Last year, the Community Health Accreditation Partner (CHAP) received part of a $2.3 million grant from The John A. Hartford Foundation (JAHF) to bring the Age-Friendly Health Systems movement to home-based care.
Almost a year later, home health providers have implemented the framework – including Enhabit Inc. (NYSE: EHAB) and Compassus – and are seeing it as a potential differentiator moving forward.
“It’s competition in a way that makes everybody better,” Bud Langham, the EVP of clinical excellence and strategy at Enhabit, told Home Health Care News. “You can see that in the Age-Friendly Health Systems, there’s thousands of organizations who’ve already gone through a similar process on the inpatient side. You don’t want to be that one system in a marketplace that hasn’t been certified age-friendly. My hope is every single market where we achieve this certification, it raises the bar so that everybody has to step up.”
Based in Dallas, Enhabit provides home health and hospice services across 252 home health locations and 105 hospice locations in 34 states.
The age-friendly framework is supposed to elevate care for patients, but in a way that also benefits their families, referral sources and payers. It concentrates on “what matters”, medication, mentation and mobility – the “four Ms.”
As more care is moved to the home, age-friendly advocates – namely CHAP – believe this is a way to elevate the industry as it gains a brighter spotlight. Beginning in April, home health providers across the country have had the option to achieve a certification for Age-Friendly Care at Home.
“The only way we can really move the needle on outcomes is through patient involvement,” CHAP COO Teresa Harbour told HHCN. “And this is exactly what care this does, it gets that patient involved in their care. This is a perfect opportunity for organizations to provide that staff education on how to engage patients in their care and how to talk to them and determine what matters to them.”
A value-based care driver
Providing care in line with a patient’s goals was always sensical. But, the four Ms around Age-Friendly Care at Home fit in perfectly with the Home Health Value-Based Purchasing (HHVBP) Model as well.
Part of the calculation behind HHVBP is patient satisfaction scores. If patients are receiving care that they believe is specifically tailored toward them, providers are much more likely to receive high scores from those patients.
“This actually is in alignment both for HHVBP and for hospice with VBID,” Jennifer Hale, the VP of clinical quality and standards at Compassus, told HHCN. “When we’re talking about what payers want, payers want the same things generally that patients want. They want care that is consistent with the wishes of the patient, they want care that is not cost prohibitive, and they want consistency of outcomes. This approach establishes the framework and the runway to do that.”
The Brentwood, Tennessee-based Compassus provides home health care, infusion therapy, palliative care and hospice care services through 200 locations across 30 states.
Both Compassus and Enhabit participated in a age-friendly pilot program recently after CHAP approached them about the program. Each will continue to abide by the framework moving forward.
Hale added that she “absolutely” thinks this could be a differentiator for both home health and hospice providers.
Meanwhile, Langham also sees the age-friendly framework as fitting perfectly alongside HHVBP and other value-based care incentives.
“In HHVBP, we’re going to be measured on how much we help patients improve,” he said. “Two huge parts of that are hospitalization rates and the patient experience. The evidence from the Age-Friendly Health Systems program shows that they lower the overall total cost of care and it improves hospitalization rates.”
Langham also said it’s a way for the patients to see that Enhabit is there for them, listening to them and building a care plan that is centered around them.
“That will help with their experience, their journeys,” he continued. “About 50% of HHVBP is experienced in hospitalizations and claims-based measures. And so it will help us, it’ll create a tailwind for organizations to step up and do the rigorous work to get certified.”
Enhabit and Compassus are two very large organizations. The age-friendly framework allows their leaders a path to further standardize care across locations.
Doing so allows them to contract nationally with other health plans – outside of Medicare fee for service – in a more promising way. It allows them to come to the table with a nationwide roadmap behind them.
“I just think about how many patient lives are going to be impacted by this,” Harbour said. “There’s so many patients and families that are truly going to feel a difference in the care that they receive. That’s the feedback that we’re already hearing from Compassus and Enhabit.”
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