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.

Alliance and Cleveland Clinic Journal of Medicine Host Capitol Hill Briefing

Guest Author: Steven Landers, MD, MPH
President and CEO, VNA Health Group
Board of Directors Chairman, Alliance for Home Health Quality and Innovation 

This past Tuesday, I had the privilege to moderate a Capitol Hill briefing as part of a collaboration between the Alliance for Home Health Quality and Innovation and the Cleveland Clinic Journal of Medicine. The briefing focused on home health and its overall value to the health care delivery system, through a discussion on a supplement and corresponding Clinical Medical Education (CME) program in partnership with the Cleveland Clinic.

The supplement, titled, “Optimizing Home Health Care: Enhanced Value and Improved Outcomes”, compiles articles from distinguished physicians, nurses and academics, who are experts in delivering health care at home. This research represents the Alliance’s support of peer-reviewed work demonstrating how home health can be used more effectively to address patient needs, improve outcomes, and lower costs in the Medicare system.

Fellow panelists included:

  • Peter Boling, MD, Chair, Division of Geriatric Medicine, Virginia Commonwealth University
  • Michael Fleming, MD, FAAFP, Chief Medical Officer, Amedisys, Inc.
  • Mark Froimson, MD, MBA, President, Euclid Hospital, Cleveland Clinic Health System
  • Eiran Gorodeski, MD, MPH, Heart and Vascular Institute, Cleveland Clinic Executive Director
  • Margherita Labson, RN, MSHSA, CPHQ, CCM, Executive Director, Home Care Program, The Joint Commission

Below are a few highlights and key points from the information packed hour:

  •  The Amedisys care transitions initiative decreased the average 12-month readmission rate from 17 percent to 12 percent.
  • The VCU Medical Center implemented a hospital-based transitional care program (TCP) 12 years ago that has served more than 500 patients.  This program resulted in a decreased use of hospital resources— including fewer inpatient days, shorter lengths of stay, and fewer intensive care unit days— after enrollment in the TCP.
  • A home-based care path following Total Knee Replacement reduces the patient’s hospital stay and lowers readmission rates.
  • The Heart Care at Home program helps patients avoid the “black hole” of returning home after hospital discharge with complicated medication regimes and restrictions through visits with home care nurses and the use of telehealth.
  • Palliative care and home health can work in tandem to reduce pain and manage symptoms while still pursing curative or life-prolonging treatments. Two programs- Kaiser Permanente’s In-Home Palliative Care Program and Sutter Health’s Advanced Illness Management (AIM) program have been successful in their efforts. The Kaiser program delivers all service into the home and contributed to increased patient satisfaction and an average cost savings of $8,000 per person and a 52% reduction in readmission rates heart failure patients.

If you missed the briefing, please visit ahhqi.org to view the webcast and materials. We will also be bringing you a detailed blog post on each of the author’s articles in the coming weeks, so please be sure to check back here for updates!