Aegis, Fox Rehabilitation See Increased Demand for In-Home Therapy Services

In-home therapy services was a big topic going into 2020, the first year of the Patient-Driven Groupings Model (PDGM). It remained an important issue in 2021, with some therapy providers seeing more demand for their services during the COVID-19 pandemic.

It’s in this environment that therapy contractor Aegis Therapies saw an opportunity. In fact, Aegis has seen its volumes now surpass pre-COVID levels.

“This is largely due to two factors: more patients being referred for care in the home versus SNFs [skilled nursing facilities] and the types of patients being admitted with more needs for therapy services,” Mark Besch, the chief clinical officer at Aegis, told Home Health Care News.

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Frisco, Texas-based Aegis is one of the largest providers of contract rehabilitation and wellness services in the U.S. The company has more than 1,400 locations across 41 states, and it partners with more than 150 home health providers.

When it comes to providing therapy, Aegis takes a comprehensive approach to care.

“A patient may have low physical therapy needs but high occupational therapy needs, for example, so it’s really important to look at a patient from a comprehensive care plan perspective,” Dawn Greaves, vice president of home services at Aegis, told HHCN. “[We] look at it from the perspective of what’s the highest priority that we need to first address to keep this patient safe and independent at home.”

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While there were early concerns about therapy utilization decreasing under PDGM, previous data suggests that the overall numbers did not see a dramatic dropoff in 2020.

Instead, the percentage of therapy visits compared to overall visits jumped from 45.9% to 46.8%. Additionally, therapy visits per episode saw a slight increase, according to data from BlackTree Healthcare Consulting.

One likely reason for this is simple: physical and occupational therapy are connected to positive impacts on patients in post-acute care settings.

Specifically, physical and occupational therapy is associated with greater increases in patient function and reductions in hospital readmission, according to a recent study from the American Occupational Therapy Association and the American Physical Therapy Association.

The study also suggests that home health patients benefit from increases in therapy across varying lengths of stay.

Fox Rehabilitation — a therapy provider that specializes in “geriatric house calls” — has found that working in the home has achieved the best outcomes for patients.

Fox Rehabilitation has seen a 36% functional scale improvement in patients and a 97% patient satisfaction rating, according to Dr. Robyn Kjar, CEO of Fox Rehabilitation.

“What better place to teach and train an older adult than in the home in which they reside,” Kjar told HHCN. “It’s wonderful when you’re able to enter an older adult’s home and actually see the challenges and the barriers that they have. It can be as little as a throw rug that needs to be moved, or the fact that they can’t get their walker in the bathroom, which causes a major safety issue for them in the middle of the night.”

Likewise, Greaves believes that working in the home allows them to use the environment to their patient’s advantage.

“As we’re providing that skilled intervention, we can also instruct them to continue these activities on their own, giving them examples for how they can incorporate that into their normal routine,” she said.

Fox Rehabilitation offers home-based physical therapy, occupational therapy, and speech-language pathology for seniors. The company operates across 21 states.

Overall, Fox Rehabilitation has seen the demand for services increase. The company has experienced a 15% increase in patient volume.

Ultimately, Kjar believes that the company’s business model of providing “house calls” ultimately increases access to care.

“If the therapist says you need to be seen three days a week — the onus is on the clinician to be there and it takes a lot of the pressure of travel and accessibility of off the family and patient,” she said.

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