Navigating Alternative payment models (APM) and the Data in 2018 for Home Care Agencies:

By ShirleyAnn Janulewicz RN, BSN, PHN

Competing in today’s healthcare market takes strategy and expertise. The Centers for Medicare and Medicaid (CMS) want to improve the patient care experience, improve the patients’ overall health, and they want to decrease the cost of care. Preventing re-hospitalization plays a major role.

When discharged, a patient may go to their former place of residence with home health to follow up, to a skilled nursing facility, or to an in-patient rehab center. Since hospitals bears the burden of risk in regards to the money they will receive from CMS in caring for that patient, they want to utilize the services that show the best stewardship of that money. They look at the data produced showing who provided the best care with the best outcomes for the least amount of money. Some of the data they use is data that is available to the consumer, such as Home Health Compare and the STAR ratings.

Home care agencies need to know how to utilize this data so they can determine their standing among their peers. They need to evaluate where they can improve their plans of care to achieve their best possible outcomes without the patient needing to be re-hospitalized.

By utilizing charts and graphs to compare this data, the home care agency can better understand the many factors involved. It may seem intimidating and challenging to those who are resistant to change; however, by taking the time to assimilate and understand data-driven care, we can better promote our strengths and work on our weaknesses to become a viable discharge alternative in the ever-changing healthcare environment.