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It Is Time for Care Re-Design

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There has always been an element of uncertainty among home health providers when it comes to the changing landscape of payment reforms. What may sound like a good idea as a news byte can unravel with deeper analysis. The current political environment has many on edge about what our future holds as we wait to see what regulations change while others stay the same. In the midst of all of this, the bottom line remains clear – old models of care delivery are not sustainable as we look to the future.

We have basically two options. One is to keep business as usual, wait to see what happens then adapt as needed. The other is to take a hard look at how we provide care now and lead change. As I listen to many in home health discuss our future, the theme of “we are the most cost effective” seems to be the strongest message. Are we really OK with coming to the Post Acute Care table with a “we are cheaper” tag line? Don't get me wrong. I understand that cost control is a significant part of reform but that will not be enough. A key message in a value based purchasing model provision of cost effective AND high quality care.

I review a lot of documentation and after over 20 years in home health I have to say that from a content perspective, I do not see too much that is any different. IPS and ultimately PPS may have driven visits down overall while therapy thresholds appear to align with increased used of PT, OT and SLP. Utilization often looks different when one patient is traditional Medicare while the other is under a managed care model. Despite these differences in visits, and therefore costs, the meat of the care plan looks unchanged. Nursing is still doing “medication management” and “wound care”, PT is all about “gait training” while OT is managing “ADL retraining” and SLP is addressing “cognitive retraining”. What I cant seem to find is a patient specific outcome focused intentional care planning process based on a solid foundation of evidenced based practice. Our continued practice of speaking in generalities is NOT positioning us for a leadership role in post-acute care.

Care redesign must be our focus for 2017. We cannot keep providing care the way we always have without proof it works. Kornetti & Krafft Health Care Solutions is committed to providing education, tools and resources to empower agencies to be ready for the future of post-acute care. Wait and see mode may find us last to the important conversations and ultimately seeing our future dictated by those who do not truly understand all that we are and can be.



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