The old axiom is true: change is the only constant. In 2014, the health care industry continued to face regulatory changes, such as the tightening of criteria for electronic health record certifications to enhance data security. 2015 has even more significant changes in store, and home health agencies will benefit from new technologies that can keep them ahead of the curve.
As part of the overall rebasing adjustments and now entering its second year of implementation as enacted by the Affordable Care Act, federal Final Rule CMS-1611-F is placing an emphasis on improving health outcomes through a patient-centered delivery model of care. This model focuses on consistent, quality care for the patient that is often best delivered at home, which will let home health agencies become increasingly integrated with all providers. The quality of patient care depends on reliable, up-to-date data. The coming year should see an increase in the use of a one-stop electronic source for patient data that updates in real time. This can have several applications, including keeping medications consistent, allowing family members to log in to check on the patient's progress and reducing the amount of paperwork for care providers. The Internet will also continue to impact health care in exciting ways. Anything that can hold a microchip can become a health-monitoring device through Wi-Fi. A bracelet can monitor heart rate or a pill can contain a camera. These connected devices open up an entirely different world of health care opportunities, including new methods of patient engagement, patient data collection, remote monitoring and even treatment. Ultimately, developments such as these will serve to integrate all elements of care and provide a cohesive approach that is tailored to individual patient needs.
Adhering to Requirements
With regulations of the Affordable Care Act continuing to roll out, it's more important than ever for home health providers to stay on top of industry changes. A new federal rule requires compliance with the new OASIS-C1 data set and OASIS Assessment Submission and Processing (ASAP) system that was effective Jan. 1. Additionally, a transition to the new ICD-10 is required, with an updated and expanded code set, effective Oct. 1. As these major changes become effective, using software to ensure regulatory compliance will be even more critical this year. The proper software can help eliminate coding errors and improve documentation processing, with less time spent on rejected claims. Another technology advancement to help ensure compliance is Electronic Visit Verification (EVV). Several states are enacting regulations requiring Medicaid providers to prove that care was received in the patient's home. EVV is possible with landline telephones and mobile devices such as smartphones and tablets. Due to a decline in usage of landline telephones, mobile methods are now preferred. The mobile application uses the GPS location tied to a patient's electronic signature. Having secure access ensures the agency is complying with HIPAA regulations by reducing the potential for unauthorized access to confidential patient information.
Home Health Business Model
Technology will do more than improve patient care and maintain compliance—it will also increase home health agency profits by increasing efficiency and maximizing reimbursement. The lengthy requirements and amount of information needed to successfully process and receive payments for Medicare claims can be challenging. Intuitive software helps guide providers to document claims correctly the first time, and can even automate the entire billing process for increased efficiency. Many home care agencies are also diversifying their lines of service to include managed care patients and provide additional revenue streams. With that expansion comes the need for software to process claims for non-Medicare patients.
In an ever-changing industry, technology is the key to increasing availability of information among providers, enhancing care delivery and coordination and ultimately making patient-centered care a reality in home health.