BIRMINGHAM, Alabama (July 29, 2020)—Telehealth and other technology, new partnerships and new ways to measure outcomes will all be important ways that home health and hospice agencies will survive and thrive in a post-COVID-19 environment, members of a panel said Wednesday at the National Association for Home Care & Hospice’s financial management conference.
The panel, which was moderated by NAHC President Bill Dombi, included:
- David Causby, president and CEO of Kindred at Home
- Mary Gibbons Myers, president and CEO of the Johns Hopkins Home Care Group, Inc.
- Sheldon Retchin, MD, commissioner of the Medicaid and CHIP Payment and Access Commission (MACPAC) and professor of medicine at Ohio State University
- John Olajide, founder and CEO of Axxess Technology Solutions
- Sheila Davis senior executive vice president of operations at Always Best Care, Inc.
Panelists agreed that there will be an even greater focus on care in the home and aging in place even after the public health emergency ends, due in part to a greater awareness of infection risks and a public fear of institutional care.
At the same time, they said, there’s no guessing when things will get back to normal—or what “normal” might look like in the future.
“We realize the current situation is not really going to go away any time soon and we’ll continue to be flexible, creative and resilient,” Myers said. “It’s going to be with us for years to come and we’ll continue to work with it.”
That will include a greater focus on preparing for communicable disease outbreaks—and not just when it comes to patients, Davis said. She said in her area of work, which is primarily non-medical homecare or personal care, personal protective equipment (PPE) is going to be a new norm.
“There is going to be more of an emphasis on infection control going forward,” she said. “That is something we have learned in our business that you have to be mindful not just of your clients but of your employees as well.”
Going forward, participants said a few things should be made permanent even after the public health emergency ends, whenever that might be. One of the main priorities is maintaining the current homebound status for home health eligibilty, said Causby—which could eventually provide enough data to convince regulators of in-home care’s value.
“This is something the home health industry has been pushing for an extended period of time,” Causby said. “I think we’re really starting to see some real qualitative outcomes in regards to being able to treat seniors in their home.
Another focus for the industry is telehealth and remote monitoring, which he said could help increase contact between clinicians and patients and alleviate a nursing shortage. Whereas now, an agency might have 15-20 home visits over a 60-day period, technology allows companies to check in on patients daily to ensure they’re following orders and taking medication, or even more often if they’re having issues.
“Hopefully the pandemic may be the thing that triggers the opportunity for (the Centers for Medicare & Medicaid Services, or CMS) to take a look at this in future years," Causby said.
Retchin said there’s already a push to make telecommunication technology permanent, with a proposed rule on the table and a bipartisan letter from 37 senators to the Department of Health and Human Services.
“There’s a lot of interest down the road on this growth and more remote technologies like continuous glucose monitoring are coming,” he said. “Familiarity with these remote technologies and building close relationships with physician groups in a team format—that’s going to result in great opportunity for the home health industry.”
Olajide said partnerships are also critical for Axxess as the technology company works to support its users. Another focus is ensuring that staff are well even as they work remotely.
"Understandably, our clients are more anxious in a COVID-19 world, so we want to make sure that … our people can be a resource for our clients to tap into," he said.
When Dombi asked the panel what they’d be focusing on or investing in in the coming years, answers included:
- building clinical teams to be prepared for hospital at home
- concerns about regulatory add-ons in private duty as states begin to reach into licensure employee recruitment
- working with new payer sources
- enhanced analytics
"I think the key is access to data on performance," said Retchin, because payers, physicians, hospitals and CMS will all want to see how measures are working. "With the appropriate analytic capacity, the homeware community has the opportunity to I think become the leader in post-acute care."
