If there was a theme this week at McKnight’s Home Care, it might be how to successfully discharge patients from the hospital to home.
Several recent developments illustrated how difficult a problem this is for home care, hospitals, caregivers and the healthcare system at large. First, a new report from technology company WellSky found that home care’s labor shortage and a high-acuity patient population at hospital discharge are making it hard for hospitals to discharge to home health agencies. While home health referrals have increased by 11% since December 2022, home health agencies’ rejection rate has risen by 40%.
Also this week, Yoni Shtein, the CEO and co-founder of Laguna, a technology solution that specializes in these care transitions, talked in a McKnight’s Home Care podcast about why it’s important to identify physical and emotional barriers, including worry and sadness, that can impede patients’ recovery at home.
“Essentially just being able to identify them enables us in real time [to] modify the workflow for the care manager and the member … and drives better engagement and better outcomes,” he said.
A smoother discharge process
A third valuable event on this topic delved into ways home care agencies can capture patients from the hospital, get paid while doing it, and make the process smoother for everyone.
Forcura, a healthcare workflow management firm, sponsored a webinar on Tuesday with three thoughtful guests: Jana Lightfoot, COO, Reliant at Home; Sandeep Sankineni, MD, regional medical director, advanced care at home, Permanente Medicine; and Bill Gammie, senior director post-acute utilization, Kaiser Permanente.
Gammie and Sankineni addressed the importance of expediting pre-service authorizations, improving reimbursements and better coordinating care.
Ligthtfoot was impressed.
“Things I loved hearing: faster authorization, better pay, more referrals, better relationship building and understanding of mutual benefits,” Lightfoot said. “And so I think if we could have that everywhere, we would all be shouting from the rooftops.”
But all too often there are discharge challenges, such as home care agencies receiving discharge plans late in the day on Friday, she explained. And while most agencies work with traditional Medicare, they do not work with all Medicare Advantage plans so there may be confusion or miscommunication about whether an agency is partnering with a particular plan.
“It’s not a one-size-fits-all and all the plans have different nuances, and we’re not in network with all of them at one time and so that creates a real problem for them as well to do anything quickly,” she explained.
To this, Gammie suggested having a discussion with the hospital and payer. Home care agencies need to advocate for themselves. Show them you can manage patients at home better than anyone. Whether it’s improving readmission rates or increasing member satisfaction, agencies need to use real data to prove their value.
“As a home health agency, you want to bring all the data and the strategy to the table and be a voice,” he said.
To iron out issues and improve relationships with the payer and hospital provider, you have to get together and talk, Sankineni said. “I think it really does come down to just … getting to the table and just hashing it out and saying this is our major need right now,” he explained. “How can you help me solve this? And you’re gonna hear the same from the other side.”
Coming together and hammering out solutions? Sounds too easy.
Liza Berger is editor of McKnight’s Home Care. Email her at [email protected].
Correction: This post has been amended to reflect the accurate description of the home health rejection rate in the second paragraph.
