Strategic Framework To Optimizing Care Value At Home

December 5, 2019

If you look at the present home health care scenario you will understand that the future of healthcare is in the home. It is for this reason that the home health care industry as well as the government are now more focused on building more strategic and a solid framework.

This framework will help the home care agencies to better their services which will in turn help them as well as the patients to optimize the health care value, at home. The main reason and objective of the government to design such a framework is the factors that are playing in the background to drive such a change.

One of the most significant factors is the cost and demographic impetus of the graying population that is changing the landscape and working process of the health care and home care industry.

The MedPAC report

According to MedPAC or The Medicare Payment Advisory Commission, it is estimated that the enrollment in Medicare will be more than 50% increasing from 54 million beneficiaries as of today to more than 80 million by the end of 2030. This estimate indicates that:

  • There will be an overall increase in the aging population of the United States
  • Census projects such as increase by 2030 based on the projection of the older US residents who are older than 65 years which is at present 13%
  • The project also says that the rise of old generation in America will be 20% and as for the people older than 85 years the Census predicts it will double by 2036 and triple by 2049.

It is also seen that the Medicare population is much healthier than the previous generations which is a good sign for the future of health care. With the developed care process and continual care, smoking rate and mortality rate has declined significantly with the older citizens now having longer life expectancy.

The system reforms

This is all due to the better home care services provided by well-trained and professional nurses and physicians who have all the required knowledge about Home Health care jobs, the rules and the set standards to follow.

It is the reforms made in the health care delivery system that has enabled such significant changes in the results. Ideally, it is the HHS goals and the Triple Aim that has caused such a solid framework. These goals and reforms are made on the basis of different factors such as:

  • The demographic trends
  • The spending concerns
  • The medical and physical needs of the patients and
  • The expectations of their family members.

With all these on the backdrop, the Medicare program emphasizeson the achievement of “Triple Aim.” They have designed a solid framework that was originally conceived by the Institute for Healthcare Improvement. However, this framework is now accepted almost universally by all home healthcare agencies in their care planning and execution.

The Triple Aim focuses on the efforts of the home care agencies and include them in the Medicare program. This in turn enables them to follow the three goals of US health care systemsimultaneously which are:

  • Improving patient experience, quality and satisfaction of home care
  • Improving the health of the aging populationsand
  • Reducing the cost of health care overall.

Ideally, the Triple Aim concept of the policy makers is what is driving the health care delivery system for a better future.

The future of healthcare

The future of healthcare is in the home. It is this realization that has influenced the home care industry to redirect care from the hospitals and other long-term care facilities such as the nursing homes to the homes of the patients.This generates significant savings for the patients as well as improve the clinical outcomes of the care process. This will ensure an increased patient satisfaction.

However, most unfortunately the contributions of the home care providers though essential for the older generations are mostly poorly understood. It is due to the possibility of the problem that results in a lot of wasted resources. However, this can be prevented by:

  • Improving care coordination
  • Reducing unnecessary acute care and
  • Providing more efficient care.

The experts say that this can prevent at least 25% of read missions. They also say that more than 20% of the patients can go home directly from the hospital and acute care facilities relying on the home care givers. Actually, more than 47% of the Medicare beneficiaries receive their post-acute care in their homes from professionals who help them with their activities of daily living.

Provide effective home care

According to the given scenario, the most effective solution to the problem is to provide the most effective and productive home care to the patients. There is an increasing number of survey reports and research data that corroborates the fact and also suggest that home health care will reduce the cost of care at home proving to be extremely advantageousfinancially for the aging citizens.

In a separate study by the American Medical Association it was found that a monitored home-based care for knee replacement in comparison to an inpatient rehabilitation provided better results and improved mobility in the patient in just 26 weeks after the surgery.

All these findings suggest that home care is the best way to get the best clinical outcomes at a low cost.

Facing the future

However, the road ahead is not as smooth as expected. There will be significant challenges and lots of barriers to overcome. It can also lead to a lot of chaos and confusion especially when people take on or are discharged without any physician’s order for a home health care. in such situations they do not get the payment in the end.

In order to prepare and face the future use of proper discharge planner, proper coordination and better cooperation and involvement of the physicians, payers, providers, patients and the government as well is required.Apart from a team work and better coordination, use of software for proper analysis of care process is also required.

In short, value-based care and fair reimbursement mechanisms will ensure no one goes home without proper care.

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