The Client Challenge
An integrated health system and major academic medical center (AMC) found its home health business line struggling to meet staffing demands and ongoing regulatory changes. Compounding challenges led to worse financial performance, significant annual admission referral denials, and exacerbated inpatient capacity challenges that delayed discharge. The C-suite felt pressure to quickly turn around the home health business to help realize its potential within a broader portfolio of care at home offerings.
IMPLICATIONS OF A FAILING HOME HEALTH BUSINESS LINE:
- Delays in inpatient hospital discharged to home with home health
- Home health admission denials due to lack of staff
- High reliance on expensive travel nurse resources
- Documentation quality and compliance issues, resulting in poor financial performance
- Lack of synergies and inconsistent patient experiences across care at home portfolio offerings
Navigating to Next: The Solution
The AMC sought to further integrate its home health business line into its broader care at home portfolio to achieve scaling advantages (e.g., staffing and resources), provide seamless care transitions, and ensure consistent patient experiences across care sites. The organization lacked a data-driven approach for examining and prioritizing performance improvement initiatives to achieve its goals. The AMC partnered with Chartis to perform a rapid assessment and develop a prioritized implementation roadmap.
Based on findings from the assessment, Chartis helped design a roadmap for the AMC to implement several performance improvement plans. The care team redesign aimed to better utilize lower-cost resources, such as licensed practical nurses (LPNs), to improve capacity and cost structure. Productivity efforts began with the development of a comprehensive dashboard, followed by tailored improvement plans for each region, along with clear goals and objectives. Finally, clinical documentation accuracy improvement efforts were aimed at optimizing reimbursement and performance in the Centers for Medicare and Medicaid Services (CMS) Home Health Value Based Purchasing and Star Ratings programs.
