The Ankota Healthcare Delivery Management Blog

Creating Meaningful Activities for Home Care Clients with Dementia

Posted by Ken Accardi on Aug 22, 2016 10:00:00 AM

 

Dementia and Alzheimer's disease are tough for everyone involved, including the home care client who is experiencing memory loss as well as their family members and their care providers.  The symptoms of Dementia and most notably the memory loss are often the reason that home care is required.  At this stage in the individuals life they need help with activities of daily living like eating and hygiene.  But to enhance their lives, a great home care agency will also provide them with opportunities for meaningful activities that can bring them joy or make their days special.

Meaningful activities give people a sense of purpose or joy, and finding out the right activities that will Memories.jpgbring joy to a particular client may be tricky because everyone is motivated by different things.

To find the meaningful activities for an individual a great start is to learn about their past hobbies and interests.  A great way to start is to see if there are any photo albums in the house where you can get an idea for activities that interest the client. I heard an Alzheimer's expert speak at a conference and share that a former homemaker may get great joy from folding towels, or a former engineer might really enjoy building things with legos.  These are also activities that they can potentially do over and over again.

Another article from ComForCare gave an example of a client who really enjoyed baseball and although he can no longer throw a ball it brings him great joy to go for a couple innings of a little league game or to have a baseball story read to them.

We had a recent guest blog about gardening as a meaningful activity for some seniors.  This can be a way to give them joy and also get them some time in the sun.

Referring back to the ComForCare article, they shared the following:

 

Meaningful activities can be important for seniors with dementia. These types of activities provide positive sensory, intellectual, cognitive and social stimulation. According to various research, they can also enhance relationships and may stimulate memory and use of language. Activities may also help reduce challenging behaviors associated with Alzheimer’s disease and other forms of dementia.

 

Focusing on Memory Care
May Be a Way to Differentiate Your Home Care Agency

In the private pay sector of home care, it's often hard for a client and their family members to choose one agency over another so they are looking for you to stand out in some way.  I've heard many stories of why an agency was picked.  In the case of my aunt Myrna, she chose an agency because the owner grew up in the same neighborhood that she did and took the time to share neighborhood stories with her.  As a result of that she perceived that his agency would provide better care.  Maybe memory care can be your niche.  If my mom had memory issues, this would likely be a top selection criteria for me.  If memory care isn't your thing, then make sure that you have a different way of standing out!

For more Best Practices, you can download a free eBook Seven Habits of Highly Effective Home Care Agencies.  Just click the link or the picture to download.

If you're interested in scheduling a live demo of our software solutions, just click the button below:

Click Here for a Free Demo

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Ankota provides software to improve the delivery of care outside the hospital, focusing on efficiency and care coordination. Ankota's primary focus is on Care Transitions for Readmission avoidance and on management of Private Duty non-medical home care. To learn more, please visit www.ankota.com or contact us.

 

 

 
If you're interested in scheduling an online demo of our home care or care transitions software solutions, just click this button:

Topics: Private Duty Agency Software, Home Care Best Practices

3 Hurdles Home Care Must Jump to Win Care Transition Referrals

Posted by Ken Accardi on Aug 16, 2016 11:58:26 AM

Care Coordination Concepts, Inc. provides practical approaches to help non-medical home care providers enhance market position by focusing on delivering health maintenance value to clients and their health system providers.  Cathy Meckes was co-founder and president of a licensed and Joint Commission accredited provider of private, insurance and waiver program funded in-home skilled nursing, nurse care coordination and non-skilled supportive services.  Cathy has written todays blog (and the white paper below).  Enjoy!

AAEAAQAAAAAAAAlwAAAAJDk2Zjc5ZWZjLWFjNTgtNDIwMC1hNDY4LTEzYjNhYjA3MTYxYQ.jpgRecent focus on transitional care has non-medical home care providers excited.  Maybe as providers consider how to ensure smooth transitions home from acute and long-term care, they will begin to understand and recognize (finally!) the role non-medical (supportive) services can play.  Maybe (finally!) providers will recognize that non-medical in-home care can cost effectively help ensure all the important aspects of transitional care, including medication management, follow-up appointments, red flag alerts and accurate information about how the patient is functioning back at home.Maybe…but maybe not.  Here are three reasons why:

 

Focus Shift Needed

The healthcare system should be focused on supporting individuals in the phase “Health Maintenance”—where in-home supportive care can make a huge impact—but the phase “Acute Care” has traditionally consumed the lion’s share of available resources. Transitional care is simply the connector between the most expensive and well-supported health system phase—acute care—and the phase we’re actually all seeking (but not adequately supporting)—health maintenance.  If providers don’t understand the role that non-medical care plays in the critically important but least supported phase of the system—health maintenance—what makes us think providers will recognize that role for transitional care?

Lack of a Clear Standard

There isn’t a uniform well-established and recognized transitional care process. Although hospital and physician groups frequently draw from research-based transitional care models for program components, the actual processes vary significantly in terms of provider leadership, other provider involvement, specific activities and communication/documentation systems.  That makes it harder for a non-medical provider to fill a standardized role, or offer a standardized service.  And because transitional care connects a patient to home, additional variables beyond those attached to the patient’s specific diagnosis and health condition—issues like home safety, cleanliness, nutritional support, transportation, personhurdles_in_home_care_1.jpgal hygiene, family support, etc.—make standardized protocols less effective.

Medicare Mindset

Some providers and even more patients think “If Medicare doesn’t pay for it then it’s not important.” Medicare does not pay for supportive services, not because they aren’t important, but because they are beyond the scope of the Medicare mission.  Fortunately, payment reforms that are moving providers toward risk and performance-based payments should underscore for providers that how long and how successfully a patient lives at home has a huge impact on successful health outcomes, defined by the triple aim goals of effective and efficient care that meets patient expectations.

So, What’s a Non-Medical Home Care Provider to Do?

  • Start by adopting health maintenance as your end goal.

  • Analyze the services you currently provide and those you could develop in light of how and what they contribute to health maintenance.

  • Consider how your services could be targeted more directly towards a contribution to improving and maintaining health, and how you can communicate that directly to the providers responsible for the patient’s long-term health.

  • Document and communicate how both the direct services you provide and the quality of the care oversight built into your processes contributes to the maintenance of good health and the avoidance of costly acute care.

The in-home supportive care providers who earn recognition and referrals for a role in long-term health maintenance will find their services in demand for transitional care.

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Cathy has written a recent whitepaper that we think you'll finf useful, entitled "Non-Medical Supportive Services: Establishing a Role in a Heath-Maintenance-Focused System" that you can download for free by clicking the link.

If you're interested in scheduling an online demo of our home care or care transitions software solutions, just click this button:

Click Here for a Free Demo 

Ankota provides software to improve the delivery of care outside the hospital, focusing on efficiency and care coordination. Ankota's primary focus is on Care Transitions for Readmission avoidance and on management of Private Duty non-medical home care. To learn more, please visit www.ankota.com or contact us.

 

 

 

Topics: Private Duty Agency Software, Home Care Best Practices, Care Transitions

A New Dream For The Home Health Care Plan

Posted by Ken Accardi on Aug 13, 2016 9:48:13 AM

 One of the industry experts I learn from every time we speak is Ginny Kenyon, principal at Kenyon Home Care Consulting.  Ginny helps open home care agencies and has given Ankota great inputs on our software.  We at Ankota strongly believe that keeping elderly people healthy and comfortable in their homes (and out of the hospital) is an important step in the evolution of healthcare.  Ginny is one of the pioneers driving moves in home health delivery.  Enjoy her post (below).

For years I have dreamed of a day when home health nurses and therapists would be in charge of their own services. Doctors would be a part of the team but not the “directors” of the care plan. To me, it has never made sense that a physician who knows little about home health services is required to sign off on all orders.

I agree physicians or nurse practitioners must confirm the working diagnosis and the medications. But in home health the professional clinician completes the assessment, defines problems in terms of their discipline and establishes the care plan, not the physician. A physician directing the home health plan of care makes as much sense as asking a plumber to sign off on and be in charge of the electrician, the sheet rocker, and the roofer when building a house. Physicians have repeatedly objected to this requirement and now with the addition of face to face documentation, their objections are even more stringent.care plan

Current Care Plan Paradigm

So how did we get here? When and why is there a paradigm that the physician directs the care plan for other providers? Therapists have individual practices not requiring physician oversight, but not nurses. The origins of physician control over nursing practice started in the early part of the last century. It was determined that the independent practice of nurses was the single biggest threat to the financial future of physicians. As a result, the American Medical Association succeed in getting congress to pass legislation requiring nurses to work under the direction of a physician. Unfortunately for nurses, doctors, consumers and payers, this has not always been the best practice.

Many physicians signing the care plan developed by clinicians tell us the plans make little sense to them. They sign what is required so patients can get the care they need. Is it any wonder the plans make no sense to them? They aren’t medical plans of care, but nursing and therapy plans written in the language of each discipline. Is it time for a change? My idea is for physicians to continue to sign the medical components – the diagnosis, medications, and required diagnostic tests – while disciplines write specific plans which are signed by individual disciplines.

Think of the money spent trying to support this false paradigm! Think of all the hours spent by home health staff gathering a physician signature on the 485 and verbal orders. Think of the patients denied services because physician didn’t want to be deal with the paperwork burden required for home health services.

Future Care Plan Paradigm

So what could the future look like?  I dream of a home health future where physicians are part of the team and work with other disciplines to achieve desired patient identified goals. Each discipline is responsible for their part of the care plan and nursing is responsible for coordinating the overall plan. Long ago, Medicare recognized home health nurses as the patient coordinator or case manager negating a change in current practice.

The physician confirms the working diagnosis and medications electronically and each discipline signs and dates their plans. Compliance with the home health conditions of participation would continue to be the home health clinician’s responsibility. In my new world, the requirement that the physician certify home bound status will go away.

Homebound Rules Need to Change 

If the intent of physicians certifying homebound status was to prevent fraud, it has not been successful. The clinician in the home doing the assessment is the best person to determine homebound status. However there is second serious issue with the homebound rule. It interferes with the ability to provide the care needed to return clients to full capacity and independence.

Much of home health’s role is assisting patients to make lifestyle changes, stabilize their condition and prevent further exacerbations which may lead to more expensive care. To achieve these goals, particularly for those with chronic diseases and co-morbidities, time is needed beyond a 60 day episode. But, because of the homebound requirement, the patient is just beginning their needed changes when they are discharged. Evidence and experience proves it takes as long as 6 months to successfully integrate a lifestyle change. We are finally seeing a glimmer of hope as CMS begins to recognize that those with chronic diseases need longer periods of care and support beyond the current homebound phase.

Also, the 485 must be revised to reflect these new changes. Numerous physicians have complained for years that the 485 makes no sense and provides little useful information. Physicians are asking for patient progress information, response to provided services and any identified medical issues that need their attention. These are not unreasonable requests and as team members are our responsibility to provide. However, this will require a paradigm shift for home health clinicians.

A New Care Plan Dream

I believe returning to an individualized plan of care structured in care plan format is the goal to strive for. Not only will this help the team plan better, but will help those new to home health better understand the care planning process. The current system does not support critical thinking skills and the entire process has become an exercise in checking off boxes.

The system is starting to change from rules of enforcement to becoming outcome focused. This change must emphasize the importance of patients achieving desired goals and outcomes as well as care cost reductions. I believe with these changes, costs will decrease and outcomes improve as well as physician, clinician and patient satisfaction.

It’s time to dream a new dream! These are just a few ideas I see the home health industry needing to achieve true patient centered care. This will allow each team member to fully use their skill set to assist patients in goal achievement. What are your dreams for the future of home health?  Contact Ginny Kenyon at Kenyon HomeCare Consulting to discuss or leave a comment below. Together we make a difference!

This article, A NEW DREAM FIR THE HOME HEALTH CARE PLAN first appeared in Kenyon HomeCare Consulting blog.

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One of Ankota's recent whitepapers, entitled "Selling Care Transition Services to Hospitals" is available for download and we think you'll find it useful.  Please click the link or the picture below to download.  If you're interested in scheduling an online demo of our home care or care transitions software solutions, just click this button:

Click Here for a Free Demo

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Ankota provides software to improve the delivery of care outside the hospital, focusing on efficiency and care coordination. Ankota's primary focus is on Care Transitions for Readmission avoidance and on management of Private Duty non-medical home care. To learn more, please visit www.ankota.com or contact us.

 

 

 

Topics: Private Duty Agency Software, Home Care Best Practices, Care Transitions, Ginny Kenyon

Are Your Home Care Sales Reps Focused on What Matters to Clients?

Posted by Ken Accardi on Aug 13, 2016 8:21:17 AM

I grew up in my career at GE Healthcare as a technology guy and I wasn't at all involved in sales.  When I left GE to work in a tech company, my role was in technical sales support meaning that I worked with the sales team and did demos and project scoping and answered technical questions for prospective customers. In observing the sales team I was concerned that they were often focused on the wrong things, but since I was new to the world of sales I presumed that I just didn't understand sales. In hindsight my gut was right.

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I recently came across an article written by Mark Roberge who is a senior lecturer at Harvard Business School (HBS) and who also works at HubSpot (the company that Ankota uses for our website, blog and marketing automation).  The article is called Are You Discussing What Your Buyers Want to Discuss? Or What You Want to Discuss? I usually try and provide a link to the original article, but in this case it came to me as an email and I couldn't find it online.  I was however able to find a link to a book review on Mark's book entitled The Sales Acceleration Formula.

Are you discussing what your customers care about?

Mark's article included the graph below that compared what customers want to hear about with what sales people want to talk about.  As you can see, they're not well aligned.  

 

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Back to my first sales experience that I mentioned above, the sales guys focused a lot on a concept called "BANT" which stands for Budget, Authority, Need and Timing.  The sales meetings mostly focused on the B and the A. "Do they have a budget for this?" and "Who has the authority to buy?" were the main questions.  The one customer focused piece, "need," got the least attention. Then timing was discussed but it wasn't from the customer's perspective and rather was "you need to pull this deal into the quarter."  The picture above shows that the BANT components are the last things that customers are interested in.

How Does This Relate to Home Care Sales?

The data depicted above generally represents B2B (business-to-business) companies who sell their product or services to other companies, but the lessons can be applied to B2C (business-to-consumer) sales as well.  A few key takeaway are as follows:

  • Price is very important to customers:  If you are a low price agency you should highlight this.  If you're a higher priced agency, you need to focus on your differentiation and the added value.

  • Use Stories to explain how your service works: How the product works is listed above as the second most important concern of customers. Rather than walking through your brochure (which is likely not highly differentiated), tell stories of how you have helped similar customers and how it delighted them

  • "Yes We Can" should be your answer to special requests: If you are a private pay agency one great way to differentiate would be the a "yes we can" attitude.  Think of the case of a family member who flew into town when their mom fell and injured her hip. This family member doesn't know how to get services in your area, but you do.  So if they ask if you can install grab bars, or cut the grass, or get the dogs in a kennel, or drive their mom home from the hospital, if you answer "yes we can" (and charge for the service) then you'll be satisfying the customer, making a few extra dollars and maybe even establishing good partnerships with others who will refer to you.

For more Best Practices, you can download a free eBook Seven Habits of Highly Effective Home Care Agencies.  Just click the link or the picture to download!If you're interested in scheduling a live demo of our software solutions, just click the button below:

Click Here for a Free Demo

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Ankota provides software to improve the delivery of care outside the hospital, focusing on efficiency and care coordination. Ankota's primary focus is on Care Transitions for Readmission avoidance and on management of Private Duty non-medical home care. To learn more, please visit www.ankota.com or contact us.

 

 

 
If you're interested in scheduling an online demo of our home care or care transitions software solutions, just click this button:

Topics: Private Duty Agency Software, Home Care Best Practices

What Rate Should You Charge for Your Home Care Services?

Posted by Ken Accardi on Aug 6, 2016 11:00:04 AM

One of my current hobbies that will perhaps later be a career is to teach in business school and to mentor start-up businesses.  Earlier this spring, I taught business strategy at the University of Massachusetts.  I'd like to now bring some of the techniques taught in business school to the topic of pricing for your home care services.   

The question of "what rate should I charge?" is an important one for every agency. To answer that question we need to look at two things.  First, we need to look at what competition in your area charges.  Second we need to understand your strategy for creating and sustaining competitive advantage.

What are Competitors Charging in My Area?

There are two resources that we've come across for you to benchmark rates in your area.  

  • Genworth: The first resource is a free website provided by the long term care insurance provider Genworth.  You can access it here. Since they are paying claims they have accurate statistics on the rates that are charged in each geography. Two things you should know about this survey are as follows:

    1. In addition to home care you can see rates for adult day care, assisted living and nursing home care

    2. The math is based on an annual rate where there are 44 hours of care per week over a 52 week year. So in order to find the hourly rate, you need to divide the annual rate by 2,288 (44 hours time 52 weeks). The depicted example is for the Phoenix Arizona area.  By dividing to get the hourly rate, we get a rate of $20 for homemaker and around $21.30 for home health aide services. 

  • Home Care Pulse: There is a private duty benchmark and quality improvement company called Home Care Pulse.  We've featured content from them on our blog many times such as this article.  Their benchmark study, which is available here, breaks down rates by geographic area and also give the low, medium and high rates. 

Where Should I Price Relative to Competition?

dollar-1362244_1920.jpgOnce you understand the pricing in your area, you need to determine where you should price and that pricing should correspond to your strategy.  The easiest explanation I can give for strategy is that it is that way that your business creates and sustains a competitive advantage.  The authority on strategy is a Harvard Business School professor named Michael Porter and he describes four generic strategies based on two dimensions.  The first dimension is whether you  are differentiating via a "low-cost" strategy or "differentiation" strategy. By means of comparison, are you Timex or Rolex?  Second, do you serve the broad market or focus on a narrow market such as memory care or pediatrics? 

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Based on Your Strategy, Pick Your Price Point

If you're going to provide a highly differentiated service to the broad market, you should be able to charge on the high end of the range for your area, whereas if you go for low cost then set your pricing that way.  By focusing on a niche you can likely charge a higher rate but you'll have a smaller potential market. There's room for successful companies with any of these strategies, so choose your course and succeed!

For more Best Practices, you can download a free eBook Seven Habits of Highly Effective Home Care Agencies.  Just click the link or the picture to download!If you're interested in scheduling a live demo of our software solutions, just click the button below:

Click Here for a Free Demo

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Ankota provides software to improve the delivery of care outside the hospital, focusing on efficiency and care coordination. Ankota's primary focus is on Care Transitions for Readmission avoidance and on management of Private Duty non-medical home care. To learn more, please visit www.ankota.com or contact us.

 

 

 
If you're interested in scheduling an online demo of our home care or care transitions software solutions, just click this button:

Topics: Private Duty Agency Software, Home Care Best Practices, August 2016 Newsletter

5 Ways Nursing Brings Value to Modern Healthcare

Posted by Ken Accardi on Aug 2, 2016 10:21:55 AM

Today's guest post is from Anita Ginsburg and offers an interesting perspective on how nursing has changed over the years. Interestingly the age of house calls was dying out 50 years ago but is now back on the rise (and we believe that the future of home care will entail more integrated delivery with nurses, aides, call centers and automation).  Please enjoy Anita's article.

Nursing is a career that has dramatically changed over its long history. Centuries ago, nursing was reserved for women and knowledge was handed down from mother to daughter. Over the last 50 years, the nursing field has experienced a remarkable amount of changes.

Training

Navy_nurses_attending_class_-_1940s.jpgDecades ago, nurses lived at the hospitals in nurse dormitories. They received a majority of their training on-site and hands on. Nurses were to treat doctors with a respect, they were required to stand up when a doctor entered the room. Today, nurses are required to have a degree, and a large majority continue their education. For example, many professionals in the field have a degree in nursing, which offers many opportunities for career advancement. They are able to have specialized areas, such as anesthesia or pediatrics. Nurses play a large role in the medical field.

Technology

16731-a-nurse-giving-a-middle-aged-man-a-vaccination-shot-pv.jpgTechnological advances have made the job of nurses much easier than in prior decades. It has given nurses additional time to devote to patient care. The bulk of the change has been focused on the management of patient records and the tracking of medication. The advances are streamlining the medical field and has allowed patients to be treated by multiple providers. Equipment has changed as well. Bedpans used to be metal and reusable. Syringes were reusable. This means that nurses had to clean them with fire after each use. IV bottles were made of glass and IV bags weren't developed yet. Nurses were responsible for caring for the equipment.

Salaries and Demand for Nurses

The salaries of nurses have changed dramatically in 50 years. While there was a short period of time when the supply of nurses was more than the demand, the demand is on the rise currently. Studies say that this trend will continue, and a shortage of nurses may be expected in the next ten years. As a result, salaries have grown at a surprising rate. Many Registered Nurses can start their career at a comfortable salary range.

Nurse Practitioners

Depending on the state, some nurse practitioners can work independently. This category of nurses grew out of a need for additional doctors. Now, we see physicians shifting a bulk of their patients to their nurse practitioners. They are respected and trusted. More and more nurse practitioners are providing primary care services, and this trend may continue to grow in the coming years.

Demand for Nursing at Home

House calls were typical for doctors and nurses, but that subsided over the years.  Now, the demand for nursing in patients homes is growing rapidly. Many patients and families feel more comfortable with this option, and the demand has greatly increased, and continues to be a need. It offers families independence and peace of mind. Supporting loved ones can become difficult on family members, and nursing at home provides a way for them to get the care they need at a personal level.

Nurses have experienced even more changes, and the field has grown as a whole. Nurses are moving towards an even brighter future as the demand increases. They are the heart of the medical field.

Anita is a freelance writer from Denver, CO and often writes about health, home, education and finance. A mother of two, she enjoys traveling with her family when she isn't writing. To succeed in the field of nursingtoday, she suggests getting a bachelor degree of science in nursing.

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Ankota has a new e-book available for download called, Winning with the Home Health Value-Based Purchasing Program, that offers further insight on the discussion.  Just click the link or the picture beow to download.

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If you're interested in scheduling a live demo of our software solutions, just click the button below:

Click Here for a Free Demo

 

Ankota provides software to improve the delivery of care outside the hospital, focusing on efficiency and care coordination. Ankota's primary focus is on Care Transitions for Readmission avoidance and on management of Private Duty non-medical home care. To learn more, please visit www.ankota.com or contact us.

Topics: Private Duty Agency Software, Home Care Best Practices

Home Care Software Vet Proposes Health Care System Solutions

Posted by Ken Accardi on Jul 28, 2016 7:09:59 PM

My friend Scott Herrmann has been a home care industry veteran with broad industry experience in home care not only in the US but also in Canada and Australia.  He recently helped Ankota with our early development of Foresight Care.  He's now working for Medocity who provide a patient engagement and telehealth solution.  Scott is our guest author today and shares suggestions for fixing the healthcare industry from his own experience.

AAEAAQAAAAAAAAWZAAAAJGMwM2FlZTk0LWNiYWYtNGVkZS04ZWMwLWUwYTA3NWYwZmFiNA.jpgThe continuing story of our fractured health care system seems to be highlighted in the news most every day. Failures in patient care coordination, from medication errors to lack of communication between providers, all add to increased costs, additional suffering for patients and, most importantly. their pocketbooks!

More often than not, these reasons become a barrier to providing quality care and better outcomes. In this day and age of MACRA (Medicare Access & CHIP Reauthorization Act of 2015) and Value Based Purchasing,  providers are driven to new performance standards or get paid less for the services they provide. MACRA and VBP both drive the providers to achieve more, perform better and get quality outcomes as fast as possible in this fairly new patient centered care coordination approach. Basically you must make improvements each and every calendar quarter. You know, do more and do it right, and know you’re penalized if you fail to do it. Trust me, that’s not easy.

Personally speaking as my own “medical supervisor,” I have learned ways to reduce my own out of pocket costs and try to begin to break down silos of information, bringing my health data together so I can keep track of current conditions and ways to stay healthy. Blood tests at an outsourced facility are actually much less expensive than having blood drawn at a clinic or my provider’s office. I still cannot believe I did the tests at the latter two, before finding out that if I eliminate the insurer from the equation my personal out of pocket costs are less than if the insurer “helps” with my care.

It seems stupid but it’s true. As long as I get the results, and the quality of the service is good, why would I want to pay more? If I stay healthy, I am never going to meet my annual deductible, so let’s use the private paid services for what I need to get done. I am not saying I don’t visit my doctor each year for an annual physical. What I am saying is there are alternatives to going there each and every time I think something may be wrong. Maybe I just need a “maintenance test” to make sure I am on track with my goals and objectives, why go to the higher cost provider when the alternative, that works is less costly. At least my wallet feels better.

What I'm getting at is that you can help yourself get better (if you really want to) by maybe taking the reins and being your own patient advocate, personally engaged in your care with your care team. I think anyone can and should be the #1 cheerleader for themselves when you need care. Maybe some technology can help with that and that’s what we should look at to help ourselves.  

fragmented-717138_640.jpgThe care fragmentation experienced by patients today is rooted in ineffective transitions of care due to the lack of a shared “patient story and medical records.” Plus, we may have a long term plan of care that can be shared among providers when the patient transitions from one care setting to another. But is it? Or am I in charge of making sure it is. I think it does fall to ourselves to manage the details amongst the different care setting and providers we use. This is speaking to all transitions of care, from hospital to home, to primary care, to specialized practitioners for specific needs in chronic illness. No matter who is taking care of me, do they have “all the info?”

So if there is not “good care coordination” amongst these care teams, and they do not or cannot share information, or the long term care plan, then how can “the plan” be managed to lower the cost of care, and gain a better outcome? It will only happen with ourselves managing the process, until the day of interoperability when all the vendors of medical technology get together and make it happen.

Although it may seem that no one is minding the store when it comes to coordinated long term care planning and interoperability, many groups have been pressing to promote effective communication and coordination across all settings. They include in no particular order, the U.S. Department of Health and Human Services’ National Quality Strategy, the Institute of Healthcare Improvement and the ‘triple aim’ framework. More “industry experts and associations” could be included - but what’s the point of recreating the list?

So as we see more “virtual health platforms” being built by all kinds of companies, the problem remains the same for the actual providers of care: no money to fund the technology and not enough evidence that proves “Virtual Care” will save time, money and of course gain that better outcome. Although the theory of “virtual care” does claim to save time and money and improve outcomes, but without funding or getting paid for virtual visits, it’s hard for providers to justify the expense.

Patients or consumers were once seen as the ones who were not willing to use this type of medical care technology, but I think that has changed. People of all ages are counting steps and managing what they are eating with smart devices or wearables. They are even taking pills and proving they did with applications that show them swallowing them. So consumers are ready today, it’s just that providers have to find time (which they don’t have much of) to make the decision whether this type of care is required and can help them reach their goals and objectives. It will, but we are not seeing enough movement towards a virtual visit world. Not yet, but I think that worm is turning.  medical-1006787_640.jpg

So where that leaves us this summer is that we need to get physicians, health plans and technology companies working together so we may move healthcare forward, improving public health for everyone. If the conversation is only between payers and providers to deliver on value based care, then how will they fix the issue without technologists at the table? We will still have too many silos if everyone does not start to realize that data is needed across platforms to gain the care coordination that will be required, not only with chronic care patients but with the increasing aging population and with the increase in the total global population. Fewer professional caregivers are coming out of universities today (due to costs?), and more population means better coordination of care (especially chronic care) will be required. We can all use technology to monitor and help guide us with what is happening with our own treatments and care. Applications can help but we will also need access to the many silos of personal medical data that exist about each of us for the care team to gain the better outcome.  

Telehealth technology and virtual care is ready to roll. I feel consumers are ready too. Let’s make sure the message is clear with your own providers and payers of care. The insurers certainly could pay for technology to help lower the costs of care for their populations but, in my opinion, they are not moving quickly enough to help their insured populations with technology options. Maybe we as the people who pay insurance premiums can get them to listen if we all rally together. We need to have everyone focused on the future of health care, and using technology that can reduce costs and provide better outcomes. Our providers will appreciate that as much as we will.

Scott R. Herrmann is the Director of Strategic Solutions at Medocity. He can be reached at sherrmann@medocity.com.

How Can Ankota Help?

If you're a home health agency delivering nursing, PT, OT and Speech Therapy, we can give you the tools to also manage aides and call center personnel and the scheduling capability to optimize across disciplines.  We also offer our Foresight Care service that uses automated phone calls to check in with patients so that you can get early warning signs of preventable hospitalizations.  Please contact us if you would like to learn more.

If you're interested in scheduling a live demo of our software solutions, just click the button below:

Click Here for a Free Demo

 

Ankota provides software to improve the delivery of care outside the hospital, focusing on efficiency and care coordination. Ankota's primary focus is on Care Transitions for Readmission avoidance and on management of Private Duty non-medical home care. To learn more, please visit www.ankota.com or contact us.

Topics: Private Duty Agency Software, Home Care Best Practices

Home Health Administrator's Handbook is a Must-Read per Tim Rowan

Posted by Ken Accardi on Jul 26, 2016 12:21:18 PM

Rowan_for_printing.jpgTim Rowen of Home Care Technology Report is a favorite of folks at Ankota, and both Tim and HCTR are invaluable resources for anyone interested in keeping up with innovations in the home care space.Tim did a pretty glowing book review of "Handbook of Home Healthcare Administration" of Home Healthcare Administration."  Tim and his team spent months pouring through this 64-chapter handbook for home health administrators and has given it a big thumbs up.

Highlights from HCTR's Review  

Some highlights pointed out by the HCTR team are as follows:

  • The high level of "KnowMarilyn_D._Harris.jpg How" of the author, Marilyn D. Harris.

    From HCTR: "Marilyn D. Harris recently celebrated her 60th year in home healthcare. She served 22 years as a director of home health and hospice services where her responsibilities included the administrative overview of a nurse-managed health center, a faith community outreach pro
    gram, an animal-assisted therapy program, and other community programs. She has worked with colleagues both domestic and international."

  • The intro covering the state of the industry by Tina Marrelli

  • The technology chapter by Suzanne Sblendorio

  • Finally, the overal message is loud and clear:  Those in the home care and healthcare fields should strongly consider getting this book.

On a related note, Ankota has a new e-book available for download called, Winning with the Home Health Value-Based Purchasing Program, that offers further insight on the discussion.  Just click the link or the picture beow to download.

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If you're interested in scheduling a live demo of our software solutions, just click the button below:

Click Here for a Free Demo

 

Ankota provides software to improve the delivery of care outside the hospital, focusing on efficiency and care coordination. Ankota's primary focus is on Care Transitions for Readmission avoidance and on management of Private Duty non-medical home care. To learn more, please visit www.ankota.com or contact us.

Topics: Private Duty Agency Software, Home Care Best Practices

The Right Path to Paying Home Care Caregivers $15/hour or More

Posted by Ken Accardi on Jul 21, 2016 10:30:00 AM

There's been a lot of talk and press about getting home care caregivers to a $15/hour wage, which equates to an annual income of roughly $30,000 per year. There's even a movement called Fight for $15 that is organizing strikes and lobbying efforts to raise the minimum wage. According to this page on payscalecom, the present median hourly wage is $10. The silicon valley darling home care company Honor is paying wages in this range and they're able to do it because they charge more and justify their higher wage with a tech-enabled better experience.  But as long-time home care expert Stephen Tweed points out in this article, a rate increase of this nature would not be affordable to seniors or to Medicaid waiver programs and would likely put home care companies out of business.  I agree that caregivers should be able to receive a living wage, but I don't think that many people will be able to afford Honor, and I agree with Stephen that if we do home care the way that we've always done it and raise the wage to $15, that it won't work.

Maybe We Shouldn't Do it the Way We've Always Done It?

Blockbuster video storeAs a comparison, let's look at the movie rental industry...  There was a time not long ago when we went to Blockbuster to rent videos.  We would go there and browse through shelves of VHS tapes, and later DVDs to see what movie we might want to watch.  There were Blockbusters pretty much everywhere and I'd imagine that the leadership in Blockbuster thought that their business model would live forever. It didn't work out that way and Blockbuster is now gone, replaced by Redbox, Netflix and other on-demand services.  We didn't stop renting videos, we just do it in a different way.

Can we do Home Care a Different Way?

First of all I believe that home care is a fantastic industry that needs to grow and not die, and I would go as far as to say that there is no way that the home care industry can fail.  But by the same token, the movie rental industry didn't fail either - only the video rental store model failed. Skeptics at this point might argue that the failure of Blockbuster and video stores occurred because technology was able to replace people, and that in home care there is no technology that is going to sufficiently help grandma with her bath and toileting.  You'd be right, there is not a way to care for fragile people in their mid-80s and above without people, but I do believe that there's a different way.

How Can We Get to $15 Caregivers?

One way to get to $15/hour caregivers is to change the model of home care from a 1-on-1 experience to shared caregiver experience.  As I've shared a few times, I had knee surgery last summer and was in the hospital for two days.  Over that period of time I had 24-hour care, but the care providers were not in my room for 24 hours. I would hazard a guess that my 24-hour care required less than 2-hours of 1-on-1 care time.  The rest of the time, the care team was helping other patients.

To make this work in home care the concept would be different that it is today.  Instead of sending a caregiver to an individual client's home, what if you sent them to a suburban neighborhood where they could care for numerous clients in a one-mile radius, or in a city to care for multiple elderly clients in the same building.  With a model like this, clients could pay less for their care because other neighbors are paying too, and caregivers can be paid more because there's more money coming in to pay them.  Making this model work would involve a lot of technology because you'd have to look at proximity for emergency support, making sure that caregivers have sufficient breaks, clients are charged fairly based on their acuity and other factors.

TNGCrewSeason2.jpgTying back to the Blockbuster saga, the movies are still the main attraction and what we're paying for.  In this new home care model, the caregivers are still the star of the show and they'll need to do more work during their shift, but ultimately they'll be able to get paid more and have a life outside of work, and we can have an affordable and sustainable care model.

Will Your Home Care Software Take you into the Next Generation?

 

If your home care software company isn't thinking about and talking to you about how you can compete in an age with more clients but fewer caregivers, or if they're thinking that the new models of payment for post-acute care won't affect you, it might be time for new software.  Please contact us if you're ready for next generation home care software. If you're not ready yet, that's fine but consider subscribing to our blog on the upper right of this screen to learn more.

If you're interested in learning more ways to improve revenue, check out our free white paper, Why Care Transitions Is The Next Big Thing for the Home Care Industry.  If you're interested in learning more, just click the link to download.

If you're interested in learning more about our home care management software solutions, or about our Care Transitions solutions, just click the button below: 

Click Here for a Free Demo

Ankota_Why Care Transitions is the Next Big Thing in Home Care_White_paper

Ankota provides software to improve the delivery of care outside the hospital, focusing on efficiency and care coordination. Ankota's primary focus is on Care Transitions for Readmission avoidance and on management of Private Duty non-medical home care. To learn more, please visit www.ankota.com or contact us.

 

 

 

Topics: Private Duty Agency Software, Aging in Place Technology, Home Care Technology, Care Transitions, August 2016 Newsletter

Longevity is More Related to Health Than to Age

Posted by Ken Accardi on Jul 18, 2016 10:00:00 AM

old-age-957492__340.jpgUniversity of Chicago Study recently concluded that age is not the best predictor of mortality, and instead you should look at the person's healthMore specifically the study looked at mobility, sensory function, mental health and healthy behaviors and concluded that a sedentary isolated 75-year old with a bad diet might be closer to death than an 85-year old salad-eating person who walks with friends everyday.  The study implies that mobility and social engagement are better indicators of longevity than blood pressure and cholesterol.

Sadly, a related NPR story is concluding that baby boomers (the oldest of whom are 70) are going to be sicker seniors that earlier generations.  The NPR story covers a study by the United Health Foundation that compared the 50-64 year old population of today with the same demographic in 1999.  They found significantly more diabetes and obesity, and predicts that 9 percent fewer boomers are going to be likely to report good or excellent health.

What Does this Mean for Home Care?

Based on the above studies, I'd be inclined to search for a home care provider who is going to get my loved one moving and socializing.  Taking this to more of a basic level, you need to be able to answer the question "Why should I choose your agency?"  We've seen and admired agencies who differentiate because of their focus on fall prevention, and seen some agencies who differentiate by providing special treats on holidays.  Your differentiation should ideally be something that you're passionate about.  First and foremost, make sure to differentiate some way

This is one of the habits in our free eBook Seven Habits of Highly Effective Home Care Agencies.  Just click the link or the picture to download!

If you're interested in scheduling a live demo of our software solutions, just click the button below:

Click Here for a Free Demo

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Ankota provides software to improve the delivery of care outside the hospital, focusing on efficiency and care coordination. Ankota's primary focus is on Care Transitions for Readmission avoidance and on management of Private Duty non-medical home care. To learn more, please visit www.ankota.com or contact us.

 

 

 
If you're interested in scheduling an online demo of our home care or care transitions software solutions, just click this button:

Topics: Private Duty Agency Software, Home Care Best Practices, August 2016 Newsletter

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Ankota provides software to improve the delivery of care outside the hospital, focusing on efficiency and care coordination. Ankota's primary focus is on Care Transitions for Reeadmisison avoidance and on management of Private Duty non-medical home care. To learn more, please visit www.ankota.com or contact Ankota.

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