One of the major changes implemented by the Affordable Care Act was the development of Accountable Care Organizations, or ACOs. These groups of providers work together to reduce overall health care costs while also improving the quality of care.
As more providers embrace the ACO model and begin looking for efficiencies in how they deliver care, the role that home health care can play is moving into the spotlight. In short, more ACOs are realizing that home health care agencies can be an important part of the care continuum, and effective partners in meeting the ACOs primary objectives in terms of cost and quality.
However, not all ACOs are necessarily bringing home health to the table when it comes to discussions of care delivery, and not all home health agencies are positioning themselves to be considered as part of these groups. This is a missed opportunity for both sides, but especially for home health agencies that need to reconsider their business models in the coming years in order to continue to be competitive.
How Home Health Care Can Contribute to an ACO
In order to be an integral part of an ACO, a home health care agency must be more than just a referral partner who takes on patients when they leave the hospital. Rather, the HHA and the hospital providers and primary care physicians must be true partners. This might include:
Not only must providers share key clinical information and discharge summaries with the HHA, the HHA must provide detailed information for physicians regarding patient status, progress, and problems. A comprehensive software program with a secure communication portal is ideal, to avoid relying on faxes and other forms of document transfer.
One of the most difficult aspects of managing patient care is communicating with patient providers to discuss patient care and solve problems or update on progress. The HHA and the providers may commit to sharing contact information to facilitate the exchange of information.
Reducing hospital readmissions is a primary goal of ACOs, and HHAs can play a significant role in meeting that goal. As part of the ACO team, home health providers can meet with the rest of the ACO team to discuss specific readmission cases — as well as cases that were potential readmissions — to determine the causes and develop strategies for avoiding the same problems in the future.
Being a part of the ACO is about more than patient referrals and growing the bottom line. It’s about being a key part of the patient care team, and helping all of the ACO partners meet and exceed their targets to ensure the highest levels of reimbursement and the best quality of patient care.
How to Become Involved in an ACO
Becoming a partner to an ACO is primarily about building relationships and finding ways to collaborate with the ACO partners. One of the best ways to do this is to leverage your agency’s data to make a compelling case for the value that home health care can bring to the entire continuum of care.
Most importantly, if your agency can show a significant reduction in hospital admissions, as well as success in meeting other metrics (such as improved ambulation, better medication, management, etc.) you can better show your value to the ACO.
While your services may not necessarily be Medicare reimbursable, by showing how you improve patients’ overall health and support the care of chronic diseases, you can offer value to an ACO working toward meeting their own goals in those areas.
With that in mind, you do not have to be everything to everyone when it comes to partnering with an ACO. Understanding your business’s strengths and where you excel can go a long way toward developing successful partnerships. Because ACOs are built from multiple providers, you don’t necessarily have to offer the same services and programs as every other home health agency in your area. In fact, partnering with an ACO can actually help reduce competition, since different agencies can fulfill different roles within the organization.
Focus on Technology
What you do need to focus on, though, is technology. Because communication is the foundation of a successful HHA/ACO partnership, you need to be willing to invest in the technology necessary to manage and document patient care. ACOs demand efficiency and accuracy, so your staff and operations must be up to the challenge of meeting the patient needs and collaborating toward shared goals.
According to research, more than 40 percent of doctors reported that care coordination for those patients who are at a high risk of readmission is a major challenge. A home health agency, then, is in a unique position to help coordinate care and reduce some of those challenges while also reducing costs.
If your agency is not yet working with ACOs, or hasn’t yet considered a partnership, the time to do so is now. And in the meantime, learn more about software solutions that can help you manage your business while collecting useful data by checking out some of Complia Health’s resources here.