Referral partnerships
4 ways to position your agency for success
by Mark Tomzak

The home health care market is positioned to grow at a faster pace than any other care setting. In fact, according to the U.S. Census Bureau, the 65-and-older population grew by 34.2% during the last decade. Additionally, the demand for home health care, as well as the likelihood of a patient’s home becoming the center of care delivery, has been steadily increasing in recent years.   

And that was before the onset of the COVID-19 pandemic. Now, with more seniors cautious about entering traditional care settings, the demand for home health care is likely to grow even more.

To help meet that challenge as a home health care agency (HHA), you need to become—and remain—one of the preferred providers within your network. But you first need to ensure that your business is positioned to manage more referrals from a staffing and process point of view, as well as to receive referrals that will positively impact your reimbursement. Implementing the right solutions and technologies is key to making that happen.

Here’s a look at four strategies HHAs can employ to expand and manage their referral networks, and ultimately, become preferred providers within their networks.

1. Make data-sharing easy within your network.

Acute care providers are continuously narrowing their network of referral partners and choosing partners based on more scrutinized criteria. With COVID-19 and increased reporting requirements, data has become even more essential to these decisions. By leveraging cross-continuum tech solutions, HHAs can enable seamless and robust data sharing with their partners.

Additionally, the same type of technology can enable a degree of standardization and automation and allow care teams to streamline clinical processes in a valuable way. For instance, there are home health care solutions that can enable clinicians to import the patient’s Continuity of Care Document (CCD), which auto-populates their record and provides a more comprehensive view into the patient’s history and their current needs. This includes medications, diagnoses, demographics and any allergies.

This type of technology can also allow clinicians to capture evaluations in real time, eliminating the burden of “paper pushing,” and reducing the chances of inaccuracies. This automation can set home health agencies up for preferred provider status because there is confidence in the credibility of the data.

By integrating workflows and making data sharing easy, agencies can ensure that relationships are strengthened between their intake coordinators and discharge planners within their network. This will not only secure more referrals to the HHA, but positively impact the care transition process as well.

2. Streamline your referral management processes.

When the Patient-Driven Groupings Model (PDGM) was implemented, the home health care billing cycle was cut from 60 days to 30. For prompt reimbursement, agencies want to get started as soon as possible on any given episode.

With a streamlined referral management process, a home health care agency can get an immediate, comprehensive view of a patient’s characteristics from the referral source. The sooner an agency can complete the start-of-care visit and meet all the clinical requirements, the faster it can receive reimbursements.

Agencies should be focused on expediting the start of care so that the highest level of care is achieved. To ensure maximum reimbursement, Low Utilization Payment Adjustment (LUPA) thresholds need to be met within the first 30 days and monitored during the second 30 days.

Additionally, by streamlining referral management, patients are more likely to receive care sooner, which can be a significant factor in lowering rehospitalization. This can also positively contribute to an agency’s Centers for Medicare & Medicaid Services’ (CMS)Five-Star Quality Rating, and in turn, affect reimbursement levels.

3. Improve outcomes & reduce hospital readmission rates.

To encourage greater transparency within the sector and to help inform consumers, CMS began publicly reporting hospital readmission rates in 2009. The Hospital Readmissions Reduction Program (HRRP) was also established as part of the Affordable Care Act. Through this program, CMS has reduced Medicare payments to hospitals with readmissions within 30 days of discharge for certain conditions.

Ever since, to help curb readmissions and to ensure that patients are placed in settings that are best suited to their recovery, hospitals have been increasingly scrutinizing senior care providers within their networks. As a result, HHAs looking to earn referrals are expected to have data-driven conversations with hospitals, including demonstrating their ability to reduce hospital readmissions and promote better clinical outcomes.

With 39% of seniors taking five or more prescriptions each day, a lack of medication management is often cited as one of the key drivers behind hospital readmissions. To change that, HHAs are increasingly making in-home medication management a core component of their operations and are turning to technology to help.

Home health care platforms with comprehensive clinical documentation can enable agencies to monitor readmission risk status. The right solution can allow all caregivers involved in a patient’s care to view every detail of a care plan so that everyone is on the same page, working towards the same goals from the onset of care delivery.

4. Leverage mobile & telehealth options.

While telehealth is still relatively new within the broader long-term sector, HHAs have long balanced face-to-face and connected care and have consistently sought to innovate and push the envelope on providing virtual care. .

More and more, home health customers are becoming increasingly interested in using mobile apps, as well as integrating telehealth solutions into their existing technology stacks. In fact, it’s commonplace that, as part of the patient intake process, agencies determine whether patients have an appropriate device and a Wi-Fi connection and are comfortable with a virtual visit.

Assessments aren’t the only way that home health care agencies are applying telehealth technology. For existing patients who aren’t comfortable with in-person visits at this time, or for agencies short on personal protective equipment, remote monitoring devices in patients’ homes are tracking vitals such as weight, blood pressure and pulse.

Preferred Status in Your Network

For most home health providers, the intake process can directly impact the ability to grow, provide care and bill. Having the right technology in place and giving care teams tools that make their jobs—and lives—easier will keep them happy and engaged.

For instance, with this type of solution, caregivers have immediate access to updated health history and care plans associated with their patients. Additionally, assessments and visit notes are designed with simple controls and selection lists to allow quick and easy data entry. As a result, caregivers are able to quickly develop care plans for patients, and have more time to focus on their relationships with patients and referral sources.

To secure a steady flow of new business in the most efficient way possible, providers should invest in the right technology. With the proper solution, providers can remain compliant while maintaining workflows that drive high-quality care and build credibility with referral partners by demonstrating those outcomes.

Mark Tomzak is executive vice president and general manager of PointClickCare’s Home Health Care division. He and his team are focused on helping home health care agencies improve clinical outcomes, maintain compliance, recruit and retain staff, and improve financial health.