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Homecare Workers are Essential to the Success of Hospital at Home Programs

By Stephen Vaccaro, President, HHAeXchange

Q: Tell us a bit about HHAeXchange and what challenges you all are aiming to solve.

A: At HHAeXchange, we connect providers, state Medicaid programs, managed care organizations (MCOs), and caregivers through one platform. This connection breaks down barriers and enables better efficiency, communication, transparency, and compliance. We believe that healthcare should be simple, effective and transparent, and have made it our mission to provide better outcomes for the millions of individuals receiving home and community-based services (HCBS).

The homecare industry’s intense growth over the past few years presents one of the biggest mutli-faceted challenges we are contending with today. Many of the smaller issues HHAeXchange is striving to resolve can be attributed to that growth. So, if we work on catching up to manage that extreme growth, then I think we end up organically addressing additional challenges at various sub-levels. Overall, this growth means that providers are having difficulty keeping up in the caregiver recruitment and retention areas. In addition, because there is such pressure to quickly fill vacancies without any gaps in care, it may be more difficult to pay adequate attention to training and orientation. The process needs to be streamlined and organized to make homecare providers’ jobs less stressful so they can focus on providing top-quality care and maintain a certain level of job satisfaction and enjoyment. We help to target those issues by offering comprehensive homecare provider platforms that contain easily implemented, intuitive solutions, which can have big implications to benefit both patients and staff. Our technology supplements agency-caregiver communications while providing tools for scheduling and referrals, reporting, billing and payroll, clinical information gathering, compliance verification and more.

Q: COVID-19 has acted as a catalyst for change and accelerated the acceptance of emerging technologies in the healthcare industry. What impact did the pandemic have on homecare specifically?

A: One of the biggest things the COVID-19 pandemic did for the homecare industry was bring to light how significantly social determinants of health (SDOH) affect population health as a whole. Because of this, the Centers for Medicare and Medicaid Services (CMS) and state Medicaid programs began working to improve investment efforts into the innovative and solution-driven initiatives surrounding SDOH. For example, it is now realized that Medicaid MCOs may be better equipped to address members’ SDOH and health equity compared to fee-for-service models, most notably when pertaining to population health management strategy, health equities, care coordination, and value-based payment.

Q: What role do homecare providers play in the overall care coordination of patients as it relates to the hospital at home concept?

A: Homecare workers provide a range of health-related, social, assistive and other services when a patient is being treated in their own home. A hospital at home program is administered because a recipient meets criteria designed to distinguish patients who need intensive services and/or multiple visits from specialists — and therefore should be treated in a hospital — from those whose needs may be met at home by visiting physicians, nurses, aides, and other clinical staff.

At the start of the pandemic, healthcare organizations had to adopt new methods and technologies in order to continue caring for patients outside the four walls of the hospital – but homecare providers have always had this insight. Now that more members of a patient’s care team – from home health aides to nurses and doctors – visit individuals in the home, they must all collaborate and work in sync to ensure the best outcomes. This takes a concerted effort on the part of the whole industry, utilizing a team-based healthcare approach to ensure all providers are working collaboratively with the patient to accomplish shared goals.

Technology, of course, is critical to ensuring the success of hospital at home. From telehealth and remote patient monitoring platforms, to biometrics monitoring that checks pulse, breathing, and other key data points, all pieces of technology must work together to ensure there are no gaps in communication and patient care. Interoperability between systems is key, and technology platforms must enable the collection of real-time patient data and clinical information from all the various point solutions and devices. That data includes all things pertaining to a patient’s condition – symptoms, improvements or declines in health, and other potential health risks – which are conveyed to the patient’s whole care team, allowing them to tailor the treatment plan so it is most effective. So, convenient and organized access to the data homecare aides collect is more critical than ever.

Q: How can technology help to ensure proper communication and patient care?

A: The pandemic made it impossible to ignore all the ways technology could play a critical role in helping to manage the growth and ensure the success of the homecare industry. Cloud-based healthcare software dynamically links contracted providers to payers, enabling improved communication, visit verification, increased compliance and overall operational effectiveness. Essentially, technology is now filling gaps to ensure that treatment is not being sacrificed, and that reliance on it will only continue. Utilizing technology to streamline all aspects of the market and make lives easier is the most attractive option for bringing in and retaining qualified staff. When you have top-notch workers who communicate effectively and are committed to their patients, outcomes drastically improve.

Q: Any final comments before we close?

A: I’d like to touch on the importance and prevalence of value-based care in today’s homecare marketplace. Rather than reimbursing providers based on the quantity of services delivered, value-based care pays providers based on the quality of care they give patients. Caregivers are in a position to improve that quality of care when they can observe, note, and report changes in condition and other potential health risks back to their agencies. The challenge is making sure that data is faithfully recorded in an accurate and timely fashion and shared with the appropriate parties. Simply collecting it isn’t enough, and it’s easy for important facts to get lost or overlooked when the documentation and sharing process is lacking, whether that’s because it’s overly complex and time-consuming or not thorough enough. More and more, payers are leaning into the value-based purchasing model and the technology that makes it possible, which creates better communication, better coordination and makes more information available.

We at HHAeXchange believe it’s a trend that is here to stay, and that’s why we’ve taken the essentiality of value-based care into account when developing our platforms and solutions.

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