Value-based care. It seems to be the phrase on everyone’s lips these days.
Still, many homecare providers aren’t exactly sure what value-based care means, or why it’s important.
Centers for Medicare and Medicaid Services (CMS) defines value-based care as paying for health care services in a manner that directly links performance to cost, quality, and the patient’s experience of care.
Unlike a fee-for-service approach, in which providers are paid based on the amount of homecare services delivered, value-based care models reward providers for the quality of care delivered – for helping patients to improve their health, reduce the impact of chronic disease, and live healthier lives in an evidence-based way.
A Different Mentality
The healthcare industry is moving from a fee-for-service model to a value-based approach, which means payers like states and managed care organizations (MCOs) are shifting their focus away from the quantity of services delivered to the quality of care provided.
First and foremost, states and MCOs want to ensure that their managed populations are healthy enough to stay in their homes (and out of the hospital). Therefore, agencies that are reducing hospital readmissions and preventing unnecessary hospitalizations are preferred.
As an agency owner, you might now be wondering:
- How can I improve patient outcomes?
- How do I prove my agency’s value to payers?
Depending on your approach, the answers might not be as complex as you think.
Homecare aides are key to driving value-based care.
One of the most untapped sources of driving value-based care is your caregivers. Agencies must not dismiss the role their homecare aides can play in building their value.
Remember: your caregivers are your eyes and ears, your windows into your patients’ health and the state of their homes. Empower your aides by teaching them what to look out for and the right questions to ask.
An ideal place to start is with the early warning documentation tool known as STOP and WATCH.
Developed by INTERACT® (Interventions to Reduce Acute Care Transfers), STOP and WATCH is a vertical acronym that lists conditions that can assist in early identification of patient changes and reduce the risk of potentially avoidable hospitalizations.
Once a caregiver observes a change in patient condition, they simplify fill out the STOP and WATCH form and promptly submit it to a licensed nurse or supervisor, who will then evaluate the patient and determine the necessary course of action.
Technology can also aid in streamlining patient observations and reporting procedures. For example, HHAeXchange offers a caregiver mobile app that automatically prompts aides at the time of clock-out with pre-defined questions regarding the patient’s condition. Caregivers can also add non-diagnosis-related observations in order to track changes such as a patient running low on medication or a malfunctioning medical device. Your agency will be notified immediately of negative changes in a patient’s health based on an aide’s response or observation, so you can take action right away.
Know your Quality Metrics
Delivering optimal care and improving patient outcomes are your top goals as a homecare provider. However, if MCOs are not made aware of your agency’s strengths, then you won’t be recognized (i.e., paid) for the value you’re bringing.
A simple way to think about the metrics you should provide in order to demonstrate value is to put yourself in the payer’s shoes: If you are looking for homecare agencies that you can trust, what would you want to see?
To stand out to MCOs, homecare providers should measure the following criteria:
- Hospital readmission rates
- Completion of scheduled visits
- Adherence to plans of care
- Hours delivered
- Billing accuracy
For agencies that are heavily reliant on manual processes to run their business, measuring this data could be a challenge. After all, managing an agency is hard enough, and the hours it would take to compile these metrics would be prohibitive.
Fortunately, technology can help agencies automatically track their quality metrics, improve patient outcomes, and optimize their overall business functions. The better your data and the better your grip on patient outcomes, the more opportunities you have to show your value to states and MCOs.
The Big Picture
When applied effectively, value-based care approaches benefit not only payers and providers, but the entire homecare ecosystem.
Value-based care models make patient outcomes a priority, and thus they increase accountability on the part of homecare providers, doctors, hospitals, and health systems. When providers get paid for helping patients stay healthy and out of the hospital, everyone wins.
To learn more about how HHAeXchange can help your agency deliver and demonstrate value-based care, schedule a demo.