Hitting the Books: How Institution-Based Home Health Providers Leverage Their Academic Ties

Academic institutions often have reputations as being enclaves of innovation. And for home health providers that operate as part of university-affiliated health systems, the proximity to their respective institutions can mean greater access to resources.

“We definitely have access to great minds, great research and expertise,” Kellie Brockman, director of business development at Duke HomeCare & Hospice, told Home Health Care News.

Duke HomeCare & Hospice is a provider that operates under Duke Health, a combination of the Duke University School of Medicine, Duke-NUS Medical School, Duke University School of Nursing and Duke University Health System. Duke HomeCare & Hospice’s service lines include home health, home infusion and hospice.

Another major benefit of being part of a university-affiliated health system is being on the front lines of cutting edge research.

“Being a part of an academic medical center, we also get involved in some of the research,” Paula Thomas, president of University of Pittsburgh Medical Center (UPMC) Home Health and Hospice, told HHCN. “We are the recipients of some of the best practices that result from that research — helping to improve care.”

Pittsburgh-based UPMC Home Health and Hospice operates seven home health agencies, six hospice agencies and three private-duty agencies across 40 counties within Pennsylvania.

UPMC Home Health and Hospice was recently able to capitalize on its ties to an academic institution when a researcher came to interview its staff for a project. The provider’s staff got to learn from the researcher, while the researcher got to learn from practicing clinicians.

“We had one of the [University of Pittsburgh] researchers come in and talk about dementia and obesity, and the challenges when it comes to home- and community-based services,” Thomas said. “While he is working on a grant to study this, he gets valuable information from our people who are hands-on. It also helps us bring evidence to the issues that are out there and that we are challenged with.”

Though access to academic research is easily the most obvious benefit of university-affiliated home health providers, the synergistic opportunities don’t end there, according to Brockman.

“Having primary care offices, as well hospital-based clinics under Duke Health, these are all settings that we can extend that care beyond,” she said. “Our home health [organization] becomes an extension of that. Within the Duke University health system, we then have a full complement of services, and we can help a patient in a variety of ways.”

At Duke HomeCare & Hospice, being part of the larger Duke Health system allows them to assess the best approaches to care more closely. It also helps the provider leverage alternative care options when necessary, according to Brockman.

Along the same lines, Indiana University (IU) Health’s home health division is able to work easily with the organization’s hospital physicians.

“When our physicians are making a referral, they are probably more comfortable agreeing to have a patient treated in their home,” Scott Brenton, vice president of ambulatory services at IU Health, told HHCN.

IU Health is comprised of 16 hospitals throughout Indiana. The organization’s home care division offers home health, hospice, home enteral nutrition, sleep diagnosis, respiratory medicine and more.

Brenton oversees home health, hospice and lifeline critical-care transport services at IU Health.

While being a university-affiliated health system makes the referral process more seamless, Brenton is quick to point out that the connection isn’t an automatic referral boost.

“The referral process from IU Health is the same if you’re an outside provider or if you are IU Health’s home health,” he said. “All of the patients are offered a choice, in accordance with [Centers for Medicare & Medicaid] guidelines.”

That said, Brenton believes that the home health divisions’ electronic medical records (EMR) enjoy more interoperability with IU Health hospitals than an outside party.

One crucial benefit home health providers within university-affiliated health systems can have is financial security, according to Brenton.

In the wake of the Patient-Driven Groupings Model (PDGM), many home health providers had to contend with the potential cash-flow issues that could occur due to a number of changes related to the new model.

PDGM changes haven’t had quite the same impact on IU Health’s home health division, for example, as it may have on a stand-alone agency, according to Brenton.

“Because we are a large academic health system, we can lean on the health systems balance sheet when experiencing transitions like PDGM,” he said.

Likewise, Duke HomeCare & Hospice, has been able to lean on Duke Health post-PDGM, according to Brockman.

“We still need to produce results, as Duke HomeCare & Hospice, but we do have the support of the health system,” she said.

Additionally, in light of the COVID-19 outbreak, Duke HomeCare & Hospice has been able to collaborate with experts within its larger health system on the best plan forward.

“I find that to be a tremendous advantage over singular entities,” she said. “We bring the perspective of the community, and they bring the hospital perspective.”