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Personal home care and home health care are both branches connected to the post-acute care family tree. As such, home care leaders believe that there are numerous ways that their organizations can help alleviate home health provider pain points.
One major pain point that can be seen across home health care are referral rejection rates. Last year, the industry had a 76% referral rejection rate, compared to 54% in 2019, according to data from WellSky.
Jeff Bevis, chief operating officer at Caring Senior Service, sees home care as a natural ally for home health providers that are struggling in this area.
“It’s been a matter of time [that we] partner with them,” he told Home Health Care News. “[One way we do] is by trying to limit the hours, or the time, that the home health nurse is spending with their client. In other words, when the home health nurse is with a client for 15, 30 or even 60 minutes, home care workers can pick up more of the non-medical client needs to keep them happy and healthy in the home.”
The San Antonio, Texas-based home care franchise company Caring Senior Service has roughly 50 locations across nearly 20 states.
Bevis noted that this kind of arrangement gets to the heart of the referral rejection rate problem. It allows the home health agency to take on more referrals without making new hires or having to stretch their existing employees.
Currently, Caring Senior Service is collaborating with two home health agencies in rural Illinois to help lift the burden on these providers.
“We assigned a care manager to each of those home health agencies, and they’re meeting with those agencies once a week to talk through the patients that are most in need of non-medical home care activities and services, in order to reduce the amount of time and pressure on the home health agency,” Bevis said. “It lets us pick up a larger part of that slack for them, and makes more efficient use of their home health nurses.”
On its end, partnering with home health providers has been a referral boon for Caring Senior Service.
“It’s reinforcing existing referrals,” Bevis said. “In some cases, it’s in strengthening new or early referral source relationships.”
Griswold CEO Michael Slupecki pointed out that home health bonuses and penalties are tied to areas that fall under home care’s direct purview.
“The OASIS-based measures all center around the ability to self-care — from grooming, dressing, bathing, toileting and eating — all things that we address with the home care model,” he told HHCN.
The Blue Bell, Pennsylvania-based Griswold is also a home care franchise. It provides personal care services via more than 170 locations in 30 states.
At Griswold, helping prevent hospital admissions is the main area of focus when it comes to partnerships with home health providers.
“We have tremendous ability, in a non-medical way, to help prevent admissions,” Slupecki said. “We can ensure that the home is a safe environment, we can assist in transfer. On the heart failure side, just monitoring weight gain or loss. On the UTI side, which is a big reason for admissions, just monitoring the frequency of urination. Home health is designed to be curative, where we view our services more on the wellness side.”
Right now, Griswold is partnering with a national home health provider through its company-owned locations.
“The way we talk to them is by having them introduce us to their clients,” Slupecki said. “We’re going to help them on their scores, because they’re impacted by client satisfaction scores. They’re impacted by acute care hospitalizations or ER visits. We feel like we can be the eyes and the ears.”
‘Boots on the ground’
Synergy HomeCare is no stranger to partnering with home health agencies.
In 2021, the company teamed up with Compassus in a deal that offered both companies’ clients access to each other’s services.
“We were focused on care coordination, and just ensuring that all of the patient’s needs were being addressed holistically between our two organizations,” Rich Paul, chief partnership officer at Synergy, told HHCN. “There was also a cross-referral relationship, so that as the acuity of our client increased, we could refer them to hospice care, and provide wraparound home care services as needed, and vice versa.”
Synergy is a Gilbert, Arizona-based non-medical home care franchise that operates more than 400 franchise locations nationwide. The company offers companionship services, in addition to personal assistance, housekeeping, live-in care and 24-hour home care services.
The company still sees significant value in these kinds of collaborations.
“Home care rounds out that continuum of care very nicely,” Paul said. “We are kind of the boots on the ground that are in the home for extended periods of time. I think because of that, we can be a good partner for home health providers.”
Moving forward, Synergy is looking to form more partnerships with home health providers at both the local and national level.
Paul believes that there needs to be more partnerships between home health and home care providers, but payer challenges are still a hindering factor.
“I think the greatest challenge in creating partnerships between home health and home care is finding a payer source,” he said. “Most of our examples of care collaboration occur with clients receiving Medicare on the home health side, and using private-pay on the home care side. In some cases, there may be a funding source like an ACO, but more often than not, because Medicare does not cover home care, it does become a little more challenging.”