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HOME HEALTH ORGANIZATIONS – TECHNOLOGY FOR EPISODIC MANAGEMENT DECISIONS
BKD NATIONAL HEALTH CARE GROUP
April 24, 2017
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If all eligibility requirements are met, each participant will be emailed their CPE certificates within 15 business days of live webinar
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4/21/2017
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PRESENTERS
Karen Vance, OTRSenior Managing [email protected]
Karen Thomas, BS, MBA, CMAPresident, Advanced Telehealth Solutions
OBJECTIVES
Identify data elements contributing to the success of CMS Triple AIM
Use data to redesign care models & improve outcomes
Recognize methods to track progress toward improvement within episodic payment models
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IDENTIFY DATA ELEMENTS CONTRIBUTING TO THE SUCCESS OF
TRIPLE AIM
HOME HEALTH & CMS TRIPLE AIM
Home health has the data to monitor & manage for success with Triple Aim
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DATA FOR MANAGING TRIPLE AIM
Improved efficiencyPayment per patient
Reduced hospitalization
Improved outcomesQuality measures
Patient experienceHHCAHPS scores
Oasis Data Set
Casper Reports
HHC
Star Ratings
USE DATA TO REDESIGN CARE MODELS &
IMPROVE OUTCOMES
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CARE REDESIGN
Data-Driven Episode Management
Assess at risk outcomes, target low-performing staff &
assure data accuracy
Manage utilization through care coordination;
monitor at risk outcomes
Measure clinical & financial
outcomes against benchmarks
EPISODE MANAGEMENT
Patient Engagement
Interdisciplinary collaboration Between visit
progress
Patient monitoring, managing own condition
Tapered visit frequency
Good outcomes, cost efficiency
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CARE TEAM INTEGRATION
Universal Understanding of Program Goals
1. Actionable Data
2. Timely Clinical Triage
3. Communication
4. CareCoordination
5. Timely Care Provider
Involvement
BEST PRACTICE ROADMAP
1. Create Goals
3. Clinical
Expertise4.
Define Equip-mentNeeds
6. Recognize Obstacles &
Missing Components
5. Understand Operational
Efficiencies & ROI
2. Design Program
Structure
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DRIVING OUTCOMES
Strong client collaboration
Effective call center – monitoring team
Appropriate patient selection
Coordinated care
Closing the Loop
Analysis
Documentation
Reporting
Internal audit
Performance improvement methodology
DATA SCENARIOS
Home health outcomesComparison
Monitored vs. nonmonitored
Acuity level & process control
Performance improvementCall center data & efficiency compared to outcomes
Coordination of careRehospitalizations – correlation to agency staff vacancies
Patient criteriaProper selection
Clinical appropriateness
Cost effectivity
Equipment needs
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OUTCOMESDiabetic Outcomes Average HgbA1c reduced 37% to 6.89
32% decreased glucose levels 24 points
52% decreased systolic blood pressure
18% lost greater than 5% body weight
69% improved score on Diabetic Knowledge Test
OUTCOMES
CHF Rehospitalization ProjectControl Study Group
Six-month hospitalization
reduction50% improved
30-day hospitalization
reduction73% improved
ER reductions68% improved
Improvement compared to control group
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CASE STUDIES
Program developmentCJR
Education observation of gait & movement
Incision care
Depression & isolationGeriatric population
Video visits
Presurgery program for CABG patientsEducation for patient & family
RPM after surgery
Resulting in a reduction of 0.7 day length of stay & rehospitalization rate of 50% less
Study to be published in near future
OUTCOMES
Multiple Co-Morbidities Improvement
Hospitalizations 56%
Hospitalization Days* 73%
ER Visits 56%
*Early detection of issues
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COST SAVINGSWorking with Advanced TeleHealth Solutions has the potential to drive
cost savings for clients & client program participants
RETURN ON INVESTMENT
Value-based purchasingPercentage – incentive or penalty
Bundled paymentsMaintaining referrals
Developing new services
Population health
Orthopedics
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REMOTE PATIENT MONITORING –THE BUSINESS CASE
Reimbursement changes in the futureValue-based purchasing
Bundled payment reimbursement
ACOs
Population health
Impact of telehealth –remote patient monitoring
Partnerships
ABOUT ADVANCED TELEHEALTH SOLUTIONS
Leader inremote patient monitoring for
14+ years
Advanced technologies& strategies
URACaccreditedhealth call
centerClients
include payors,providers &employers
Results: reduction in
hospitalizationsover 50%
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RECOGNIZE METHODS TO TRACK PROGRESS TOWARD IMPROVEMENT WITHIN EPISODIC PAYMENT MODELS
LEVERAGE DATA
Measure key data indicators
Monitor progress
Manage performance
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MEASURING, MONITORING & MANAGING
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CONTINUING PROFESSIONAL EDUCATION (CPE) CREDITS
BKD, LLP is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. Complaints regarding registered sponsors may be submitted to the National Registry of CPE Sponsors through its website: www.nasbaregistry.org.
The information contained in these slides is presented by professionals for your information only and is not to be considered as legal advice. Applying specific information to your situation requires careful consideration of facts & circumstances. Consult your BKD advisor or legal counsel before acting on any matters covered.
CPE credit may be awarded upon verification of participant attendance
For questions, concerns or comments regarding CPE credit, please email the BKD Learning & Development Department at [email protected]
CPE CREDIT
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Karen A. Vance | Senior Managing Consultant | [email protected]
Karen R. Thomas | Advanced TeleHealth Solutions