The Essential Guide to Home Health Value-Based Purchasing
Home Health Value-Based Purchasing is in full swing in nine pilot states, but even if your agency is not part of the pilot, there is no time to wait. Use the pilot as an opportunity to learn and prepare, because it is extremely likely that HHVBP will become a permanent part of CMS’s HHA reimbursement strategy.
“The Essential Guide to the Home Health Value-Based Purchasing Progam” will provide you with everything you need to know, as well as what steps to take to make sure you succeed under the program’s rules.
KEEPING PATIENTS OUT OF HOSPITALS
Telemonitoring Companies
For telemonitoring companies, healthcare technology has advanced rapidly in recent years, and what was once globally termed “telemonitoring” has now evolved into distinct sub-categories that include telehealth companies, telemedicine companies, and remote patient monitoring companies – the latter of which is used interchangeably with telemonitoring companies.
So, then, how do telemonitoring companies, telehealth companies, and telemedicine companies differ?
Telemonitoring Companies: Focusing on Reducing Hospitalization Re-Admissions
Telemonitoring companies focus their services on patients who have been recently discharged from the hospital, as well as patients managing chronic illnesses. For telemonitoring companies, the goal is to provide these patients remote patient monitoring and around-the-clock support from a URAC-accredited health call center in an effort to reduce visits to the emergency room and hospital re-admissions. Telemonitoring companies deploy countless post-discharge and disease management strategies to keep patients healthy, happy, and far away from the hospital. What’s more, these companies augment the care provided by the patient’s clinical team, even when the patient is unable to visit his or her personal physician.
One strategy deployed by most telemonitoring companies is ongoing patient education. Among patients who must self-manage one or more chronic diseases, there are many contributing causes for hospital re-admissions, including lack of education and poor lifestyle choices. By implementing coaching techniques and using tools such as virtual consultations, telemonitoring companies can improve a patient’s ability to self-manage their conditions.
Telemonitoring companies provide patients the ability to connect directly to a care team for one-on-one coaching consultations that help alleviate concerns, improving daily habits, and improve management strategies for patient self-care.
Telehealth Companies: On-Demand, Virtual Consultations
Both telehealth and telemedicine are terms that represent the transfer and exchange of medical information between different sites. Telehealth dates back to the 1960s when physicians monitored the physiological parameters of astronauts. Today, with the improvement of Internet computing power, telehealth has evolved. As a result, there are a wide array of technological and communications tools available that enable direct, remote patient consultations across almost every medical environment and specialty.
Today, telehealth companies are defined as companies providing on-demand virtual consultations between patients and physicians. For instance, it is now routine for insurance companies to offer virtual consultations via a phone app. These consultations are usually at less cost – or even at no cost – than an in-office visit. A patient simply opens the app on his or her phone, clicks the “request consultation” button, and waits for a physician to appear on phone’s screen.
Telemedicine Companies: Connecting Hospitals and Clinical Services
Telemedicine has largely been defined as the technology that allows healthcare professionals to evaluate, diagnose, and treat patients at a distance using telecommunications technology. The approach has been through a striking evolution in the last decade, and it is becoming an increasingly important part of the American healthcare infrastructure.
Although the terms telemedicine and telehealth are often used interchangeably, there is a distinction between the two. Telemedicine refers specifically to remote clinical services and is frequently used by hospitals for specialist consultations, the remote readings of radiology studies, and more. In addition, telemedicine is often implemented by rural hospitals as a strategy to provide access to specialists not available in their communities. Finally, telemedicine differs from telehealth in that telemedicine is largely provider-to-provider driven, while telehealth is patient-to-provider driven.
According to Medicaid, “telemedicine seeks to improve a patient’s health by permitting two-way, real-time interactive communication between the patient, and the physician or practitioner at the distant site. This electronic communication means the use of interactive telecommunications equipment that includes, at a minimum, audio and video equipment.”
A Side-By-Side Comparison
- Telemonitoring Companies: Focus on remote patient monitoring of recently discharged patients and patients suffering from chronic diseases in an effort to reduce E.R. visits and hospital re-admissions.
- Telehealth Companies: Focus on providing on-demand virtual consultations for patients and is often offered by insurance plans in an effort to reduce costs.
- Telemedicine Companies: Focus on delivering remote clinical services, usually from hospital to hospital.
Who Wins When It Comes to Medication Compliance?
One of the many reasons patients are re-hospitalized is because they fail to maintain compliance with their medications. The causes of this are numerous and range from access to affordable prescriptions to general patient forgetfulness. Of the three tele-companies mentioned above, telemonitoring companies are the only ones with a proven record of improving medication compliance. Why is this? Because telemonitoring companies monitor patients 24/7 via a clinical call center, which gives them the ability to ensure their patients are always properly adhering to their medications – and taking interventional steps when the patient is not.
Medication compliance through remote patient monitoring is especially useful for Alzheimer’s patients, mental health patients, or patients who struggle with understanding the importance of their medications.
I don’t go to the hospital now because I’m able to check my vitals daily and I’m not afraid. I could barely function before, and now I feel safe. The staff is never in a hurry, never too busy for me. It’s a comfort to know that they are watching out for me. It’s like having a whole bunch of friends around all the time.
The numbers from Cardeum shows significant reductions in emergency room visits and re-hospitalizations, particularly for high-dollar patients.
Telemonitoring has been very helpful. In the past, anytime a patient had a problem with blood pressure or a medicine had to be changed, it was very difficult to monitor, and many times we had to bring the patient back to the clinic or we had a nurse go check their blood pressure. Since telemonitoring, it’s really been very convenient, especially for the patients.
By carefully monitoring the patient several times a day, Cardeum could tell when it was time to make a home visit and administer care. As a result, the patient was much more comfortable and the home visits saved a trip to the hospital. With the budget crisis in the state of Missouri involving Medicaid state management, telemonitoring is such an inexpensive alternative to multiple trips to the emergency room or doctor’s office.