How to Launch a Value-Based Care Model

//How to Launch a Value-Based Care Model

How to Launch a Value-Based Care Model

Coaching Homecare Workers on Technology

Payers make decisions concerning the frequency and degree of home care that patients require to be safe and healthy in their homes. While home health agencies work to achieve the day-to-day care goals for patients that are set by payers, there is rarely feedback returned to those in charge of such critical determinations.

However, the industry is moving to a client -centered focus, and home care agencies must now play a much more significant role in decision-making processes to continue to deliver the best care to patients.

Home Caregivers at Ground Zero

Caregivers are familiar with their patients, and they can recognize before anyone else when a patient is not behaving or responding as they normally do. Oftentimes, caregivers can pick up on even the most subtle changes, like whether a patient is having more trouble speaking than usual or they seem to be more out of breath than they have been lately.

These subtle changes in clients could be early warning signs of something complex and serious; the goal is to act accordingly on these changes before the client’s condition develops into a crisis situation.

It’s the caregiver who is at ground zero – the first to be able to pick up on unusual shifts in a client’s demeanor or well-being. They are positioned to capture timely information and data about clients – but that isn’t enough to influence outcomes.

The real value lies in using point-of-care data along with actionable insights for comprehensive client care at home by incorporating the latest industry technology as a part of routine care practices.

Technology and Home Caregivers

Unfortunately, most home health caregivers and agencies aren’t equipped with or haven’t had exposure to  the technology needed to quantify what they observe in clients’ homes. These advanced tools can provide a much-improved approach to population health initiatives and value-based care, so it’s crucial that agencies embrace the industry’s latest technology-based solutions. Doing so will enable the agency and its home caregivers to:

✔  Automate check-ins with clients on a daily basis with cloud-based telecommunication technology

✔  Use a simple mobile platform to record insights, findings, and actionable data

✔  Provide immediate intervention and escalation recommendations to risk-bearing providers like hospitals, medical groups, and payers

To capitalize on the insights of caregivers and the technology that is now available to turn insight into action, home health agencies must train caregivers to perform higher-level recording tasks. The potential is infinite when caregivers can monitor behavior and conduct assessments with easy-to-use mobile tools, whether it’s a client’s pain level, nutrition risk, fall risk, activities of daily living (ADLs), or even caregiver strain.

Real-Time Escalation Capability

What people can do in minutes or hours, Artificial Intelligence, or AI, can do in seconds. It can identify and prioritize data by evaluating a client’s health data record with assessments and insights in real time, creating recommendations for care that a caregiver may not have considered.

Clinical supervisors can use this information from the AI to escalate any requests for changes in care and improvements to care plans; with a cloud-based information system, health care providers, payers, hospitals, home care agencies and other licensed professionals can all connect in a way that’s efficient, effective, and readily available to authorized persons, all in one location.

The critical factor in being able to turn client information from the home into meaningful data is the technology used by home caregivers. When mobile tech is paired with AI, agencies are granted a newly empowered hand in decision-making processes; they can quantify the client experience and engage in critical exchanges of information between clinicians, agencies, and payers. This, in turn, affords payers the ability to adjust actions in order to provide the best care solutions for clients.

Value Versus Volume

The Centers for Medicare & Medicaid Services (CMS) recently proposed the Patient-Driven Groupings Model (PDGM). Under the PDGM, therapy volume will no longer determine payment rates; instead, the needs and clinical characteristics of clients – and how well given therapies cater to those needs – will define payment. This proposed model of value vs. volume is intended to remove incentives for home care agencies to provide therapy that is not necessary or effective. While agencies have traditionally been paid for the number of treatments administered, the plan proposes that they instead are paid for treatments given that are valuable to the well-being of the client.

Six Steps to a Value-Based Model of Care

Valuable care involves more than just recording and reporting data; home care agencies must be able to demonstrate why specific treatments are of critical importance to the well-being of patients. The challenge is to bring that value to life with a value-based model of care. Following are six steps to get started:

  1. Commit to a Primary Organizational Strategy.

It should not only be outcome-based but also client-centered. Communicate this shared vision with staff.

  1. Coach Your Team on New Technology

Homecare providers need to be able to access and use mobile technology to collect and relay assessments from clients’ homes. The data serves as the evidence-based recommendations payers need for escalations and interventions.

  1. Search Out an Intervention Partner

Identify an accountable care organization (ACO) or other risk-bearing provider to help launch your value-based care program. They’ll be able to validate initial workflows as well.

  1. Baby Steps

Prioritize any clinical escalations that you can act upon; they should be meaningful and achievable for your clinical team. Keep in mind that a valuable tech solution will filter out unnecessary “noise” and will provide proper context – this will help providers make the best care decisions.

  1. Use Success as a Building Foundation

Over time, when you and your partners have established a record of demonstrated outcomes and proven clinical impact, build on that and grow your program by expanding escalation paths and clinical recommendations.

  1. Market Your Agency as a Leader in Innovation

Payers and ACOs need to become aware of your hard-earned expertise; they accept a significant amount of risk when they partner with home caregiving agencies. Agencies that demonstrate that they can minimize risk to clients and keep care delivery costs to a minimum are the agencies that payers and ACOs want to partner with.

The benefits of monitoring client journeys in their homes is becoming widely recognized by ACOs, payers, health systems, and hospitals. As health care moves to a client-oriented outcome-based model, the priority is shifting from predetermined lengths of stay to optimizing care. Growing pressure to reduce medical costs, unnecessary treatments, and unplanned long-term care placements are fueling the CMS proposition to push the value-versus-volume shift forward in the medical care field.

As the United States is bracing for its large and rapidly aging population to require more medical care, a human resource shortage will require home caregivers to handle more complex tasks; the opportunities are growing for professionals to observe clients, monitor changes, gather actionable insights, and have a critical hand in the entire client care process for the first time in modern history – as long as they embrace technology and all it has to offer homecare workers.

Discover how Stay Smart Care’s unique at-home care programs incorporate the latest mobile technology for optimal aging-in-place services. Contact us today to learn more.

2019-10-15T20:46:22+00:00October 15th, 2019|