Inaugural #HomeHealthChat: Cost-Effective Home Health Care

On Tuesday, July 23rd, the Alliance hosted its inaugural #homehealthchat on Twitter. The Twitter chat focused on the cost-effectiveness of skilled home health care and featured the Partnership for Quality Home Healthcare (@PQHH) as the Alliance’s co-host.

The hour-long conversation covered topics ranging from the benefits of coordinated care to the consequences of reinstituting a copayment on home health care episodes. Chat attendees discussed and provided examples of home health care as a cost-saving and patient preferred alternative to other forms of post-acute care.

The following questions were posed during the chat:

Q1: What makes home healthcare a cost-effective alternative to other settings?
Q2: Who benefits most from cost-effective home healthcare?
Q3: How would a co-pay affect patients who want to receive care at home?
Q4: What types of clinical and medical care can home health professionals offer patients with their homes?
Q5: What role can coordinated care play in improving the patient experience and quality of care?

The Alliance will host future home health-focused Twitter chats on the fourth Tuesday of every month at 2pm ET. Be sure to check here for updates on topics and questions! If you have topic ideas for future Twitter chats, or are interested in co-hosting a chat, please email C. Grace Whiting, the Alliance’s Director of Strategic Initiatives & Communications, at gwhiting@ahhqi.org.

Below are some of the highlights from the first chat:


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!

 

New Data on Hospital Readmissions: CACEP Working Paper #4

The Alliance today released Working Paper #4 of the Clinically Advanced and Cost-Effective Placement (CACEP) research project, which examines hospital readmission and admission frequency and associated Medicare episode payments across three episode types: post-acute, pre-acute, and non-post-acute (community-based) care. Hospital readmissions and admissions were analyzed within the context of patients’ chronic conditions and demographic characteristics.

Key Findings

  • Hospital readmissions increased Medicare episode payments by at least 100 percent.
  • Patients with more severe primary chronic conditions tend to have more readmissions.
  • 22.4% of post-acute care episodes have at least one readmission.
  • Medicare post-acute care payments more than double when an episode contains at least one readmission, from an average payment of $15,335 without a readmission to $33,926 with a readmission.

Additional Working Paper #4 Resources

Full Report 
Study Highlights
Executive Summary
Webinar
Presentation Slides

Home Health Implications

CACEP Working Paper #4 data suggest that better management of chronic disease across all three episode types through home health intervention could enable more patients to remain out of the hospital following an initial admission, or prevent avoidable hospitalizations all together.  Clinically appropriate and cost effective care ultimately can improve the quality of patient care and reduce the cost for the Medicare program and taxpayers.  Home health care combines the right mix of care management, prevention training and close observation to significantly reduce hospital admissions.

As lawmakers look into ways to reduce spending from hospital admissions and readmissions, how can home health be part of the conversation? Please comment below to submit your ideas. 

Stay tuned for the release of the final paper of the Clinically Advanced and Cost-Effective Placement (CACEP) project this fall. Details coming soon!

Home Health News Roundup: Week of July 14 – 20

Care Transitions Program Shows Home Health Care “Highly Effective” in Reducing Rehospitalizations

Home Healthcare News

A collaborative effort among hospitals, home health agencies, and a Medicaid-managed care program in upper New York has been successful in reducing hospital readmissions, according to a new report. Read more

 

Home Health Care Goes High-Tech

The Asbury Park Press

New technology is making it possible for more care to be administered from home. Read more

 

Home-Based Care Teams Offer Help for Patients With Dementia

U.S. News Health

New research suggests coordinated home healthcare efforts for patients with dementia can improve quality of life and delay the need for nursing home care. Read more

 

Home Monitoring Device Market Surge to Keep Seniors at Home 

Home Healthcare News

The market for in-home health monitoring services is expected to grow from fewer than 3 million to more than 36 million units over the next five years, according to forecasts from ABI Research. Read more

 

Hospitals’ readmission rates still too high, government says

The Washington Post

Despite government efforts and the threat of financial penalties, hospitals are making little headway in reducing the frequency at which patients are readmitted. Read more

 

HHS: Health law project will cut state costs in major programs

The Hill’s Healthwatch

HHS Secretary Kathleen Sebelius says a new project under the Affordable Care Act will improve care and cut spending in the Medicaid and Medicare programs. Read more