The Drive to Value-Based Post-Acute Care

Value-based care is all over the news these days. Earlier this month the Community Oncology Alliance submitted a value-based care proposal to HHS. The American College of Emergency Physicians proposed to CMS a value-based payment model that will track patients 30 days after discharge. The American Academy of Family Physicians also weighed in on value-based care plans introduced as part of the CMS Primary Cares Initiative. Meanwhile, a large cohort of payers are actively looking to work with agencies and care providers that are taking on value-based care. 

And yet, as a recent study by Humana, with help from Penn Medicine discovered, there’s ambiguity around the phrase “value-based care.” What survey respondents could agree upon: “Value-based care applies to individuals and populations and is determined by health outcomes and cost.” Another truism: those home healthcare and hospice providers that get a jump on value-based care will be well-positioned to add new and expanded payer partnerships and an expanding slice of the $99 billion market to its list of accomplishments.

“We’re seeing that fee-for-service care, regardless of the setting, is going away. Value-based care puts the patient in the center of the universe and helps all providers share risk and improve outcome,” explains one of Forcura’s favorite industry experts, Gina Mazza, Senior Vice President at Fazzi Associates, a home healthcare and hospice consulting firm based in Northampton, Mass. “Home health agencies that are exploring this and doing well have been able to use it to their advantage as a competitive tool,” she agrees. 


It All Comes Down to Data

There are many home health providers that fall into the “doing it well” category, says Brent Korte, executive director of homecare services for EvergreenHealth. These agencies understand that data is the key to value-based success and are using technology and other tools to get the most out of their data. At the most basic level, care providers need fast, simple access to patient data as well as contract, cost, and outcome data. 

“We need to know if what we’re doing works. We need to become more agile. Access to data helps us hone in on inefficiencies and, for instance, get orders back more quickly,” explains Korte. His agency went through this process, moving to a value-based focus. The process started with educating its clinicians so that they understand what they are charting for matters, he says. His agency also requires everyone admitting patients – approximately 180 people – to become OASIS certified. In addition, the agency uses technology to remove barriers to care and improve efficiencies around processes such as document workflow and care coordination. 

While it can take a while to create a value-based strategy and incorporate the technology that makes it happen, it’s something that all care providers should strive for.

The Health Care Transformation Task Force (HCTTF) announced that by the beginning of 2018 almost half of its provider and payer members had shifted contracts from fee-for-service arrangements to value-based care. That compares to only 30 percent in 2015. Post-acute care providers need to get started now if they don’t want to be left behind. (The HCTTF is a consortium of payers and care providers including Aetna, Anthem, Inc., multiple Blue Cross Blue Shield, Kaiser Permanente, and Trinity Health, among others.)

Payers like value-based care because patient outcomes are better, readmission rates go down, and there’s more communication across the entire care continuum. This applies in particular to continuity of care, says Mazza of Fazzi Associates. “Data means you’ve always got a good picture of how the patient is doing and nothing falls through the cracks. Without automation and technology you’re faced with missing things. When an agency isn’t digging for information, you’re not surprised, which is one of the worst things that can happen to a provider.” 

Predictive analytics can help providers uncover potential gaps in care, for instance, or a patient who isn’t progressing as quickly as he or she should. It’s also just easier to make decisions when you have data, says Mazza. “Changes in care must be informed by data,” she says. “With data, you have a far better care practice.” 

It’s easier to work across the healthcare spectrum. As hospitals, doctors, and other healthcare providers embrace value-based care and continue adding healthcare technology, analytics, and tools, home healthcare and hospice agencies are going to need to be able to integrate with those data sources or face missing out on partnerships and business. 

And of course the biggest benefit is that not only will agencies be a step ahead of where CMS will undoubtedly drive reimbursement, they'll improve patient care overall. As value-based care truly gains traction in the post-acute space, we at Forcura are committed to empowering our customers to move the needle on better outcomes – and thrive in this patient-focused economy. 

We are currently deep in development with decision-support and business intelligence tools designed to help post-acute providers and their partners make smart clinical and business decisions that drive value for the patient, the provider and the healthcare system as a whole. I can’t wait to share what we’ve been up to and am excited about the prospect of value-based care making a real impact on our ability to serve the unique needs of each patient in a meaningful way.

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Annie Erstling is Chief Strategy Officer at Forcura. In this role she is responsible for driving growth and oversees the company's strategic planning, product innovation, marketing and strategic partnerships. Annie is passionate about the real impact that data and the free flow of communication in healthcare can have on improving the patient experience and driving better outcomes. Connect with Annie on LinkedIn.

Topics: Innovation & Interoperability in Healthcare, healthcare

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