Home Care Heroes Blog

When You Deliver the Maximum Authorized Medicaid Home Care, Everybody Wins

seniors-1505935_1920We've had the chance to meet and work with hundreds of home care agency owners and one thing that we've observed is that the majority of owners started their agencies because they have a skill and a heart for caring. As they grow, they begin to realize that successfully running an agency needs them to additionally have a focus on revenue cycle management, and this is not something that they bargained for.  When this realization hits, some owners bring on an accountant to help them through it and others take it upon themselves. 

Home care owners are rarely if ever greedy, and sometimes when we talk about making sure that all of the authorized units of care are scheduled and tracked, they're uncomfortable because it sounds greedy. There are multiple reasons why it's important to schedule all of your units. Below are the reasons why.

The Importance of Scheduling All Authorized Units of Home Care

Here are the reasons why you should schedule all of your authorized units of care:

Maximize Care for Your Clients

The authorization that the state has allocated to your client is based on a "Level of Need" (LON) or "Level of Care" (LOC) assessment. These assessments are generally done by a 3rd party who has been trained to assess the client's ability to independently perform their Activities of Daily Living (ADLs), which include nutrition, hygiene. mobility and other basic needs. When they authorize home care, it is because the client needs it, so you should do everything you can to deliver all of the authorized care.

Your Caregivers Need the Income

The pay received by most Medicaid caregivers falls below what is considered a living wage. They are willing to work and proud to work as a home care aide and in general they don't want to be receiving welfare. Making sure that all authorized care is scheduled helps your caregivers.

Agencies are Measured on Fulfillment of Authorized Hours

States request reports from home care agencies to determine which agencies are doing the best job delivering the authorized care. By delivering all authorized units, you are showing the state that your agency is completing their mission.

When Not All Care is Delivered, the State May Lower the Authorization

We've seen cases where the authorized care for individual clients is reduced because it's not being used. The state rationalizes that if they allocated 372 units of care and you're only delivering 250 that perhaps that's all that the client needs. This puts your clients at a disadvantage.
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The bottom line here is that if you focus on delivering the best care that you are able to and use the full authorization that your clients, caregivers and agency benefit. This is fully aligned with the core values of giving great care and helping people. In the end, there's nothing wrong with "doing well by doing good."
If your back office processes and systems are holding you back from delivering the maximum care for your clients, then you likely need a change. Whether we provide software for your state or not, please let us know if we can help you to maximize care delivery for your clients. 
If you'd like to learn more about managing Medicaid Home Care businesses, please download our free e-Book "Best Practices for Success in Managed Care Medicaid Home Care" by clicking the link below:
Help Me Optimize My Missouri Medicaid Home Care Agency


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.




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