Two years ago, the Centers for Medicare & Medicaid Services (CMS) launched its nine-state pilot of the Home Health Value-Based Purchasing (HHVBP) program, with plans to expand the initiative nationwide in the next several years. This program has forced home health agencies to retool and seek every possible opportunity for reducing costs and creating market differentiation.
One of those opportunities is remote patient monitoring.
One of CMS’s biggest aims of the HHVBP program is to reduce the number of unplanned hospitalizations during the first 60 days of home health. Agencies that fail to meet this and 23 other quality measures that comprise the Total Performance Score stand to lose a substantial amount of revenue. One of the quickest ways to reduce the number of unplanned hospitalizations is through remote patient monitoring.
For instance, a care manager who is remotely monitoring a patient can proactively identify emerging issues before they become full-blown problems and provide immediate interventions – leading to improved outcome measures, reduced hospitalizations, and reduced E.D. visits. That’s not all. Remote telemonitoring clinicians can also improve HHCAHPS scores – just consider the impact a care manager can have on communication between providers and patients.
Improving the Agency’s Total Performance Score
Of the 24 existing measures that contribute to the agency’s Total Performance Score, remote patient monitoring can positively impact 15 of them. Issues in ambulation, bed transfer, bathing, dyspnea, pain management, medication compliance, ADLs, and IADLs – these are specific outcome measures included in an agency’s HHVBP Total Performance Score – can all be improved through remote patient monitoring. What’s more, improvement in these areas will likely lead to a reduction in home health hospitalization rates.
Where remote patient monitoring is most valuable is for patients with one or more chronic conditions, such as congestive heart failure, chronic obstructive pulmonary disease, coronary artery disease, diabetes, hypertension, and asthma. In addition to monitoring biometric readings for these patients and intervening when necessary, telemonitoring clinicians can:
- Evaluate patients’ medication compliance, including whether a patient has filled a prescription on time or is taking a drug as prescribed.
- Help patients identify the link between the onset of symptoms and a newly prescribed drug.
- Provide education to help patients understand their co-morbidities and how best to manage their conditions.
- Coach patients to better manage their overall health.
- Assist clinicians with monitoring a patient’s treatment plan.
- Help patients get the most from their home health visits.
To illustrate the impact a remote care manager can have on a home health agency’s outcome, consider a patient with chronic obstructive pulmonary disease: by checking in to see if he is using his maintenance medications every day, the remote care manager can prevent problems that could eventually lead to a hospitalization. Consider the congestive heart failure patient; a recorded spike in the patient’s weight could transmit an early warning to the remote care manager that patient’s heart might soon have trouble pumping enough blood through her body. Finally, consider the diabetic patient with crashing blood sugar who would usually wind up in the ED; as the home caregiver records the blood sugar data, it could generate an alert for the remote care manager, who then calls the home and suggests the patient drink some orange juice to bring the patient’s blood sugar back to normal range.
The Rise of Telehealth
With these types of patient benefits – coupled with real improvements in healthcare outcomes – no wonder why telehealth has already been embraced by hospital providers across the country. In fact, recent studies estimate that as many as 50% of hospitals use telehealth in some capacity, with another 10% considering a telehealth launch in the near future. What’s more, in another survey, 89% of healthcare executives responded that telemedicine will transform the U.S. health care system in the near future. Undoubtedly, home health will not be immune to such a transformation.
And for good reason. With recent technological advances in telehealth, it has now become commonplace for remote patient monitoring technology to be able to record a patient’s vital signs, activities of daily living, dietary habits, medications compliance, and more, with this information easily accessed by and shared with the entire care team – including home health staff, physicians, and family members. Built-in algorithms can trigger alerts and notifications, resulting in rapid interventions, significantly improved communications, better patient care, better results, better outcomes – and happier patients.
About Karen Thomas
Karen Thomas is a certified management accountant and the president of Advanced TeleHealth Solutions, one of the leading telehealth monitoring companies in the U.S. Karen is a nationally renowned speaker, a lecturer for Missouri State University’s graduate-level Health Care Administration program, and a contributing author to, “Home Telehealth: Connecting Care Within the Community,” published by Royal Society of Medicine Press Ltd. Karen has appeared on numerous webinars and has spoken at dozens of conferences on the benefits of remote patient monitoring, generating enhanced clinical outcomes, patient engagement, and coordination of care. She is a member of the Missouri Governors Innovation Task Force, a past board member of the National Association for Home Care and Private Duty Home Care Association, a member of the American Telemedicine Association and the American Society on Aging, and a past ex-officio member of the advisory board of HealthCare Technology Association of America.