Stanford Health Care Details Its Capacity Constraints, Home Health Issues

Health systems, even after the COVID-19 pandemic, remain overwhelmed. Their discharge partners – such as home health providers – are theoretically supposed to help mitigate the stress they face.

That’s a tall task, however, as home health providers are also overwhelmed. Providers are rejecting referrals at a higher rate than ever.

In an ideal world, however, the home health agencies that best understand their health system partners will be able to better help them.


Last week at Home Care 100 in Scottsdale, Arizona, Dr. Jay Shah, the chief of the medical staff for Stanford Health Care, explained to home health leaders the top priorities of Stanford Health Care after the pandemic.

The No. 1 priority is to “optimize outcomes once the patient has left the hospital.” About 25% to 30% of the patients Shah sees, for instance, end up being readmitted to the hospital. That’s a major problem for the Stanford system, as capacity issues remain acute.

Patients are coming back to the hospital much more within the health system than they used to.


“A half a day length-of-stay reduction for us would be phenomenal,” Shah said. “If we can do that every single day, there’s cancer cases, cardiac cases that we can actually not defer. Imagine telling a patient who has been prepping for weeks or months for that big cancer operation, ‘So sorry, we can’t do your case today.’”

Shah is also a physician, and a cancer surgeon by training.

“I always say, ‘if I’d known [this problem] about four days ago, we could have prevented this ED visit, or that readmission,” he said. “But we don’t have the communication infrastructure right now to hear about it.”

This particular issue is causing health systems tens of millions of dollars, according to Shah.

Patients, instead, are being caught in the middle of “inefficiencies in the system right now.”

“There’s around $7 million in lost revenue, in terms of what this costs us, if we add up all the hours of every provider for every patient that’s sent to home health,” Shah said. “In terms of the administrative overhead, that’s another couple million dollars, and then the billing that we’re not doing for the work that is being done. If you add all of those up, it’s easily over $10 million for one system. And this is not new work that has to get done. This is work that’s being done, and what we’re losing on all this.”

One way to address this problem is to find more, and better, home health partners. On top of that, however, there needs to be better means of communication between both parties.

If that communication improves, both parties stand to benefit. And, of course, the patient stands to benefit, too.

“We can all appreciate that this system is not optimal right now,” Shah said. “Because the providers on the hospital side are busy. The providers on the home care side are busy.”

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