THRIVE: Informatics and Data in Post-Acute Care
Author: Maxwell Healthcare Associates
Posted: March 12, 2024
The post-acute industry becomes increasingly volatile every day as it transitions towards a focus in value. At Maxwell Healthcare Associates, we believe that if caregiver passion exists within the agency, any organization can thrive with the proper knowledge. The team at MHA comprises many longstanding industry veterans from all aspects of the care process. Through each interview we aim to empower your agency in making the shift from surviving to thriving amid the strenuous post-acute care environment. In this interview, we sat down with Dustin Cowan, Senior Consultant on the Analytics team at MHA. Cowan discusses the current state of post-acute care, pressing technology trends in informatics, and the best practices to thrive in a data-driven agency.
What trends do you see in Home Care and Hospice that are easily combated through data analysis and performance monitoring?
We continue to see cuts in CMS reimbursement for home health and Hospice as well as increased regulation and an emphasis on quality. I think that it's very important to make sure that we are keeping up with our own comprehensive data, and our performance metrics. We're always given historical data from CMS. We're trying to look forward and optimize and become better, but right now with the EMR and informatic technology we can be comprehensive and see our real time outcomes. Where do we need to tighten up and do better so that we can stay a strong competitor in the industry? So, looking forward, rather than just relying on our historical data, we can use our current data to make us better suited in the future rather than being reactive when the time comes.
What are the main EMR issues that you see agencies struggling with and what can be done on an optimization front to combat these issues?
The number one issue that we see time and time again is the infrastructure; the setup of the EMR not walking hand in hand with the processes that are set out by an agency. So, making sure that we can marry our processes with the build and the capability of the EMR that's being utilized is really gold for the agencies that we work with. Making sure that they have the tools and are working with a partner that's knowledgeable and really understands the infrastructure set up as it relates to the EMR that's being utilized. Furthermore, working with your team to provide that change management piece so that everything goes smoothly and is able to alleviate any issues that arise.
What items from CMS do you believe will create the need for agencies to optimize a specific process or multiple processes?
Every single day we are seeing an increase in our managed care, and a decrease in our traditional Medicare. That managed care means that we're getting, at best, 90% reimbursements for the total cost of that patient. We must make sure all our processes are tight and compliant on that quality front. Understanding that we have a need that needs to be taken care of, but we are working with that agency to make sure that they're set to go. Because it’s not going to get any better, there are going to be continued cuts to our bottom dollar, so at this point in time you can't really afford to have any fat. You must be very streamlined and take that approach to provide care to the patients you serve.
What is the number one item that you see agencies struggle with in the informatics space?
We see time and time again a situation where this agency bought onto this EMR and they've kind of taken this “cookie cutter” approach, used it, and created all these external processes to keep their own internal processes going. We see this very often, we have healthcare professionals that are trying to grab on and become IT professionals as well, really stretching their responsibilities. So, we step in and fill that role, and help them so they understand all the setup. If the setup of the EMR isn't completed to fit your processes, then you're never going to be able to grow into that agency or that company that you want to become.
What are some best practices that agencies should utilize to avoid struggles while undergoing growth?
Knowing your competitors and knowing the space that you're growing into. That kind of falls back into performance metrics; knowing your performance metrics, knowing what you do well, what you want to highlight, knowing your competitor’s performance metrics, what they fall short on. With this information you're able to capitalize on that business, and that really comes into if you're wanting to grow as an agency. Sales and operations must be on the same page, they must be working towards that common goal. When you're working shoulder to shoulder with your sales team you can spin that into the niche of your environment, ultimately moving into your desired growth.
What are some commonly ignored performance metrics that you believe will make a transformative difference when analyzed and used to inform decision making?
That would be dependent upon the service line. I think each service line has some hidden value in some of those metrics that we get. We pull from Trella, from CMS, or wherever that comes. For Hospice for instance, you know looking at the number of visits performed in the last days of life, that shows you that the Hospice agency that you're working with is very attuned to the needs of the patient, they understand all those processes, and they're providing the care patients need at the optimal time when it's most needed. I think that there's lots that you can derive from a Hospice agency just by looking at the visits that they're performing in the end of life. For home health it's kind of the opposite approach. I think looking at the visits especially with referrals that come out of acute care facilities; looking at the “how”. What do we do in the beginning when we admit this patient, how well is this agency performing visits, and front loading those visits so that we keep that patient out of that facility again. So, making sure if you look at the number of visits completed in the first two weeks for home health you can see not only how tight their internal processes are so that they're getting the referral, and they're turning that referral and converting it to an admission, but then once they admit the patient they're also providing a high number of visits in that beginning. This shows they’re dedicated to managing that disease process and keeping that patient out of the hospital.
THRIVE with MHA – Strategic Business Insights
Post-acute agencies are experiencing a pivotal time where insight and data-driven decisions are essential to do more with less. As clinicians give their all to continually provide the essential care to those in need, agency documentation and compliance must remain top of mind. Staying up to date on trends is an essential step towards success in the post-acute industry. MHA is your partner throughout this process, empowering you to make the strategic jump from surviving to THRIVING. Our experts provide leading strategic recommendations and transformative data insights to overhaul your process and guide you toward ideal success. Don’t hesitate to reach out if you are ready to strategically redefine data confidence and reach your desired growth and success. Contact us today at [email protected] or visit www.maxwellhca.com to schedule an assessment.