更多的长期和急性后护理正在机构环境之外提供, particularly for seniors and those with chronic conditions. The shift to home-based care will continue to grow long after the pandemic, 随着医疗保健连续体变得更加包括家庭护理bet8娱乐提供商,以帮助控制成本和减少住院. 这种环境为家庭保健机构(HHAs)创造了新的机会,通过支持人口健康和基于价值的护理的创新协作和协调战略来发展和繁荣.
Financial Challenges and Alignment Opportunities
大流行正在使家庭保健bet8娱乐的主要入院来源从机构转诊转向更多的社区转诊, which carry a lower reimbursement rate under the Patient-Driven Groupings Model (PDGM). As a result, 82% of all HHAs have seen revenues decline by 15% to 20%. Prior to the pandemic, it was predicted that PDGM alone would be too burdensome for smaller, cash-strapped HHAs, with some being forced to leave the market. 一旦来自《bet8娱乐》救济资金和工资保护计划(PPP)贷款的生命线消失, 除非卫生保健机构找到维持或增加收入的方法,否则财政挑战将加剧.
以下是hha在“新常态”下应该利用的几个新的收入机会和调整策略.”
Capitalize on the shift to value-based care and population health management.
在医院外提供纵向护理的bet8网站备用正在寻求与家庭保健/家庭护理bet8娱乐提供者合作, through clinically integrated networks (CINs) or other collaborative arrangements, 促进及时转诊,更好地管理慢性病患者. With the pandemic, 大多数负责任的护理组织(ACOs)都在发展他们的家庭护理项目,因为他们担心病人得不到他们需要的预防bet8娱乐,或者当他们有严重问题时没有寻求治疗. While a large portion of that home care is focused on primary care, 门诊bet8网站备用有家访计划的第二个主要原因是支持护理协调工作和从住院环境到家庭的过渡. Organizations participating in the soon-to-be-implemented CMS Innovation Center Direct Contracting Model 作为直接合同实体(dce)也与家庭健康和临终关怀机构合作,以促进更高质量的临终关怀,同时降低总体成本和不必要的ICU使用率.
家庭健康和临终关怀提供者可以很好地将自己融入到ACO中, DCE, or CIN by facilitating timely, seamless admissions into home care services; providing remote patient monitoring; and developing clinical programs that prevent hospital readmissions and unnecessary visits to the ED.
充分利用医疗保险优势(MA)和管理式医疗扩大了覆盖范围.
Under the 2018 Chronic Care Act and with the recent expansion of “Primarily Health Related” supplemental benefits, MA plans are now covering additional in-home services, such as adult day care, caregiver support, palliative care, and home safety devices/modifications. In addition, the MA Value-Based Insurance Design Model (VBID)包括a部分下的临终关怀福利组成部分,将在2021年覆盖206个县. This means home health, hospice, palliative care, 非医疗家庭bet8娱乐提供者有更多的机会与当地社区的MA计划发展关系. 考虑与这些提供商建立网络并保持一致,以便扩展bet8娱乐并利用与这些利益变化相关的新机会. 通过高效和有效地满足这些计划的需求,并展示可衡量的质量和成本节约,专注于为这些计划提供价值.
Become a preferred provider for at-risk arrangements.
Have conversations with risk-bearing IPAs, DCEs, ACOs, 和MA高危项目的提供者成为家庭护理bet8娱乐的首选网络提供者. Align operational processes with high-quality outcomes, and track, collect, 并分享数据,以证明家庭护理bet8娱乐为这些合作伙伴提供的价值. By reducing readmissions, ED visits, and fall rates, and achieving high patient engagement and satisfaction ratings, 家庭护理组织可以支持和改善风险型企业的绩效.
Branch out and develop nontraditional partnerships to facilitate growth.
Engage with external partners or other healthcare providers in the market, 例如家庭初级保健和紧急管理bet8娱乐(EMS)提供者以及大学和技术培训计划, to solve problems and create new, novel solutions in this evolving environment.
- In-Home Primary Care Partnerships: In-home primary care 这些模式往往利用家庭保健和家庭护理提供者的bet8娱乐来照顾弱势群体. Areas of programmatic focus may include chronic disease care, acute care, palliative care, or end-of-life care utilizing physical therapy and skilled nursing services, or assistance with activities of daily living. 与家庭医疗集团的整合是一个更好地协调bet8娱乐的机会, improve communication, and get needed orders for home health coverage.
- EMS Collaboration: Partnerships and collaboration between EMS providers and HHAs also offer an opportunity to fill care gaps and keep people safe in their home. The Association for Home & 北卡罗莱纳临终关怀(AHHC)是一个大力倡导这些类型的互补伙伴关系,以改善健康结果的组织. 通常在急救人员对病人进行评估和治疗后,病人决定不去医院. If there are issues such as frequent falls or complications with diabetes, 护理人员可能需要转介到HHA进行持续的熟练护理或其他个人护理家庭支持bet8娱乐. 与当地紧急医疗bet8娱乐小组建立关系的卫生保健机构和家庭护理提供者将有助于确保患者得到适当和及时的转诊.
- University and Training Partnerships: In order to meet growing census demands, 家庭护理提供者需要加强招募和保留策略,以有效地照顾越来越多的高敏锐度患者和在家接受治疗的合并症患者. Outside of the caregiving space, home care agencies also need support staff such as coders, billing managers, schedulers, and IT experts to run the business. Partner with universities and technical training programs to build curriculums, 并提供临床轮转和实习机会,以创造一个潜在的员工管道,他们在家庭护理的独特方面感到舒适和训练.
An Opportunity to Grow
卫生保健机构有机会使自己成为提供者和患者不可或缺的合作伙伴. With the financial challenges associated with COVID-19, 与此同时,人们加速转向以价值为基础的护理,越来越多的人希望在家接受医疗保健, 现在是家庭护理组织创新和展示其满足bet8网站备用能力的时候了, payer, and consumer needs.
Looking to strengthen and grow in the home care space?
Connect with ECG’s Performance Transformation experts.
Contact UsPublished January 4, 2021