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Forces and Trends Shaping the Future of Home Health Care in America

By Stephen Tweed

VNAA LogoAs I write to you I’m flying from New Orleans to Atlanta, having just come from the Visiting Nurse Association of America’s annual conference. Having started my consulting and speaking career in home health care with the VNAs, it’s a real joy to stay connected to the free-standing not-for-profit home health agencies across the country.

Because these agencies are so connected to their communities and because they provide huge amounts of care for low income and no income patients, they are in a critical position to be influenced by the forces and trends that are shaping the future of home health care in America.

If you have heard me speak or read my writing in the past, you know that a big part of what we do at Leading Home Care is to track the forces and trends shaping the future of home health care, hospice, and private duty home care. Remember that “forces” are those pressures that cause change and “trends” are the patterns of change that are caused by the forces.

Five Forces Affecting Your Future

We have identified five forces that are the primary causes of change in health care in America.

  1. Economic Pressure
  2. Demographic Shifts
  3. Consumer Choice
  4. Technological Change
  5. Political Power

Ten Trends that are Leading the Way

Whenever I am speaking or exhibiting at a state or national conference I attend as many of the general sessions and breakout sessions as I can to hear what the speakers are saying about our industry. Knowing the topics that home health agency executives are interested in helps me stay in touch with the changes that are taking place. Here are ten trends that are currently shaping home care and hospice in America.

  1. Population Health – The advent of the Affordable Care Act and numerous demonstration projects are attempting to find new models of care to improve the overall health of defined populations of demographics and diagnoses.
  2. Community Partnerships – In order to meet the needs of patients and payers, home care agencies are partnering with other providers and non-provider organizations to coordinate the delivery of care.
  3. Accountable Care – New programs to increase personal accountability for health along with programs to provide incentives for organizations to improve health outcomes is creating unique opportunities for home care companies.
  4. Managed Medicaid – A number of states have expanded their Medicaid programs under the Affordable Care Act and are relying on managed care companies to provide predictable models to project the overall cost of care. The actions of managed care companies with regard to payment rates and policies are creating challenges for providers and many providers are opting out of caring for Medicaid beneficiaries. What will be the impact if there are millions more Medicaid beneficiaries but fewer physicians and other providers who are willing to care for them?
  5. Transitions in Care – Finding new ways to smooth the transition of patients from one care provider to another to improve outcomes and to reduce re-admission to hospitals and SNFs.
  6. Hospital Re-admission Reduction – This is a major program under the Affordable Care Act to reduce the cost of hospital care by reducing avoidable re-admissions. Research is showing the significant role that home care can play in reducing re-admissions.
  7. Focus on Consumer Satisfaction – The coming of Star Ratings is another step forward to making health care organizations accountable for patient and consumer satisfaction, and providing information to help consumers select health care providers.
  8. Revenue Cycle Management – The huge influx of payers for home and community based services means billing and collection is much more critical, and many agency financial issues are around their ability to collect money owed to them.
  9. Applying Technology to Improve Processes and Outcomes – New technologies are appearing every day that are designed to improve processes and outcomes and the vast choices can be overwhelming to home care executives.
  10. Data to Guide Strategic Decision Making – The use of new technologies is making vast amounts of data available for use by executives in making strategic business decisions. They key is how to gather, access, and use this data for wise decision making.

As a leader in your home care or hospice organization, I encourage you to examine these trends, study the impact of the trends, and develop strategies to adapt to the changes that are occurring in home and community based care.

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