Senior man in wheelchair being pushed by son using face mask at hospital

Home health agencies fared poorly in a new study tying hospital readmissions to post-acute care options. Patients with acute myocardial infarction, heart failure and pneumonia who were released to home health agencies  following a 30-day hospital stay were at greater risk of readmission than patients who were released to skilled nursing facilities or the care of primary care physicians, according to the study by Health Affairs,

A research team combed through data obtained from the Centers for Medicare & Medicaid Services’ Hospital Compare readmission rates from more than 3,000 hospitals between 2013 and 2019. It considered several measures of post-discharge care supply around the area each hospital served. Researchers looked at the number home health agencies, nurse practitioners, primary care physicians, licensed nursing home beds and SNF beds on a per capita basis.

The higher readmission rates among patients who had received home health services may be connected to frequent staffing changes and a discontinuity in care lead author, Kevin Griffith, Ph.D., told McKnight’s Home Care Daily Pulse 

“There is tremendous variation not only in the supply but in the quality,” Griffith explained. “You have more frequent staffing changes … If you have people coming and going, you might not see someone regularly and you might not be sure if what you’re seeing is reason for readmission, but you send them anyway.”

The researchers suggest that hospitals take a more active role in the development of post-discharge care options in their communities or partner with existing service providers to improve continuity of care and clinical outcomes. 

“Having a varied supply is helpful, but what we also underscore is that hospitals try to do a better job of understanding: Who are these options working for? They can do a better job of that,” Griffith said.

The study comes at a potentially significant time for home health agencies as they prepare to switch to a value-based purchasing model under Medicare next year. Value-based care ties reimbursement to the quality of care provided versus the volume of care. A recent report from the Center for Medicare & Medicaid Innovation found that home health agencies in nine states participating in the CMS value-based care pilot between 2016 and 2020 saw a decrease in hospital readmissions than agencies participating in the traditional fee-for-service model.