Staying Ahead Of The Curve: Clinical Investment Strategies At AccentCare, VNS Health

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After the implementation of the Patient-Driven Groupings Model (PDGM), many home health providers began adjusting their clinical strategies.

One strategy, for instance, was a larger focus on wound care programs. During the worst parts of the pandemic, many providers similarly invested in respiratory programs to care for highly complex COVID-19 patients.

Today, home health providers like AccentCare and VNS Health are doubling down on those investments. They are also implementing behavioral health services business lines and using technology to augment care.


“When we really peel back the onion, there’s an incredible amount of clinical expertise that exists in the home health, hospice and palliative industry,” Tim Ashe, chief clinical officer at WellSky, told Home Health Care News. “Alongside the progression of evidence-based care are investments in technology, clinical decision-making tools and predictive analytics that really leverage and support the clinician.”

The Overland Park, Kansas-based WellSky is a post-acute technology company that uses software and analytics to help providers achieve better outcomes.

The clinical investments being made today may not look exactly the same as they did two or three years ago, Ashe said, but the end goal is still the same: to stay ahead of the curve.


“It may not look like we’re building expertise around a specific disease state,” Ashe said. “It’s going to look more like we’re making investments in clinical decision tools and support tools to make sure that, from a population standpoint, we get the best clinical decision every single time. Because we’re adding standardization and consistency to support the individual clinicians and the skills that they have.”

Operationalizing clinical excellence

With so many service lines under one roof, AccentCare’s main focus in 2023 has been centered around establishing a care continuum in each of its markets that can drive solid patient outcomes.

The Dallas-based AccentCare is a provider of home health, hospice, palliative care and care management services. Dr. Natalie Pagoria, the company’s chief medical officer for home health and innovations, told HHCN that technology has been a large part of recent clinical investments.

“From a home health, palliative and hospice perspective, we’ve been utilizing Medalogix technology to help facilitate the recognition of patients’ needs,” she said. “We view it as a tool to assist. It’s not replacing clinical judgment and clinical expertise. It is really meant to augment, because, ultimately, our clinicians are the experts on their patients and what those patients need. We see some of the technology as having the ability to augment in conjunction with clinical experts to recognize unmet needs and help facilitate access to those needs.”

Medalogix is a predictive analytics company that works with some of the largest players in both home health care and hospice.

AccentCare has also invested heavily in its wound care program, its behavioral health program and its palliative care offerings. Pagoria said the scalability and effectiveness of those programs can all be tied back to investments in technology.

“The buzzwords that I always use are operationalizing clinical excellence,” she said. “That’s where we really doubled down this year – focusing on the foundations, focusing on our core programs and figuring out how to do simple better.”

AccentCare is just one example of a home health provider that’s trying to build out a larger continuum in order to become a one-stop shop of sorts.

Still, successful partnerships — like its recent joint venture with Memorial Hermann, for instance — make achieving better clinical outcomes even more feasible.

“We continue to look to grow and build these truly collaborative relationships that are built on the expertise of the systems, as well our own construction of the post-acute setting,” Pagoria said.

Pushing technology forward

Like AccentCare, VNS Health is committed to new technology investments and leaning on evidence-based practices to shepherd in a new era of clinical excellence.

“Our care management organization uses a system which helps us drive clinical outcomes, and it’s all based on evidence-based best practices,” Andria Castellanos, EVP and chief of provider services with VNS Health, told HHCN. “We use business intelligence and analytics — which were a very big source of our investments in the past — to help us risk stratify patients.”

New York-based VNS Health is one of the largest nonprofit home-based care organizations in the U.S. It offers home health, hospice, palliative care and mental health support services, among others.

When envisioning the future of its clinical capabilities, Castellanos rattled off a number of tech advancements that will theoretically help improve outcomes: virtual and telemedicine visits, alert management systems, interactive voice response systems, remote patient monitoring, secure messaging to patients and other tools built for clinicians to make their work more streamlined.

One of the most successful examples is in VNS Health’s wound care program.

In 2021, VNS Health decided to revise its wound management program. After self-evaluating, the company invested in a product that uses AI technology to measure and monitor wound pressure injuries.

“Approximately 36% of our patients have some form of wound,” Tony Dawson, SVP and chief quality officer for provider services at VNS Health, told HHCN. “Of the wounds that we do see, approximately 58% of them have one wound and 41% have more than one or two. The new AI technology allows us to automatically capture the length, width and surface area accurately. We used to literally use a tape measure. Now we use an app on a nurse’s phone. It allows us to have sound clinical judgment and comprehensive assessment of the patient’s wound.”

The technology was rolled out in November 2022. As of January, VNS Health had captured over 4,000 images and Dawson said it has “revolutionized” the way it offers wound care.

“It also allows us to have improved communication and contact with our physician team so that the physician can see what’s actually happening in the home with our patients in real-time,” Dawson said.

The innovations happening in home health on the clinical side are a far cry from 20 years ago.

“Dating back to my early days in the industry around 2000, some organizations made decisions based on the availability of resources,” Ashe said. “Fast forward to now, it’s almost a given that these wound care programs go in line with these highly-acute comorbid patient populations and that they’re almost a must.”

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