Partnering with Hospitals to Reduce Readmission Rates
This primer will help to prepare your home health care agency for a new venture
by Lenny Verkhoglaz

According to CMS, Medicare spending grew by 5.5 percent in 2014—bringing the total to just more than $600 billion. Parts of the Affordable Care Act (ACA) are designed to help curb the Medicare program by keeping hospital readmission rates down. This initiative has helped to create strong relationships between hospitals and home health care companies.

Why Now?

The ACA is reducing Medicare payments to hospitals that have a high rate of patients readmitted within 30 days of initial release. The concern regarding hospital readmission rates relates to patients with chronic illnesses such as asthma, chronic obstructive pulmonary disease (COPD), diabetes, depression, heart attack and heart failure. There is no cure for these illnesses, which is why patients are often readmitted after receiving hospital care. According to Hospital Compare data from 2009, hospital readmission rates for a heart failure patient was up to 24.5 percent.

A key component to preventing patients from being readmitted is to ensure they receive the proper care at home after they are released. This is where home health care companies come into play.

How Home Health Care Helps

There is a push to a fee-for-value model, which means providers must take an active role in helping patients get care and services outside of the hospital. When a hospital patient who has a chronic illness, or one who simply needs additional care, is getting ready to be released, the hospital calls a homecare company to schedule a consultation visit. For example, when my company gets a call from the hospital, we send one of our nurses to do an assessment. Once the patient is back at home, we pair the patient with one of our caregivers. This relationship has proven to be beneficial to all parties involved.

Physicians can diagnose a condition and provide treatment, but once patients are released, the responsibility of care falls on patients or their families. By having a caregiver in the home with the recently released patient, the responsibility becomes shared.

Often, patients are released and aren't able to care for and support themselves due to physical or mental limitations, which is why the assessment is crucial. It is important to have an honest scope of the patient's condition to make sure he or she gets the type and level of care needed. Caregivers and nurses provide hands-on care and support to patients and help to educate the patients and family members on how to provide self-care, what signs and symptoms could trigger a readmission and the interventions that can alleviate the symptoms.

How to Form a Partnership

Sometimes, the toughest part is getting in to meet with the hospital discharge planners. Luckily, with the push from the ACA to lower admission rates, hospitals are open to forming relationships that can help patients.

Home health care is a booming industry not short of competition, so you must market your services to the right people. Scan the community and see what hospitals are in close proximity to your business. Develop marketing materials that represent your services and show how your company will be an ally to the hospital. You can go a step further to develop disease-specific programs that incorporate teaching materials and phone follow-ups to improve outcomes. If you can develop a strategy that shows how your services will benefit patients and the hospital, you have a higher chance of being selected as a partner.

Adequately Preparing Caregivers

Hospitals are looking for capable, well-informed and reliable home health care agencies with which to partner. In order for a partnership to form, the agency must be able to meet the hospital's demands for caregivers.

While the need for caregivers is consistently increasing, there is a shortage of qualified candidates. It is important to select caregivers who will live up to your brand's values, are dedicated, will be loyal and have the desired skills and knowledge.

Additionally, education for caregivers needs to be continuous. Your agency should participate in regular training sessions to help caregivers gain new skills.

Getting Your Agency Ready

The decision to partner with a hospital is a big responsibility. You have to be ready to assess the patient and assign a caregiver when you receive a call from the hospital. In addition to having a large network of caregivers, this also means having the internal ability to handle the logistics.

As a franchise concept, my company has locations in various stages throughout the country. At this point, not every location is actively pursuing hospital partnerships, but we are training each one to be able to do so. Some of our more experienced franchise partners have already formed strong bonds with hospitals and have proved to be an important ally as they aim to keep readmission rates low.

We recently implemented a care management program, Executive Care 360, to advance our ability to provide high quality care to more people. This systematic approach not only increases the client's experience, but also promotes consistent care.

Having a system in place that allows you to manage all the caregivers and the status, needs and current state of each client is essential. We are now able to help more hospitals, care for more clients and exceed expectations.

This is an interesting time for the home health care industry, as there is a transition from a fee-for-service to a fee-for-value model that is changing the way the sector operates. This has formed a demand for home health care agencies and a need for quality care.

Below are a few items to keep in mind when researching partner opportunities with local hospitals.

  • If hospitals do not cut down on readmission rates, they will be monetarily penalized.
  • Home health care companies have stepped up to the plate to help provide care for hospitals' recently released patients.
  • In order to form partnerships with hospitals, it is up to the home health care agency to market its services.
  • Recruit skilled, dedicated and reliable caregivers. Provide them with training and ongoing education opportunities to develop and refine skills.
  • Make sure the agency is properly prepared to take on more clients, handle more complex logistical issues, provide education for the patient and the family and can maintain a full, strong caregiving team.