How Home Health Providers, Payers Are Adapting to New Referral Patterns
Home Health Care News | By Patrick Filbin
Prior to the COVID-19 pandemic, it wasn’t uncommon for home health agencies and other post-acute care providers to beg hospitals to be a part of their post-acute networks.
Three years later, that’s generally not the case. The referral patterns in home-based care have seen a radical shift, and agency leaders are still adjusting to those changes and making adjustments on the fly.
“We were used to hearing from hospitals that we had to have a five star rating, have to have a medical director and all these other ancillary services,” Health Dimensions Group (HDG) CEO Erin Shvetzoff Hennessey said at Aging Media Network’s Continuum conference in December. “Now, the hospitals are realizing that the patients that they need help discharging don’t always fit into this five star model. These are difficult patients and sometimes difficult patients result in survey activity that doesn’t move you into the five star category. So, if you start to create this preferred provider network, it gets a little too preferred — and they need post-acute care to take these patients and to clear the hospital out.”
HDG operates a portfolio of 25 senior living communities across eight states. It also has a major contingent of skilled nursing properties.
Hennessey said that, because patients being discharged from the hospital are more complicated than they were before, two different referral groups are starting to emerge.
On one side, there are the five star referral partners who meet all the certain metrics that hospitals like to see.
“And then there’s this off-to-the-side network where we know that discharge planners are really connecting with post-acute,” Hennessey said. “These are the providers saying yes. Now we have this formal network and this informal network that’s actually getting patients moved.”
Referrals to home health care have been on a steady increase over the last three years. At the same time, providers are rejecting them at an unprecedented rate…
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