VNAA - The Visiting Nurse Associations of America Skip to Navigation

Trending now: #FutureofHH

If you're on Twitter, you've surely noticed this trending hashtag.

That's because the Institute of Medicine (IOM) and National Research Council of the National Academies of Science (NRC) hosted a two day workshop entitled "The Future of Home Health Care." I believe this fantastic event, sponsored by the Alliance for Home Health Quality and Innovation (among others), will serve as a catalyst for policymakers to look anew at home health care services as a critical care, support and value-added component of integrated health care delivery systems.

The full proceedings and presentations will be available via webcast in the coming days. I especially recommend the consumer session with James Martinez who opened the proceedings with a powerful, heartfelt, first-hand perspective of the role home health care providers played in supporting his parents at the end of their lives.

Workshop speakers, a highly esteemed group of experts from many disciplines, did not question and, in fact, highlighted the following:

  • Home care services add both cost value and quality value to the health care system, to patients and to caregivers.
  • Home care services have a crucial role in community care, not just post-acute care.
  • Information technology is an enabler for home care services, not a solution.
  • Demand for home care services across all programs, Medicare, Medicaid and commercial, will only grow given population demographics and the prevalence of chronic disease among all age groups.

Of greater importance, I believe, was the recognition of several other factors not commonly accepted across home care providers:

  • Stakeholders (policymakers, payers, providers) must rethink the standard 60 day episode. Patients may only need one or two visits, providers should be paid for those visits and those visits may not constitute a traditional "LUPA."
  • Stakeholders must focus on the needs of the patients, including functional needs which may require nothing more than a new bannister on a staircase. Eric Dishman, Intel, stated: "Our thinking needs to be: home and community based care needs to be the default. THEN we can work on the business and payment models. THEN we can identify the technologies to best support patient goals."
  • Multidisciplinary teams, including physicians, will be required for success.
  • Stakeholders must rethink the balance of social services and medical services.
  • Home care providers must acknowledge that "networks of home care providers" rather than referral exclusivity may be the future.

Of course, payment models were widely discussed with widespread acknowledgement that the current Medicare fee-for-service, siloed payment model has stifled innovation in home care and prevented a truly integrated, patient-centered delivery approach. To quote one presenter: "the current home health payment model remains the greatest barrier" to truly achieving the Triple Aim. The concluding panel on the workshop's first day, however, generated great excitement by demonstrating six innovative programs designed outside the arbitrary restrictions, regulatory burden and payment constructs of the current Medicare home health program.

The workshop clearly highlighted home care delivery's rapidly evolution outside the confines of the nation's biggest payer, Medicare. Our diverse industry should now align to demand and achieve change in the Medicare home health benefit.

Help us keep #FutureofHH trending.

Comments

 
By: Chris Holland
On: 10/06/2014 09:32:23
Points made require the attention of every home and community health leader if we're going to thrive in the future

Leave a comment

Please complete the form below to submit a comment on this article. A valid email address is required to submit a comment though it will not be displayed on the site.

Please enter this number in the box below: 329

.  2121 Crystal Drive, Suite 750, Arlington, VA 22202

.  571-527-1520 / 888-866-8773

.  webadmin@vnaa.org