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Home health care has some hardwired challenges. But there are also other challenges that can be overcome, that can be largely erased in the future.
Artificial intelligence’s capabilities, for example, are cause for hope. The same goes for value-based care opportunities.
Unlocking those opportunities is going to take time, effort and focus. Home Health Care News recently sat down with Michael Johnson, the chief researcher for home care innovation at Bayada Home Health Care, to chat about that – and much more.
The conversation is below, edited for length and clarity.
HHCN: What technological advancements do you think will significantly impact home health care in the next decade?
Johnson: AI, bots – anything that helps aggregate and collect data.
There’s so much documentation to justify payments. We spend more time looking at our devices than we do looking in the eyes of our patients. I challenged my team to find technology that lets people spend more time with the patient.
We will create a better client experience, which will satisfy clinicians. If we can get AI to help us decrease the time it takes to get data into the chart and organize it, we can achieve at least two portions of the quadruple aim: better care, lower cost, better patient experience and better clinician experience.
With the shift toward home-based care, how do you envision the role of nurses and home health aides evolving in the coming years?
Studies that talk about the shortage of home health aides, for example, worry me because there’s an opportunity to leverage folks whose education is less than others.
Good home health aides are worth their weight in gold because they know how to get patients to do something they don’t want to do. It’s super important. I would rest on ‘I’m the expert, you must,’ and the patient would say yes and not do it when I left. Home health aides make sure it gets done.
Registered nurses (RNs) do many things that others with less – but adequate – training could do for a lower cost. If every patient we see were the same, we’d need the same level of clinical care. But they’re not.
Let’s think about how we can distribute the workload and ramp up people’s skill sets.
How do you think value-based care models will influence the delivery of home health services?
Suppose we demonstrate that we can save the system money through value-based purchasing. Let’s get some shared savings from that, and then we can pay home health aides a living wage. All of a sudden, you can easily find staff, you’re not dealing with staffing shortages. They’re wholly underpaid for their value, but the system doesn’t and isn’t set up to leverage that value.
Why wait for someone to go to the hospital before they get home health care? Why don’t we identify them early on and reduce hospitalizations, not readmissions? The system doesn’t value that by virtue of how it gets paid.
Medicare is a behemoth; it’s hard for them to move quickly, and they’re so tied into physician and hospital payments. But with some smaller regional payers, we’ve had some luck doing value-based purchasing or value-based contracts with them.
It’s a significant initiative for us, with every single payer, to renegotiate contracts and, wherever possible, insert something more value-based per visit. I think there will be continuing, slow, incremental progress.
In what ways do you believe cultural competency training can benefit home health care organizations and their staff?
When I think about cultural competency, I think about recognizing people for who they are. Treating each other with dignity and respect.
In home care, we’re pretty white; we’re pretty middle class. We’re pretty female. How do we recognize that and make some concerted efforts to increase diversity? With diversity of gender, diversity of race and diversity of thought come better ideas and better solutions. That, to me, is the most significant value.
We’re making every effort to ensure a diverse workforce – that’s job number one. There are some fundamental ways that we should treat each other as human beings, irrespective of race, color or gender. Call it emotional intelligence.
One of the key actions I like under our core value of compassion is working with a spirit of universal faith, hope and love. When I first read it, the word ‘love’ gave me pause. I questioned if we were supposed to use that word. But let’s not be afraid to say that and let’s show love in different ways because that is what demonstrates dignity and respect for one person or the other, irrespective of how similar or how different you are.
Do you think cultural competence does anything to alleviate patient worries or anxieties over having home care?
People feel more comfortable, at least initially, with somebody like them caring for them. It puts people at ease more quickly. The patients need to see themselves in the caregiver. From a patient’s perspective, if you can reduce their anxiety, there are benefits to their healing that are hard to measure.
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