Home Health Changes: Home Health Agency Startups Make Lemonade Out of Lemons

With the passage of the healthcare reform bill, many changes are taking place in the home health, home care and hospice industry. These are especially challenging for home health agency startups. Now, as never before, we have great challenges and opportunities. It is much like taking lemons and making lemonade.  The lemons are the cuts to reimbursement, the audit companies reviewing agencies and demanding paybacks, and the increased competition as more and more home health agency start-ups enter the marketplace. So how do you make lemonade out of all of this?

The first place to look, especially for home health agency startups, is for the opportunities that the changes have brought. The demonstration grants specified in the healthcare reform bill are offering opportunities to be more effective and decrease costs, giving bigger profits to the participating agencies.

Secondly, CMS has clearly designated COPD, CHF, diabetes and depression as the largest cost diagnoses in our current healthcare system. The goal of CMS is to find ways to reduce the spending while improving the outcomes for individuals with those diseases.   Agencies, particularly home health agency startups, that develop home healthcare systems that respond to these issues in cost effective ways with excellent outcomes will be the winners.

Penta Health is one of the nation’s leaders in the development of practice changes in response to these diagnoses. Their approach to care is the opposite of what currently is being provided. Most agencies and systems tout that they provide patient-centered care, but do they really? Is the patient directing the care or are the experts deciding what is best?  The latter is the truth in almost all areas of healthcare.  Rarely does a provider, much less a system, really provide “patient driven care.”  Penta Home Health, however, really does.

The Look of Patient-Centered Home Healthcare

Patient-centered home healthcare begins with a comprehensive assessment to identify healthcare issues and develop a plan of care. This is where the system departs from current practice, and where a home health agency startup can compete. A patient-centered home health plan of care is developed based on the patient’s desires and goals. If a diabetic patient has no interest in learning about or sticking to a diabetic diet, diet counseling and education are not included in the home healthcare plan.  Does that mean that diet is never discussed?  The answer is, not necessarily. If the patient-expressed goals require that the patient follow a diet to control their diabetes, then, with permission, a diet compatible with their lifestyle and goals would be provided.  All home healthcare is planned using best and current practices that are grounded in research-based outcomes but centered around patient-expressed goals.

Other organizations are scrambling to find ways to provide patient centered home healthcare. During the next three to five years, we can expect to see major changes in how home health is provided and compensated. We may see current barriers, like the homebound rule, removed, particularly for chronic diseases.  This will be particularly troublesome for home health agency startups.

One of the biggest dangers to existing home health agencies and home health agency startups is the entrance by non-home health organizations into the home health marketplace to become a player with Accountable Care Organizations, Medical Homes, Care Transition and Independence at Home projects.  Just as the entrance of digital watches into the marketplace changed the entire landscape of the clock industry, home health may well experience a similar shift.

Now is the time to prepare for the new future of home health.  Home health agencies, including home health agency startups, have a three-to five-year window of opportunity to capture their future.  Home health agencies must reinvent themselves by altering the way they plan and provide home health services, and through initial and ongoing staff education.   All staff, including home care aides, will need to be trained in the four major diagnoses, including the most current medical care.  Staff will need to change from the current organizational/clinical-focused home care plan of care to a patient-expressed-goals plan of care.  All care must be based not only on patient-expressed goals but also on up-to-date treatment modalities and medications.  This will mean that staff must be always learning and applying their learning to their practice.

Making these changes to existing home health agencies and home health agency startups will not be easy.  Many home health agencies will require assistance. Resources are available to assist current home health agencies and home health agency startups to make the needed changes, and now is the time.  If your home health agency needs assistance with how and where to go with these new opportunities, contact Kenyon HomeCare Consulting for an hour of free consultation.

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