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Introducing APTA Home Health's innovative podcast, "Home on the Go" – your go-to source for insightful discussions and expert insights on all things related to PT in the home. This dynamic podcast is designed to keep you informed and engaged, offering a unique blend of informative content and real-world experiences in the rapidly evolving landscape of home health services.

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The Bottom Line: Top Billing, Financial Mistakes Responsible for Home Health Agency Struggles

Home Health Care News | By Joyce Famakinwa
 
Home health providers often make mistakes that leave money on the table at best, and at 
worst, lead to financial ruin. 
 
However, providers that learn to avoid these stumbling blocks will be better positioned to achieve longevity and financial stability. 
 
In general, the home health consulting firm SimiTree has noticed an increase in the amount of providers that have been struggling with things like unbilled claims, inaccurate primary payer selection and more, according to Lynn Labarta, vice president of post-acute revenue cycle management at SimiTree. 
 
In fact, Labarta recently wrote about this very topic for SimiTree. 
 
“SimiTree has thousands of customers in the home health and hospice space all over the country, and we have been seeing an uptick in these issues and agencies struggling or feeling that they may not survive,” she told Home Health Care News. 
 
Labarta believes that not staying on top of unbilled claims is the No. 1 issue that providers are currently struggling with. It’s an issue that pops up at companies of all sizes.
 
“We see this unbilled claims issue with all sorts of agencies — all the way from startups to mid-size agencies, even some of the largest agencies in the country struggle with this for different reasons,” she said.
 
Broadly, most providers’ EMR has a section in the software where all of the unbilled claims are housed. These are claims that can’t be billed because there is some type of hold on them. Typically it’s a clinical hold, or regulatory issue that prevents the claim from being billed. 
For many providers, this is where most of the revenue lives. 
 
“We’ve seen agencies that have thousands of claims sitting in the unbilled claims list,” Labarta said. “When you translate the thousands of claims sitting in that bucket, depending on the size of the agency, you’re talking about hundreds of thousands of dollars. Of course, if you’re dealing with a smaller agency it could be smaller dollars, but it still impacts cash flow. This makes agencies feel like they’re seeing patients and working very hard, but not seeing the money coming through the door.”…

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‘Not About A Shiny New Toy’: How Home Health Providers Are Succeeding With More Complex Patients

Home Health Care News | By Patrick Filbin
 
As home health patients become sicker and more complex, providers have been forced to find ways to keep their care models financially viable.
 
In order to combat some of those “acuity creep” challenges, industry leaders are leaning on technology, data-driven decision making and more value-based care.
 
“We continue to navigate through a very regulated industry,” Janice Riggins, chief clinical officer at VitalCaring, told Home Health Care News. “That continues to pose issues for us, in addition to expenses for training and education. The recruitment and retention of qualified staff that have that clinical expertise is a financial implication. All of these aspects are at a very heightened level. Now more so than ever.”
 
The Dallas-based VitalCaring provides home health and hospice services across six Southeastern states.
 
Staffing costs and physician engagement
 
When taking care of the sickest and most complicated patients, it’s imperative that clinicians and caregivers are properly trained and that staff resources are optimized.
 
“Training and education is an investment that needs to be considered,” Riggins said. “It’s really important for our staff to have continuous training in order to handle these complexities of the sicker patients, which add to that overall operational cost.”
 
In this care environment, clinicians must be operating at the top of their licenses, McBee Associates President Mike Dordick told HHCN.
 
“Unlike going in and changing a wound or basic injections, you’re going to the sicker patients where there’s a lot more that clinicians have to be able to to deal with,” Dordick said. “Your resource allocation and your staffing strategy has to be at a higher level than if it was a lower-acuity patient.”
 
McBee Associates is a consulting firm that works with hospitals and post-acute care providers.
Maintaining an adequate staffing level will always be a struggle for providers. The same goes for covering the costs that are necessary to take care of new-age patients.

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2024 Predictions: Three applications for AI in Home Healthcare

McKnight’s Home Care | By Preeti Kaur
 
Business is booming in the healthcare generative AI market. The sector is projected to reach a staggering $22 billion by 2032 — enabling technology providers, health systems, payers and others in the ecosystem to develop game-changing capabilities that are reshaping the field. 
 
Frankly, the timing couldn’t be better for the home healthcare sector, an area that is  particularly ripe for transformation. Variable schedules, provider shortages and a vulnerable aging population make managing logistics and providing care uniquely complex. In the face of these challenges, AI offers a compelling solution to streamline back-end tasks and enhance the patient-provider relationship.
 
So, while 2023 may have been the year of AI awareness, 2024 is set to be the year of AI advancement and widespread adoption. Although I’m encouraged by what we’ve already achieved, I’m more excited about the coming benefits that adoption at scale will provide both home care operators and patients.
 
Specifically, I envision AI revolutionizing the home healthcare industry in several important ways in 2024:
 
1. Improving personalization at scale
 
With nearly 3 million home healthcare patients across the nation, personalizing their individual experiences is a time-consuming and complex undertaking. However, AI excels at this task. It’s capable of analyzing vast amounts of data to identify individual preferences, behaviors, and patterns much more quickly and accurately than human workers.
 
Expect certain applications that are already in use to achieve more widespread adoption by home healthcare agencies in the next year, including:

• Streamlining care plan creation: With AI, providers can quickly generate personalized care plans based on the patient intake call, health records, and knowledge of similar patient profiles. AI-generated plans may include granular details like care reminders, medication schedules, and even activity recommendations.
  
  
• Optimizing care matching: AI handles the complex process of matching care providers with patients based on factors like scheduling needs, travel times, personality and skills, helping create more effective provider-patient assignments.
  
  
• Coaching providers: Using call recordings and transcripts, AI can offer recommendations for care providers. This could include general areas of improvement (e.g., areas where additional training is needed) as well as recommendations that are specific to the patient-provider relationship (e.g., future conversation topics).
  
  

2. Supporting task prioritization
 
By 2025, the U.S. is expected to face a shortage of over 400,000 home health aides. As the aging population continues to increase, AI offers home healthcare providers the ability to alleviate time-consuming tasks, streamline provider workflows, and reduce costs. One such application includes task prioritization and reorganization to help providers and administrators navigate an overwhelming list of to-dos. This use case is currently in development and will hopefully make its way into home healthcare in 2024:

• Optimizing task management: AI can analyze patient needs, biometric data, urgency and potential risks to create a daily list of to-dos for providers. Consider a patient who requires immediate attention due to a sudden change in their condition. AI can help restructure a provider’s daily schedule and find coverage if necessary, to ensure the patient receives prompt care. This capability isn’t just helpful for providers; it can also offer benefits for operators and desk-based administrative health workers.
  
  
• Generating communications: While AI is already widely used to generate communications, this capability becomes even more valuable when used alongside task prioritization. If a provider needs to rearrange the order in which they visit patients, AI can provide a script to quickly communicate with patients. In the event of a provider change. It can also communicate thorough notes on the patient’s needs to substitute providers.
  
  

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