Ankota: Ushering in the Next Generation of Homecare Blog

“If home care agencies really want to reduce hospital readmissions, there is one simple thing they can do that they often don’t.”, said Diane Omdahl, RN, co-founder of 65 Incorporated, an organization helping seniors understand Medicare. Do you know what it is?

This provocative quote is from an excellent article by Stephanie Bouchard, Managing Editor of Healthcare Finance News. She interviewed Diane Omdahl in preparation for her article “Readmissions penalty presents a business opportunity for home care companies”.

According to Bouchard, Omdahl spent 20+ years in the home care space and says that the same misconception about not seeing patients on the day of discharge persists as much today as it did 20 years ago.

“Home care agencies often do not see the patient on the day of discharge,” she said, because they are under the misunderstanding that Medicare will not cover a visit on a discharge day”. “But that is not the case”, Omdahl said. “Medicare will cover visits to patients on the day of admission and the day of discharge.”

“That’s one of the things that home care agencies have to realize,” she said. The sooner they can get out there to see the patient after discharge, the better off they’re going to be and the patient’s going to be.”

If you're interested in learning more about the new opportunities in transitional care, please take a look at the video below and let us know what you think!

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.

We ran across a fascinating article by Tammy Worth recently, called “Home Health On Road to Reducing Readmissions”.  In her article, Tammy makes a compelling case that even before impending readmission penalties are imposed on home health providers, the industry has already begun to put in place practices that focus on reducing readmissions.

At Ankota, we see multiple examples of how our home health customers are leveraging this growing trend on a daily basis. So the question really is...how can home health care providers really profit from this industry focus on readmission penalties?

According to home care experts, home care companies have a tremendous opportunity to expand their businesses and help shape coordinated care efforts by offering services to hospitals already seeking to avoid patient readmissions and the related penalties. Remember, the Affordable Care Act imposes penalties on 30-day readmissions for certain conditions. (See our blog on this topic here.). Penalties can indeed be stiff – the maximum penalty is up to 3% of a hospital’s regular Medicare payments.

Hospital case managers and rehabilitation units are looking for well-established, well-disciplined and efficient agencies that will provide good care to their discharging patients so they can make safe referrals.

With that in mind, here are three easy actions you can take to help your agency stay strong:

1. Identify and build relationships with the key referring agencies in your area – the hospitals, emergency departments, accountable care organizations (ACO’s) – so that the role your home health care organization can provide is factored into patient discharge and treatment plans from the very beginning.

2. Take an in-depth look the performance of your home health care team and fill any gaps. Share your performance data with the hospitals and other referring agencies you are working with to build credibility and trust.

3. Work hard to understand what your hospitals need. Offer solid strategies to help meet their needs, and look for opportunities to develop new programs and offer training to make sure you can deliver the services and care sought by your referring hospitals.

In that same vein, H. Carol Saul, a partner in the healthcare and life science practice at Atlanta law firm Arnall Golden Gregory, offers some great insight on the topic...

“Hospitals are major referral sources to home health organizations and they want agencies that can show that they have low levels of hospital readmissions...More savvy home health organizations have already been using low readmission rates as a marketing tool”, Saul noted. She has seen some with specialty programs focusing on clinical conditions tied to readmission penalties – heart failure, pneumonia and heart attacks.

“There is already a lot of innovation going on around this and it is one example of how the Affordable Care Act is standing some old things on their head,” Saul said.  We at Ankota could not agree more.

If you're interested in learning more about the oportunities in care transitions, click the link below to receive a free White Paper on the subject.

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.

Among the many hats that I wear at Ankota, one of them is marketing.  I've heard the description that marketing is sometimes described as mixing Kool-Aid and hoping people with drink it.  Similarly, the expression "drinking the Kool-Aid" refers to holding an unquestioned belief or philosophy without critical examination.    

With that in mind, I've noted that around 1 in 5 home health agencies that I speak to really resonate with what we're doing to assist the home health industry dominate the care transitions market, but the other 80% don't.  

I welcome differing points of view and new ideas, but I do feel passionate about the ability of transitional care to both offer a high level of care and to lower healthcare costs.  

Allow me me make my case (and try to back it up with the critical examination)...

Ankota's Kool-Aid for Care Transitions:

• 30-Day Readmissions are Costing our Health Care System $26 B a year.  You can confirm this here or in many other places.
• Home Health Agencies are Under Pressure with Reduced Reimbursement and Attempts to Reduce the Number of Agencies in the Market: Read this article or this one.
• 5% of Patients Consume Half of the Health Care Dollars: You can look that one up here or here
• 50% of the Cost of Health Care is $1.4 Trillion: per CMS
• When Care Transitions Are Managed, the admission rates can be greatly reduced.  See this article or many of the posts in the Ankota blog that share care transition success stories.
• The Office of the Inspector General (OIG) has issued a ruling that enables third party contractors like home health agencies to manage care transitions, but it's a little bitcomplicated: More info here
• Other Industries are Focusing on This Opportunity: Read here to see what pharmacists are doing or here to look at what hospitals are doing.

Based on the above, we at Ankota believe that home health agencies would be highly motivated to enter the care transitions space so that they can help with the $26B 30-day readmission problem and position themselves to grab a share of the $1.4 Trillion consumed by the most costly 5% of patients.

If this has convinced you that we're not just drinking the Kool-aid, click below and let us help!

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.

This is going to be a quick post.  Our great friend Ginny Kenyon from Kenyon Health Care Consulting posted an article for home care entrepreneurs telling them 5 things to avoid in their start-ups.  If you're starting a home care agency, please read her full article and get her help if you're not on track.

5 Mistakes to Avoid:

• Poor Preparation: Strategy, Understanding the market
• Insufficient Capital: $60,000-$80,000 for non-medical and up to $300,000 for a Medicare Certified Agency
• Sloppy Operations: Will "sink the ship"
• Hiring the Wrong People: Your team represents your brand to your market
• No Tracking System: Your scheduling, billing nad payroll can't afford issues

7 Habits for Highly Effective Agencies:

We've written a paper describing the 7 habits of highly effective home care agencies.  Looking across the agencies that we support, we've observed a set of habits that differentiate the winners, and we're heppy to share it with you.  Please click on the image below:

 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.

I found an interesting graphic on the website for the Healthcare Intelligence Network (www.hin.com) that itemizes the top components that occur in a home health visit.

The top 6 components, performed on more than half of the visits, in order, are as follows:

1. Medication Reconciliation
2. Clinical Assessment
3. Patient / Caregiver Education
4. Fall Assessment
5. Socioeconomic Assessment
6. Nutritional Status

Here's a the full graphic:

What will this mix of Components Look like in 10 years?

Based on the change in health care to capitated payment structures, we believe that there will be new components on the list in the coming years.  Some of the candidates are as follows:

• Readmission Prevention Visit: This would be a visit that focuses on the items that can avoid a readmission, including teaching the patient how maintain a Personal Health Record (PHR) and how to advocate for themselves when they see their doctors, checking on red flags associated with the patient's condition, monitoring med adherence, and making sure there's a follow-up appointment with primary care and that the patient attends. Ankota has software to manage this (including referrals and care coordination with the hospital) that you can learn more about here.
• Chronic Disease Hospitalization Prevention Visit: 5% of the population account for 45% of all healthcare costs, so in a model where providers and payers have a fixed dollar amount per patient, more attention will be paid to saving costs be avoiding hospitalizations for this population.  We believe that Accountable Care Organizations (ACOs) will want to partner with Home Health to provide ongoing services for these individuals to avoid hospital admissions.
• Proactive Admission Avoidance: We're starting to work with a doctor in Boston who has a system to analyze home health aide logs to predict hospital admissions and to proactively send a nurse to try and avoid a visit to the emergency room (where the cost of the nursing room visit is a fraction of the emergency room charge.  Also, patient's who are part of the aforementioned 5% often become part of the 5% when an "event" happens like a heart-attack or a fall.  New technology in an arena that we'll blog more about called "big data" can analyze populations and predict the patients who are most likely to join those ranks next, and put them on a protocol to avoid hospitalizations, save costs and improve patient quality of life. Note that these factors comprise a key health care initiative called the Triple Aim.

At Ankota, we strongly believe that Home Health Agencies can be the critical factor that saves hundreds of billions of dollars per year in health care costs while providing better population health and higher patient satisfaction.  To help with this, we've created software for HIPAA compliant care coordination, care transitions and ongoing care.  Click on one of the images below to learns more.

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.

While building Ankota, I was introduced to another local company caled iGetBetter and was invited to help them develop their technology.  Is iGetBetter a great name, or what? Unlike Ankota, which focuses on helping home care organizations deliver ongoing care and care transitions more efficiently, iGetBetter focuses on the patient and helps them stick to their care plan.

Although not explicitly named, here's a link to an article in the Patriot Ledger talking about how iGetBetter is helping patients with Congestive Heart Failure (CHF) avoid readmisions.  CHF doesn't mean that your heart stops beating.  Instead it means that the heart isn't getting enough blood to the organs, and the organs don't get enough oxygen and blood builds up in the heart and lungs.  Weight gain and swelling in the ankles is a tell-tale sign for a potentiall CHF readmission.  iGetBetter allows you to create a patient care plan telling them what to do each day (for CHF or other diagnoses that can cause readmissions).

Why is Ankota partnered with iGetBetter?

There are two shifts in health care that all agencies should be embracing, as follows:

• Move to Patient-Centric Care: iGetBetter, as a complement to Ankota's care transition software achieves this objective
• Coordinating Care between care delivery organizations: Although Ankota is great at connecting the health care ecosystem (e.g., referrals from hospital discharge are sent to you electronically and shared in a HIPAA compliant way with your team members whether they are employees or subcontractors), iGetBetter takes it even further, delivering a full chart of daily vital signs, care plan compliance data and alerts back to the prescribing physician.

If you're ready to move your agency forward by creating a care transitions program, we'd love to show you the software for Ankota and iGetBetter,

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.