March #HomeHealthChat: Home Health Partnerships with Family Caregivers

On Tuesday, March 25th, the Alliance hosted its monthly #homehealthchat on Twitter.

The topic of the chat was home health partnerships with family caregivers, featuring co-host National Alliance for Caregiving, a non-profit coalition of national organizations focusing on issues of family caregiving.

The Alliance hosts a home health-focused Twitter chat on the fourth Tuesday of every month at 2 pm ET. Be sure to check here for updates on topics, co-hosts, and questions!

If you have topic ideas for future Twitter chats, or are interested in co-hosting a chat, please email the Alliance’s Special Assistant to the Executive Director Jennifer Schiller at jschiller@ahhqi.org.

Below are some of the highlights from the chat:

January #HomeHealthChat: Health Care Delivery Reform

On Tuesday, January 28th, the Alliance hosted its monthly #homehealthchat on Twitter.

The topic of the chat was health care delivery reform, featuring co-host the Altarum Institute, a nonprofit health systems research and consulting organization. Altarum integrates independent research and client-centered consulting to create comprehensive, systems-based solutions that improve health. Tweets sent from Altarum were on behalf of Dr. Joanne Lynn.

The Alliance hosts a home health-focused Twitter chat on the fourth Tuesday of every month at 2 pm ET. Be sure to check here for updates on topics, co-hosts, and questions!

If you have topic ideas for future Twitter chats, or are interested in co-hosting a chat, please email the Alliance’s Special Assistant to the Executive Director Jennifer Schiller at jschiller@ahhqi.org.

Below are some of the highlights from the chat:

 

Home Health Care For The Frail Elderly In Focus This Week

Home health care for frail, elderly patients is making headlines this week.  The Atlantic recently featured a piece on the economic benefits home-based primary care can offer to the US health care system going forward.

Focusing predominantly on Dr. Brad Stuart, the founder of Advanced Illness Management (AIM) at Sutter Health, the article takes a look at how treating frail, elderly patients with a comprehensive home-based plan can be more efficient and cost saving in many cases. The AIM program takes an overarching approach to patient care, managing patients’ chronic conditions with in-home visits and care coordination. Each patient is assigned a team of doctors, nurses, specialists, and more under the direction of a primary care physician. Patients remain in the AIM program for the duration of care, utilizing each individual resource as needed. This approach allows care to prevent hospital readmission, saving the patient and health care system time and resources. Earlier this year the Alliance held a webinar with Dr. Stuart and his colleague from the Coalition to Transform Advanced Care (C-TAC), Tom Koutsoumpas, on treating advanced illness, which touched on the AIM program. (Slides from their Innovation Perspectives webinar can be found here.)

Examples of successful home-based care stories in the article included those from MedStar Washington Hospital Center’s Medical House Call Program. One patient, a 92-year-old male had been in and out of the hospital before becoming a part of the MedStar program. The self-proclaimed hospital-hating patient has not been back to the hospital since joining the Medical House Call Program. We profiled the Practice Director for the Medical House Call Program, Dr. Stephanie Bruce, in September as part of our Innovation Perspectives Capitol Hill briefing on how health care delivery reforms are leveraging home health care. The full profile of these innovations at MedStar featuring Dr. Bruce can be found here, and a replay of the briefing can be found here.

Healthcare at home may offer a solution to the costs driving health care spending in the United States. As the article contends, with the Affordable Care Act penalties for hospitals with high rates of readmissions, many hospitals are less eager about readmitting Medicare patients. In addition, many Medicare demonstrations, pilots and programs have been created to pursue and explore innovative new models of care, offering home health care an opportunity to show its value in improving patient care and reducing overall cost of care. Sutter estimates in the article that the AIM program saves Medicare upwards of $2,000 per patient per month. Over time, the savings seen by including more comprehensive home-based care could be significant to providers and the health care system as a whole.

The article contends that the future is currently bright for home-based comprehensive care, as both the logistical and financial opportunities are there to see a push in the implementation of programs such as AIM and the Medical House Call Program. As part of our educational mission, the Alliance is proud to continue the discussion of affordable and high-quality home-based care with innovators such as Dr. Stuart and Dr. Bruce.

 

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If you’re interested in learning more about the Alliance’s Innovation Perspectives series, click here for more information. Dr. Joanne Lynn, Director of the Altarum Institute’s Center for Elder Care and Advanced Illness, will be the next featured guest on our December 5th webinar at 2:30 pm ET. Dr. Lynn will speak on reforming care delivery to better support frail and elderly seniors who need both health care and long-term care. Click here for more information on next month’s webinar, and here to read Dr. Lynn’s recent opinion piece in the Journal of the American Medical Association.

From the desk of the Executive Director

As the landscape of health care continues to shift, now is the time to further the conversation on the role of home health in the future of health care delivery. New and emerging health care delivery system reforms focus on new ways to improve the quality of care delivered while lowering costs.  Home health care is being used in many of these emerging delivery system reforms.

Last week, the Journal of American Medical Association released a piece from Dr. Steven Landers, President & CEO of VNA Health Group and Chairman of the Alliance’s Board of Directors, on the increasing importance of home health care to Medicare patients (available here). Titled, “The Future of the Medicare Home Health program,” the article serves as a starting point for further conversations on the state of health care, and the ways in which home health care can provide a high-quality, lower-cost alternative for many patients.

Some of the key trends discussed in the piece include:

  1. An increasing patient desire to age at home
  2. A need for cost-effective solutions in the U.S. health care system
  3. The idea of home health care as a patient-preferred and high-quality alternative to other care.

Dr. Landers’ article offers perspective on the current state of health care, which should be addressed with regard to the present and future value of home health care in the Medicare program.

In our role to engage in and inform a directed conversation on the value of home health care, the Alliance is working to lead and support research and educational efforts to improve the U.S health care system. As part of our efforts, we are cultivating research on the value of home health care; educating policymakers, the public, and key stakeholders on home health’s role in a changing health care landscape; and working on solutions to improve home health through quality and innovation.

We are also encouraging our members to engage in the ongoing dialogues about how to foster solutions to improve health care in America in multiple venues—through our working groups; outreach to policymakers, patients, other health care providers, and key stakeholders through our social media channels; and through events such as Alliance webinars and congressional briefings.

“Beyond these suggested reforms, there also needs to be substantial national investments in education and research in home health care,” Dr. Landers concludes. “By revisiting the nation’s home health policy, there is an opportunity to improve quality, independence, and compassion for the largest group of older Americans in the nation’s history.”

Given the attention being paid to health care and the Medicare program in the context of the recurring budget battles in Washington, D.C., now is the time for home health to speak up as discussion and debate over the future of health care amplifies. We have a great opportunity to be leaders on a national stage and we invite our members to join us in educating the public on the value of home health care in the future.

Patient Safety and Engagement

This month, the Alliance for Home Health Quality and Innovation is focused on the importance of patient safety and engagement in health care at home through a series of events and partnerships. Join us for these upcoming Alliance events!

Tues., August 27th: #HomeHealthChat on Patient Safety and Engagement

On Tuesday, August 27th the Alliance will host its second Twitter Chat at 2 pm ET, co-hosted this month with the Visiting Nurse Association Health Group and guest host Sherl Brand, BSN, RN, VNA Health Group’s Chief of Business Development, Vice President External Affairs. Questions in the chat will tackle topics such as what home care can do to prevent falls in the home and the community and how to help patients become empowered to be safer at home.  To participate, login to Twitter on August 27th at 2 pm ET and type #homehealthchat into the search box, there you can follow the discussion and participate live using the aforementioned hashtag. For more information on “How To” Twitter chat and a tutorial video, please visit http://ahhqi.org/resources/twitter-chat.

Wed., September 4th: Innovation Perspectives Webinar with the National Partnership for Women and Families

The Alliance will host a new Innovation Perspectives webinar on Wednesday, September 4th at 2 pm ET featuring speakers from the National Partnership for Women & Families. “Patient & Family Engagement Across the Care Continuum,” the third webinar in the series, will focus on the National Partnership’s model of patient and family engagement and how home health can better partner with patient-centered initiatives. For more information on the webinar, or information on past Innovations Perspectives webinars, please click here.

 

In addition, the Alliance is on the advisory editorial board of Urgent Matters, which is hosting a Webinar on Friday, August 23rd on Federal Liability Protection for Emergency Care:  Urgent Matters, an initiative funded by the Robert Wood Johnson Foundation to reduce emergency department crowding and relieve patient flow, will host a 90-minute webinar titled, “Federal Liability Protection for Emergency Care” on Friday, August 23rd at 11 am ET. The Alliance is proud to be a member of the Urgent Matters editorial board and we encourage our members and followers to participate in the important discussion on patient safety, specifically the Health Care Safety Net Enhancement Act of 2013. Click here to register for the webinar.

 

For questions about any of these events, or to feature an event in our blog or e-newsletter, please contact the Alliance’s Director of Strategic Initiatives and Communications, C. Grace Whiting at gwhiting@ahhqi.org.

Alliance to Guest Host for the Home Health and Healthcare Advocacy Group on LinkedIn

We’re excited to be a guest host this month for the Home Health and Healthcare Advocacy Group on LinkedIn. The group, moderated by Right at Home’s Rob McClenahan, encourages participation of all home care and healthcare professionals who have a genuine interest in improving the quality of patient care. Home Health and Healthcare Advocacy’s works to promote genuine and uncompromised dialogue between professionals on how home care and healthcare can be improved for the betterment of each individual, patients, and the globalized medical community on a domestic and international basis. Topics and discussions typically focus on continuum health care, home care and care transitions.

For the month of August, the Alliance will be a “guest host” and co-moderate a robust discussion on the ever-evolving world of home health care and the ways in which environmental and technological changes allow us to adapt and collaborate in order to continue providing quality health care.

 

Why Join the Discussion?

Participating in our LinkedIn discussion is a great way to develop new connections with other professionals who share a passion for home health and the work being done to improve patient care. You’ll have the opportunity to connect with new people on-line, gain a new perspective, and build your existing network of home health and healthcare connections.

 

How to Participate

  1. Login to your LinkedIn account. If you do not already have an account, you can create one for free here.
  2. Join the Home Health and Healthcare Advocacy Group by clicking here and clicking the “Join Group” button.
  3. After you have joined the group, navigate to the Alliance’s guest discussion page by clicking here.
  4. Start by reading the conversation, and then get involved by “liking” the post or sharing a comment with your insight!
  5. Follow the conversation over the month, and feel free to share your thoughts as the discussion progresses.

 

Still have questions about how to navigate LinkedIn? Feel reach to reach out to the Alliance staff to walk you through your participation. You can reach the Alliance’s Director of Strategic Initiatives and Communications, C. Grace Whiting at gwhiting@ahhqi.org or (202) 239-3983 or the Alliance’s Special Assistant to the Executive Director, Jennifer Schiller at jschiller@ahhqi.org or (202) 239-3206.

 

Connect with the Alliance on LinkedIn!

Follow the Alliance’s Page by clicking here.

Connect with Alliance Executive Director Teresa Lee, by clicking here.

Connect with the Alliance’s Director of Strategic Initiatives and Communications C. Grace Whiting, by clicking here.

Connect with the Alliance’s Special Assistant to the Executive Director Jennifer Schiller, by clicking here.

Introducing the New “Healthy At Home” Twitter chat

The Alliance for Home Health Quality & Innovation is pleased to introduce our monthly Twitter chat. The “Healthy At Home” monthly Twitter chat intends to bring together various stakeholders in the home health policy community, including home health associations, providers and caregivers, patients and clinicians, and the policymaking community.

We’re excited to engage you in a new conversation about the value that home health care can offer to patients in the U.S. healthcare system.

 

WHEN: Fourth Tuesday of Each Month, 2pm ET

Next Chat:  Tuesday, July 23rd.  The Partnership for Quality Home Healthcare is our July co-host.  The chat will focus on “Cost-Effective Home Health Care.”

Discussion questions for the chat include:

  1. What makes home healthcare a cost-effective alternative to other settings?
  2. Who benefits most from cost-effective home healthcare?
  3. How would a co-pay affect patients who want to receive care at home?
  4. What types of clinical, medical care can home health professionals offer patients  within their home?
  5. What role can coordinated care play in improving the patient experience and quality of care?

 

WHERE:

Follow the hashtag #HomeHealthChat at www.twitter.com.

 

HOW DO I PARTICIPATE:

The Alliance will also host a half-hour “How To Twitter Chat” on Thursday, July 18th at 4 pm ET. Use the information below to join the webinar.

Webconference Information

1.  Visit http://fuze.me/20691910;

2.  Call (347) 817-7654 or (800) 844-3988; and

3.  Enter Meeting Number:  20691910

You may also view our handy “How To” Twitter Chat graphic here, which contains all the information to get you connected with the #HomeHealthChat each month.

Optimizing Home Health Care: Enhanced Value and Improved Outcomes

This spring, the Alliance for Home Health Quality and Innovation released an electronic supplement to the Cleveland Clinic Journal of Medicine, “Optimizing Home Health Care: Enhanced Value and Improved Outcomes.” The supplement features six research articles from leading home health experts, and can be read in its entirety here.  Physicians can also seek Continuing Medical Education (CME) credit online related to three of the journal articles and free of charge, by clicking here.

In a continuing effort to educate the care community on the value of home health, the Alliance is issuing a series of one-page documents for each article. The first in the series summarizes the article, “Home-based care for heart failure: Cleveland Clinic’s ‘Heart Care at Home’ transitional care program.” The article focuses on potential value for home care in treating patients with chronic heart failure (HF).

Article Highlights

  • Heart Care at Home, a program initiated by the Cleveland Clinic in 2010, seeks to minimize possible risks in the transition of HF patients from inpatient to home care.
  • As part of the program, home care liaisons visit HF patients approximately two days following discharge from the hospital into the home to teach patients how to use their telehealth equipment.
  • HF patients, in the Heart Care at Home program, receive weekly contact and monitoring from telehealth nurses for 30-40 days after the program begins.
  • Home care nurses are trained specifically to work with HF patients and telehealth technologies.
  • The program yielded high success in 30 day readmissions rate, which were nearly four percent lower for first-time enrollees in Heart Care at Home versus publicly reported Cleveland Clinic rates.

To access the one pager please click here.

Connecting Home Health Care to the Care Continuum: Thoughts from Pamela Duncan, Wake Forest Baptist Medical Center

Recently, the Alliance for Home Health Quality and Innovation profiled healthcare innovator Pamela W. Duncan, Ph.D. as part of the new Revolutionizing Healthcare-at-Home series, in an article titled, “Connecting Home Health Care to the Care Continuum.” One of the goals of this new series is to showcase how the innovative use of home health can improve the lives of patients and improve healthcare outcomes.

Dr. Duncan currently serves as a professor of neurology at the Sticht Center on Aging, Geriatrics & Gerontology at Wake Forest Baptist Medical Center and an Innovation Advisor for The Center for Medicare & Medicaid Innovation. Her most recent project for the CMS Innovation Advisors Program focuses on transitions for patients with congestive heart failure, looking at streamlining the transition between hospital and home health.

Article Highlights

  • Dr. Duncan’s work looks at health care in the context of a cohesive community of care, with home health playing a significant role in a patient’s disease management and the transition from hospital to home.
  • As the intermediary in the transition, home health offers both clinical care and connections to community resources—critically linking acute care treatment with at-home recovery.
  • While the data from the program is still new, Dr. Duncan says she has seen significant reductions in rehospitalizations using cross-continuum collaboration.
  • Creating transitional care programs like the one implemented by Dr. Duncan may help providers and health systems save time, energy, and money while improving patient outcomes.
  • In order to better utilize home health for care transitions to primary care and community-based resources, Dr. Duncan suggests that home health providers should place a greater emphasis on education and improving relationships with other members of the care continuum.

To read the full profile, please click here.

Celebrating Older Americans Month: Utilizing Home Health Care to “Unleash the Power of Age”

This month is Older Americans Month, a joint recognition month sponsored by the U.S. Department of Health and Human Services’ Administration for Community Living and Administration on Aging. The 2013 theme, “Unleash the Power of Age!”, celebrates the contributions of older Americans in this country. Some of the month’s activities include a “challenge” for adults age 60 and older to demonstrate how they continue to be actively engaged in their communities (for more information, please visit http://www.olderamericansmonth.acl.gov/challenge.html).

After receiving treatment for an injury or illness, many older Americans face the challenge of becoming active again. A look at the Home Health Chartbook identifies some characteristics of older adults using home health services:

  • Following an inpatient stay, 38.7 percent of Medicare beneficiaries are discharged to post-acute care.
  • Major joint replacement or reattachment of lower extremity without a major complication or comorbidity accounts for the largest percentage of Home Health Part A claims in 2010 at 10.77 percent, or 211,779 claims that year. Another 31,145 claims were made for hip and femur procedures with a complication or comorbidity.
  • Medicare home health users with the most common diagnoses experienced slightly lower 30-day rehospitalization rates than skilled nursing facility users, including a mere 4.33 percent rate among major joint replacement or reattachment patients.

Home health is a vital post-acute tool for patients, especially older Americans, looking to safely recover from injury or illness while continuing to work toward a healthy and productive future. One rapidly growing treatment in particular – total knee replacement (TKR) procedures- are critical for older Americans who wish to remain active and involved in their community. A recent article from the Cleveland Clinic Journal of Medicine’s electronic supplement, “Optimizing Home Health Care: Enhanced Value and Improved Outcomes” focuses on the ways home health can benefit TKR patients.

In an effort to address patient concerns over the length of expected recovery from TKR, a Rapid Recovery Care Path was developed which emphasizes discharging patients back into their homes as soon as it appears safe to do so. Since the program’s implementation in 2006, the program has shown several positive results, including lower readmission rates for patients discharged to home as compared to rates before the protocol was implemented, and a cost savings to the system of about one-third compared to patients discharged to an inpatient post-acute facility. (The full article on TKR can be found here.) Better outcomes at decreased costs will help older Americans stay active members of the community, continuing to improve the lives of others.

Additionally, older patients have found they prefer to recover at home as described in an April 2013 study in the International Journal of Nursing. In the study, early assisted discharge patients (those who were discharged on day four and received visits from a home care nurse until day seven) managing from Chronic Obstructive Pulmonary Disease preferred to receive care in the home. (To read an abstract of the article, click here.) Similarly, a 2011 study published in Telemed and E-Health shows high-levels of patient and healthcare professional satisfaction using in-home telerehabilitaion. (To read an abstract of the article, click here.)  These studies confirm that in general, older adults prefer to recover from illness in settings that allow for more independence—specifically the home.

We at the Alliance, as part of the home health care community, congratulate and thank older Americans for their positive contributions to society, and encourage the continued support of our older population. In order to best care for, and thus benefit further from, the older American population we must be steadfast in our commitment to providing high quality health care.  Home health lets older Americans in need continue to contribute to society from a safe and comfortable setting while they are treated.  Appropriate use of home health enables a very capable and important population to unleash the power of age.