
Visit AlayaCare at this year’s Home Care Association of America (HCAOA) conference, taking place from September 22-23 at the JW Marriott Tucson Starr Pass Resort in Tucson, Arizona. AlayaCare is title sponsor of the HCAOA’s Technology Showcase, which will explore how technology is impacting the home care industry and advancing how seniors receive care at home.