UW Health’s Home Health Arm Is Addressing Reimbursement Challenges With Optimism

For many in the home health industry, constant reimbursement hurdles can be overwhelming.

But for small agencies, reimbursement challenges can also be a further push to evolve operations.

“I love the care that we provide in our community, and I see it making a difference in the lives of our patients,” Tonya Gray, the director of home health and home care services at UW Health in northern Illinois, told Home Health Care News. “We have an aging population that is not going away; it is going to expand, that’s for sure. And I love that I’m right in the middle of it.”


UW Health in northern Illinois has a hospital-based program offering services including skilled intermittent home health, home care and home infusion to people in Illinois.

Despite some of the reimbursement struggles that may exist for a smaller agency — this UW Health home health program has just under 100 employees — Gray said there is reason to still be optimistic.

One of the reasons why Gray is so optimistic is because of where she works. Her organization has created a one-stop shop for senior care, in essence.


“I love the fact that we’re hospital-based and we can continue with that continuum of care on the post-acute side,” Gray said. “The patient gets to have their entire experience with UW Health. From the clinic side, after they’re discharged, they come to us, and I love being part of that continuum of care.”

So many providers and other home-based care companies are figuring out their own way to become a one-stop shop.

Investors are paying attention to those shops, too.

In UW Health’s case, the long-term viability of the strategy will come down to minimizing costs and becoming a more efficient business.

“You’re always going to have to face that challenge of not having enough reimbursement to cover your expenses,” Gray said. “So you have to be creative and find ways to minimize your costs and to be more efficient in the workplace.”

Today, staffing continues to be a hurdle that Gray is focused on.

“That is the one that can keep you up at night,” she said. “I have more referrals than I can accommodate, and that bothers me that I have to turn some down due to staffing.”

Gray and her team are trying different ways to get more nurses in the door. From old-school approaches like on-the-spot hiring events to new-school strategies like lucrative signing bonuses, the provider is trying a little bit of everything.

“We did a hiring event just this morning in Rockford and made four offers today,” Gray said. “I’m very optimistic about that and I love that approach. It’s quite different from how we normally recruit here. We also have a $15,000 sign-on bonus that we offer our full-time RNs. In my opinion, we have a very lucrative benefits package. We offer tuition reimbursement, we have an on-campus daycare. These are just some of the things we offer and our HR team does a great job in making sure our pay rates are comparable to what’s being offered in our market area.”

As some of the reimbursement models shift to value-based purchasing, Gray said that being part of a health system is an advantage.

“Most of our quality indicators are based around value-based purchasing,” Gray said. “Our health system has a system-wide readmissions team and home health is part of that. We have a seat at the table so that we can look at our readmission rates and make sure we have measures put in place to prevent a rehospitalization.”

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