This article is sponsored by CareXM. In this Voices Interview, Home Health Care News sits down with Ellen Kuebrich, Chief Growth Officer of CareXM, to talk about solving for staffing while lowering operational costs. She shares a perspective on the current landscape of home-based care and where it’s headed, and she also discusses the strategic modeling that has helped some of the top HHH agencies in the US operate more efficiently.
Home Health Care News: What career experiences do you most draw from in your role today?
Ellen Kuebrich: For over 15 years, I have been immersed in post-acute care, consistently using enterprise-level cloud-based solutions with the ultimate goal of improving patient and resident outcomes. What strikes me most in my current role is the need for provider partners to proactively grasp the intricacies of today’s health care landscape. It is far from a simple transactional process, nor should it be treated as such.
Our aim is to establish authentic partnerships by championing the industry in legislative arenas, understanding policies and reimbursement systems that providers have to navigate, and actively collaborating with them. My most rewarding experiences have always originated from advocating for and collaborating with health care providers, offering genuine solutions that improve patient and resident outcomes.
What is your perspective on the current landscape of home-based care?
As the aging population of baby boomers continues to grow, there is a clear trend of individuals desiring to age in their own homes. Approximately 9 out of 10 baby boomers express this preference. However, this desire for home-based care coincides with a shrinking health care workforce and projected declining birth rates in the future. This combination poses a significant challenge, as the available labor force will struggle to meet the demands of the increasing aging population.
In our ongoing discussions with clients and prospects, we address the pressing issue of labor and staffing shortages. Home health agencies face mounting difficulties in adequately staffing their operations. The cost per visit in the field continues to rise, and the competition for resources among these companies is intense. From my perspective, the labor market will remain highly competitive and challenging for the foreseeable future.
The prevailing belief in the industry is that deploying technology is essential to generate efficiencies that were previously unattainable, providing some relief for our teams. While this is undoubtedly true, we must also ensure that these technologies are user-friendly, minimize nurse burnout, reduce administrative burdens and offer intuitive decision support. It is crucial that these solutions do not become cumbersome, but rather enhance the overall caregiving experience.
Tell us about the CareXM offering and what it solves.
CareXM is a triage technology that bolsters the capabilities of internal care teams. We revolutionize triage in two key ways. First, we introduce technology into the process. Traditionally, patient calls are handled either by an internal team or outsourced to nonclinical medical answering services or a group of nurses. What we do differently is incorporate smart routing technology, supported by our team of nurses. This enables companies to operate with a leaner triage team while ensuring competent backup for their internal team during calls or visits. Our approach allows companies to optimize the capacity of their internal nurses without overwhelming them.
The second aspect where CareXM transforms triage is through proactive triage. In contrast to reactive triage, where we respond to incoming patient calls, our technology integration provides valuable data on call frequency, patterns and reasons. With this information, we can proactively address potential issues. For example, if we observe a significant number of weekend calls for medication refills, we can use an automated patient engagement solution to communicate with the patient population in advance. This could involve sending voice messages or text reminders on Thursdays, asking if they require any medication refills before the weekend.
Although the actual task of refilling medications still falls on the provider, we strategically shift the interaction to a fully staffed Thursday, instead of relying on a skeleton crew on Saturdays. This approach helps us maintain cost efficiency and reduce hard dollar costs. Additionally, we work collaboratively with our partners to decrease incoming call volumes, further driving cost reduction.
You work with seven of the top HHH agencies in the US — what have you seen work from a strategic modeling perspective?
We collaborate with large agencies in various ways, offering flexible technology solutions tailored to their needs. Some agencies prefer to fully staff their own triage center, utilizing our technology solely for their internal triage function. On the other hand, there are agencies that entrust us to handle 100% of the calls, particularly those they prefer not to handle themselves. We excel in taking on these calls that agencies may not want to handle directly. Our strategic model is a “smart hybrid approach, which results in cost reduction and improved outcomes.
Our technology operates by initially routing a patient’s call to a small centralized client team. The technology instantly identifies team members’ availability and selects the first available person. If no one is available within the client team, the call is seamlessly directed to our team. This process ensures that patients promptly connect with a nurse when they require assistance, ensuring first-call resolution.
Another advantage of integrating technology is the ability to redirect non-urgent calls to a non-clinical team, which is more cost-effective to handle. By filtering out the non-clinical call volume, nurses only receive relevant and critical calls, optimizing their time and resources.
During weekends and evenings, all calls are routed to us, enabling the agency’s nurses to truly clock out and take a break. This approach allows agencies to utilize their staff up to their maximum capacity without exceeding it. They maintain confidence that their patients are reaching the appropriate professionals at the right time to receive the necessary help. Consequently, this smart hybrid model dramatically reduces costs by eliminating the need to engage an agency for 100% of their call volume.
Share some of CareXM and its partners’ outcomes.
The outcomes we achieve, as well as those of our partners, are interconnected and yield significant improvements across multiple areas. First, we consistently achieve a dramatic 20% reduction in the cost of the triage function within organizations. This reduction is partly due to the proactive triage approach, which leads to a decrease in patient calls by up to 50%. Fewer incoming calls allow nurses to focus on critical care, enabling them to practice at the top of their license. This, in turn, increases nurse satisfaction and has been shown to decrease nurse turnover by 18%.
The benefits extend to the patient experience as well. With our technology integration, patients are seamlessly connected to nurses when they need assistance. This seamless connection, coupled with the reduced wait times resulting from proactive triage, contributes to impressive patient outcomes. We have achieved a 15% reduction in readmissions, as patients who can readily access a nurse for triage and assistance are less likely to seek unnecessary emergency room visits. By effectively reducing readmissions, we improve patient outcomes.
Further, patient satisfaction is significantly enhanced. As we delve into value-based care, two vital components come into play — readmission rates and HHCAHPS rates. The HHCAHPS questionnaire, which focuses on communication between providers and patients and the ease of accessing necessary care, aligns with our solution. By enabling patients to easily access the care they require at the right time, we contribute to higher levels of patient satisfaction.
Where do you see home care going in the next five years?
I think we will continue to face limitations in the health care industry. However, these constraints can foster innovation. Health care providers will likely reassess their care delivery approaches and seek innovative solutions. Government funding is expected to support this innovation, as we have already witnessed in the realm of value-based care. Additionally, providers will need to be creative in addressing staffing challenges. The labor constraint is unlikely to subside, and ongoing workforce management initiatives will be a necessity for the foreseeable future, particularly in the next five years.
This is an opportune time to explore innovative staffing strategies and determine how nurses and teams can best use their time. For instance, our patient engagement platform offers automation for scheduling and appointment reminders. Some companies use it for tuck-in calls. By considering where our teams should focus their efforts, we can identify areas suitable for automation or technological support, freeing up nurses to concentrate on more critical tasks.
In the next five years, I believe we’ll also see a significant shift in perspective on care delivery, driven by the focus on value. We will witness a transition from volume-based reimbursement to value-based purchasing, which we’ve already seen with notable payers like Optum’s bid on Amedisys and their acquisition of LHC, as well as the involvement of United and Humana, all of which operate within the value-based care framework. This trend emphasizes the importance of delivering value and ensuring patients receive the desired outcomes.
Further, we can expect a growing emphasis on whole-person care. Instead of treating individual conditions in isolation, health care providers will adopt a holistic approach, considering the overall well-being of the person. This shift recognizes the significance of preventive care in extending both the length and quality of life.
In a couple of words, finish this sentence: “In 2023, the home-based care industry has been defined by…”
…the shift to value-based care.
Editor’s Note
CareXM is a leading healthcare technology provider, partnering with seven of the top ten home health and hospice agencies to deliver innovative solutions that extend the capabilities of care teams. Our patient engagement platform and 24/7 on-demand triage service is a game-changing solution that reduces nurse burden, drives down costs, and improves patient satisfaction. To learn more, visit www.carexm.com
The Voices Series is a sponsored content program featuring leading executives discussing trends, topics and more shaping their industry in a question-and-answer format. For more information on Voices, please contact [email protected].