Delivering high-quality home health care depends on who's on your team. It's impossible to deliver high-quality care without the right people on board across all departments of your home health agency, from clinical to administration support.
But the quality of your hires depends on your recruitment strategy. Make the best hires for your HHA with these six tips:
1. Create a great candidate experience
"Candidate experience" is one of the buzziest phrases of the year, and for good reason: Creating a seamless, stress-free application process makes a positive impression on candidates and is more likely to lead top talent to accept an offer at your agency. A bad candidate experience generates bad press, too, with 72 percent of job applicants sharing their negative experience on review sites such as Glassoor, according to a study by Future Workplace.
Here are the hallmarks of a great candidate experience – let them guide your recruitment strategy:
- Timeliness: Recruitment can be time-intensive, but if candidates are left waiting to hear from you they may be picked up by another agency. Keep the process moving.
- Communication: Regularly update candidates on their status and stay in regular communication with them throughout the recruitment process.
- Simplicity: If people have to jump through hoops to apply for a job at your organization, they're going to look elsewhere. Streamlined, intuitive application processes are best.
2. Reach right-fit applicants
Another key to making great hires in home health is effectively reaching right-fit candidates. Advertise postings on social media sites such as LinkedIn and health care job boards. Work with a recruiter who specializes in the home health field and ensure they're fully briefed on the scope and demands of the job.
Make sure people can apply for jobs at your agency on their smartphones, too, as 78 percent of millennials and 73 percent of Generation Xers used mobile devices to search for jobs in 2016, according to findings from the Pew Research Center.
3. Offer competitive salary and flexible benefits
To attract the most qualified clinicians and administrative support staff, you need to offer competitive salary and benefits packages. Ensure the standard elements are there – great health insurance and retirement savings plans, for example, but also consider offering other non-typical benefits that are growing in popularity, such as generous PTO days, student loan repayment assistance and financial advisory services.
4. Look for soft skills
Of course, any new hire to your HHA needs to have the right technical and medical skills for the job, but it's also important to hire for soft skills, especially in patient-facing roles. Soft skills to look for include:
- Effective written and verbal communication.
- Creative problem solving.
- Collaboration and teamwork.
- Time management.
5. Plan onboarding
Onboarding may seem like the last thing to think about when it comes to recruitment, but it deserves front-and-center attention. A great onboarding process is part of creating a positive candidate experience, and a structured program can help new hires hit the ground running. A strong onboarding process is one that includes ample training time and familiarizes the new hire with the teams and workflows of your agency.
6. Stay organized
Staying organized throughout the recruitment process helps improve the experience for both employer and employee. An EMR like Thornberry's NDoc® solution can help you HHA keep things running smoothly while more resources and time are devoted to recruitment efforts.
The success of your HHA depends on the quality of its hires. Follow the six tips above to attract top talent and keep them on board through great application experiences.
When healthcare providers are doing everything they can to help patients get back on their feet or manage chronic illnesses, infections can decimate their efforts in the blink of an eye.
Unfortunately, at many hospitals across the country, sepsis may be doing just that. And that means big problems for home health agencies, who send and receive patients to and from hospitals and depend on low readmission rates to avoid financial penalties.
Sepsis is characterized by a breakdown in the body's healthy immune system response to infection. It is one of the top causes of hospital deaths in the U.S., with more than 1.5 million people developing the condition each year, according to the Centers for Disease Control and Prevention. One in three patients who die in a hospital have sepsis, a sobering statistic.
In response to this growing threat, state legislatures and regulatory bodies are mandating stricter standards for infection control by healthcare providers. The most famous case of this is New York State, which now requires all healthcare agencies to adopt more detailed, evidence-based screening and treatment protocols. The Centers for Medicare & Medicaid Services followed suit, updating its conditions of participation to make it mandatory that all HHAs operate an infection control program.
As the discussion around sepsis intensifies, here are five things home health agencies should know about this dangerous condition:
1. Older patients are at increased risk of developing sepsis
While sepsis can develop in any patient, older individuals, who represent the bulk of home healthcare patients, are most at risk. A study published in the World Journal of Critical Care Medicine attributes the high incidence of sepsis in elderly patients to reduced immune system functions, high rates of co-morbidities and frequent and long hospital stays. Sepsis is the top reason for ICU admissions for elderly patients.
2. Sepsis advances quickly
The insidiousness of sepsis lies in its ability to progress rapidly. A study published in the New England Journal of Medicine of more than 49,000 patients at 149 hospitals in New York State found that for every hour clinicians don't engage in sepsis control protocols, mortality rates increase by between 3 percent and 4 percent, Stat News reported.
3. Sepsis is becoming antibiotic resistant
There is growing concern over antibiotic resistance in the treatment of sepsis, a challenging issue seeing as antibiotics are a key treatment for the condition, as the Sepsis Alliance Explained. One study of 76 patients in the North American Journal of Medical Sciences found that the six antibiotics used most often to to treat infections demonstrated an average resistance higher than 50 percent.
4. We're probably noticing sepsis more
While the number of cases of sepsis has more than tripled in recent years, health experts say that the explanation is more likely that the condition seems more prevalent today because clinicians have gotten better at identifying the signs of sepsis, according to Bloomberg.
Clinicians are "actually recognizing a much more common condition than we realized in the past was actually there," said Dr. Greg Martin, a professor of medicine at Emory University, in an interview with the source.
5. Prevention is the best medicine
The facts above point to an important conclusion: Prevention is the most effective way of combating sepsis. More comprehensive infection control protocols can help clinicians mitigate risk factors and identify patients most likely to develop the condition. Take the example of New York State, which saw sepsis mortality rates decrease nearly 16 percent as a result of the new and improved infection control processes.
An EMR with enhanced infection control protocols is an important ally in the fight against sepsis. HHAs should choose a platform that enables clinicians and staff to have greater visibility into infection stages and provide more detailed documentation. Thornberry's NDoc® solution now features enhanced infection control protocols that include expanded data-collection fields and agency-wide reports – learn more about NDoc®, sepsis and Medicare infection control compliance here.
Now that spring has come – at least according to the calendar – it's a great time to scrub the floors, open the windows and let the fresh air in. But if you work in the home health industry, it's also an opportune time to reassess your agency's budget and strategic priorities. The seasons aren't the only things changing – so is home health spending.
Recent findings from the Centers for Medicare & Medicaid Services Office of the Actuary predicts that home health spending will increase 6.7 percent by 2020, which is a higher growth rate than any other health care category, Home Health Care News reported. With spending set to compound over the next several years, HHAs should consider their future growth and resource needs today.
Let's take a closer look at changing spending patterns in the home health industry and what they mean for your agency:
A growing market
In addition to the 6.7 percent annual growth rate between now and 2020, the Office of the Actuary forecasted that home health spending will rise to $103 billion this year alone, representing a growth rate of 5.9 percent compared to 2017. Furthermore, industry spending is expected to increase to $173 billion by 2026.
It's not just home health investment that is increasing, however, but total health care expenditure across the board. CMS predicts national health spending will display a 5.5 percent annual growth rate between 2017 and 2026, rising to a total spend of $5.7 trillion by 2026. This follows 4.3 percent spending growth in overall health care in 2016.
Medicare and Medicaid spending in particular will also see an increase, rising 7.4 percent and 5.8 percent annually per year by 2026. Expenditures in these categories have already kicked off their forward momentum, with Medicaid spending growth anticipated to jump to 6.9 percent this year from the modest 2.9 percent growth seen in 2017.
Why the increases?
There are a number of factors that industry analysts attributed to the rise in home health spending. One main reason is an aging population – researchers say 20 percent of U.S. citizens will be age 65 and older by 2030, according to the Census Bureau. By 2050, there will be 83.7 million people age 65 and older, nearly double the amount in 2012.
The CMS Office of the Actuary cites higher incomes and more expensive medical goods and services as other reasons for the spending growth.
So what do all these numbers mean to you?
It's time to invest
Your HHA needs to be able to remain competitive with fellow agencies that are all spending more of their resources to improve quality of care. There are two key steps critical to doing this.
First, your HHA needs to adopt a forward-looking approach to operations – what will you need to do now to set yourself up for success five years down the line? How will your agency capitalize on an accelerating market over the next decade, while navigating inevitable payment reform and downward pressure on reimbursement? Taking a long-term view of strategy can help you ensure the sustainability of care and remain agile.
Second, it's time to invest in the best home health technology. With competitors enhancing their platforms, you can't afford to skate by with a solely adequate system any longer. An innovative and responsive EMR like Thornberry's NDoc® solution can provide your agency with the dependable technological infrastructure it needs to grow productivity and manage and administer care seamlessly and efficiently.
With home health spending surging over the next several years, you need to make sure your HHA earns part of the pie. Invest in industry-leading home health technology to remain competitive and improve your quality of care.
If you're buying something online, you do your research. You rifle through the pages of Amazon reviews, learning what users liked and disliked about a product and their suggestions to future buyers. You trust the reviews because it's not just something that the seller made up: it's honest-to-goodness feedback that tells you whether the product is likely to be worth your investment.
If you apply this strategy to buying home goods online, then you should definitely apply it when purchasing EMR technology for your home health agency. You won't find the reviews on Amazon, but you'll find them on the KLAS Research website. KLAS is a leading healthcare IT research firm that provides the definitive ranking of vendors in the industry – it's the trusted go-to guide for home healthcare executives making buying decisions for new technology.
Here's more on what KLAS is, and why you should care about it:
History of KLAS
As business and healthcare both become more data-driven, the need for transparency is paramount. A desire for greater transparency was what was driving four members of the healthcare IT industry to create KLAS Research in 1996. Today, the firm has more than 130 employees who analyze data and interview clients to publish industry-leading KLAS reports and rankings.
You know how some Amazon reviews include a disclaimer that says the reviewer received the item for free as part of a contest or survey? You probably don't trust those ones as much as the reviews without those qualifiers. And when you're buying a large-scale software suite, the need for an impartial, balanced review is even greater. KLAS Research is lauded in the industry for honest, fair reviews, without kickbacks or other incentives tied up in the vendor evaluation process. With a commitment to honesty and transparency, you can trust the reviews you read without worrying they're sponsored content.
KLAS data scientists delve into the numbers to figure out where EMR and other healthcare IT vendors stand. However, this isn't the whole picture. KLAS staff also conduct in-depth interviews with real-life clients of vendors to find out the human side of their business. Are people happy with their products and with customer service? Do they have a positive impression of their vendor? Do they think their organization has benefited from adopting the vendor's software? All these questions and more are addressed during the KLAS research process, and the results of these client interviews weigh heavily in KLAS annual industry rankings.
"KLAS staff conduct in-depth interviews with real-life clients."
Holistic view of business
Today more than ever before, healthcare providers and business executives want to put their money where their morals are. KLAS Research understands this and incorporates ratings in ethical categories into their vendor rankings. Does the vendor act ethically and strive to do good? Can their clients trust them? While on the surface these qualities seem distinctly un-quantifiable, KLAS has a thorough vetting process that addresses all aspects of a vendor's operations.
Make an investment with confidence
Buying a new EMR is a major decision, and one that is not to be taken lightly. The software you choose will have a profound effect on your organization. That's why you should depend on KLAS to help guide your buying decisions – their reports and rankings give you the information you need to know to make a purchase with confidence.
2018 is right around the corner, and while you're probably thinking about your New Year's Eve plans and setting some personal resolutions, it's also important to think about how you can prepare your home health agency for success over the next 12 months.
There are a lot of changes coming for home health and hospice this year, and a lot of exciting opportunities to strengthen patient care, too. To guide your New Year-strategizing, here are seven tips for preparing your home health agency for 2018:
1. Review the past year
You can't effectively look ahead without looking back first. Review what worked and what didn't in 2017 so you can adjust your strategy and make improvements in 2018. Another area to review is the technology at your agency – perhaps your EMR's security was not up to par and it's time to make an upgrade. By reviewing the past, you can create an effective strategy and more realistic budget for the new year.
2. Set SMART goals
As you evaluate the past year and think about your HHA's priorities in 2018, set SMART goals (Specific, Measurable, Attainable, Realistic and Time-Bound) to help your agency stay on track. With all the hustle and bustle of the end of the year, SMART goal-setting can fall by the wayside, but taking the time to detail your ambitions and objectives makes it more likely you'll actually achieve them.
3. Make a plan to weather the transition to new conditions of participation
This year saw the Centers for Medicare & Medicaid Services finalize new conditions of participation for home health agencies to participate in the Medicare program for the first time in decades. On Jan. 13, 2018, the changes will go into effect, which means your HHA needs to be ready to transition swiftly and smoothly. The new CoPs are designed to improve patient care and include some significant updates. A clear plan for implementation, effective staff communication and an interoperable EMR will help you successfully weather the transition.
4. Dig into the details on OASIS, HIS and payment changes
There are a variety of current and potential changes going on across the board that will affect HHAs and hospice providers in 2018 and beyond. CMS altered its "one clinician" convention regarding the Comprehensive Assessment: Starting Jan. 1, 2018, clinicians will be permitted to gather feedback from other staff at the agency to aid in the completion of OASIS items related to the Comprehensive Assessment. You can read more about this change here. CMS also submitted a proposal to remove 35 OASIS items starting on Jan. 1, 2019, and while that's still a way off, HHAs should be ready to adjust their workflows accordingly.
But that's not all. CMS updated the 2018 Medicare wage index and payment rates for HHAs, and also finalized proposals for the Home Health Value-Based Purchasing Model.
And on the HIS side of things, the final version of HIS data submission specifications, which include will become effective on April 1, 2018.
Going into 2018, make sure you understand the impact of these and other changes and how your HHA can be in compliance.
5. Survey consolidation activity and referrals
Consolidation is now "a defining factor in healthcare business models," as an article for the Healthcare Financial Management Association put it, and this is certainly apparent in home health. Several factors have driven consolidation in home health, including more palpable pressure to operate at a larger scale and at a higher level of operational efficiency as well as changes to how referrals are handled, advisory firm Harris Williams& Co. explained.
In fact, while M&A activity in healthcare overall slowed in the second quarter of 2017, it actually increased in the home health and hospice sector, according to Baker Tilly. The number of M&A transactions was up by 29 percent from the first quarter of 2017 and up 50 percent from the second quarter of 2016.
Prepare for potentially more M&A activity in 2018 and consider how your HHA can strengthen its referrals arrangements in this more heavily consolidated landscape.
6. Figure out how you can help partners reduce their hospital readmission rates
The new payment changes from CMS further incentivize the reduction of hospital readmission rates. Take a look at your existing strategy for reducing readmissions and see where it can be improved. It may be worth considering beginning to provide palliative care services at your HHA – a growing number of agencies are doing so to fill a gap in care while reducing readmissions for hospitals and other partner providers.
7. Re-evaluate how ACOs are affecting you – and if you should join one
In 2017, more than 359,000 clinicians joined ACOs, CMS reported. ACO participation is on the rise, with more home health agencies in particular joining in. The arrangement can help providers work together to reduce readmissions and costs and improve the quality of care, so consider if working toward joining an ACO should be a goal for your agency in 2018.
With the tips above, you can set your HHA up for success in 2018. Happy New Year!
More home health care agencies are providing palliative care services to their patients. In many cases, this arrangement benefits providers, patients and their communities.
As this is an emerging shift in home health, there is still much up in the air regarding palliative care. We've compiled a list of helpful questions and answers below:
Q: What is palliative care?
A: Palliative care is a program of services and support that are intended to control or reduce symptoms. Care is often administered over a long period, and can help individuals manage chronic illnesses. Palliative care is considered holistic and comprehensive, taking into account all aspects of a person's experience living with a certain condition. This means that palliative care is not just focused on treating an individual's illnesses, but on providing patient education, emotional support to patients and caregivers and strategies for living well with a long-term condition.
Q: How does palliative care differ from hospice care?
A: While hospice care is typically offered to patients who are predicted to live six months or less, palliative care can be provided to individuals at any stage of their condition, including at the time of their initial diagnosis. Patients do not need to have been diagnosed with terminal conditions to receive palliative care.
Similar to hospice care, palliative care can be jointly managed by a diverse team of healthcare professionals including doctors, nurses, home health clinicians and physical and occupational therapists. Unlike hospice, palliative care can include aggressive treatment.
Q: What are the benefits of palliative care?
A: Palliative care is beneficial because it can help individuals have a higher quality of life while dealing with serious illness. With its holistic approach, palliative care can help reduce physical pain, support mobility and promote positive emotional well-being while dealing with illness. And since a palliative care plan is often developed by several of the patient's healthcare providers through a coordinated effort, clinicians can customize the nature of palliative care to suit the patient's needs and update the plan according to any changes.
Q: Why are home health agencies starting to provide palliative care?
A: Many home health agencies are beginning to provide palliative care because it can help keep patients with long-term conditions out of the hospital. Through the Value-Based Purchasing payment program, the Centers for Medicare & Medicaid Services has increased its penalties for hospitals, home health agencies and other providers that have high rehospitalization rates. HHAs have found they can effectively treat patients through an informal palliative care program to lower rehospitalization rates for both their agency and their partner hospitals.
Patients who may not qualify for the hospice benefit because their condition has not yet become terminal can still receive support to help them reduce symptoms and have a higher quality of life.
"Palliative care can help keep patients with long-term conditions out of the hospital."
Q: How does palliative care services fit into Medicare payment models?
A: Medicare does not currently cover palliative care, and does not reimburse HHAs for providing this type of care. Instead, HHAs are finding that palliative care patients are covered under fee-for-service. However, HHAs can see financial benefits from providing palliative care in reduced hospital readmission rates and thus lower Medicare penalties.
As the popularity of HHAs operating palliative care programs grows, it's possible CMS may re-evaluate their payment models. Effective January 2016, CMS began paying for voluntary Advanced Care Planning under certain payment systems.
Q: Which types of technology does an HHA need to start providing palliative care?
A: Interoperability, or the capacity to effectively share patients' accurate and updated health information among providers, is of particular importance in palliative care. A comprehensive EMR like the Thornberry NDoc® solution can provide the intuitive and interoperable system HHAs need to successfully implement and maintain palliative care programs.
Think of technology integration as the thread that ties all the elements of your home health agency together. From keeping track of patient appointments to informing long-term care strategies, interoperable technology weaves different colors to create a stunning tapestry of high quality care and patient satisfaction.
Let's take a closer look at the ways technology integration is essential in home health care:
Enables comprehensive patient support
Though all the individuals your agency sees may be supported by homecare, each is following his or her own unique health journey. Technology integration enables your clinicians and staff to have a comprehensive understanding of these individual stories.
Integrating your agency's EMR with detailed patient profiles and analytics functions allows clinicians to view not just which health conditions a patient is facing, but how their health has changed over time. By having access to these insights, they can develop more targeted strategies for managing long-term illnesses and can make personalized recommendations for preventative care. And when the EMR is interoperable with the systems of hospitals, primary care practices and specialists, home health agencies can have a more accurate understanding of a patient's overall health journey.
Expands the reach of care
An important key to providing care is enabling patients to have easy and convenient access to health information. One important way to do this is through patient portals, which, when integrated with the larger EMR and clinical databases, can be vital touch points of interaction. Through these portals, patients can view their appointment schedules, read care recommendations from clinicians and access their medical histories.
But technology integration also expands beyond patient portals to have exciting applications in telehealth. Video conferencing, streaming technology and other advancements can make it possible for home health providers to reach patients in rural or isolated communities.
By bringing together disparate systems, technology integration streamlines workflows, reducing costs and improving the efficiency of care. When all systems work in tandem with total readability and accessibility, staff and clinicians spend less time searching for the right data and more time developing care strategies. Technology integration also supports home care agencies to join Accountable Care Organizations, enabling the easy exchange of data and empowering these agencies to become able players in the modern healthcare landscape.
Personalized patient support, enlarged scope of care and streamlined workflows – these are three important reasons why technology integration is essential in home health care. Thornberry's NDoc software was developed with interoperability front and center – contact us and learn more about how our EMR can support your agency.
We at Thornberry enjoy going to tradeshows because it gives us the chance to talk with home health and hospice agency decision-makers and hear what's on their minds. Well, according to our recent tradeshow visits, a lot of people just aren't happy with their current software.
We had some heart-to-heart conversations with these dissatisfied customers, and heard these four specific complaints again and again:
1. Bad support and service
Service is everything when it comes to having an EMR experience that meets your agency's needs, but it seems that a lot of vendors are forgetting this in 2017. Many customers we talked to said they were fed up with being treated like a service ticket. Telephone calls about technical issues went unanswered. Training during implementation left much to be desired. Updates were rolled out with no context. These issues and more leave home health and hospice agencies wondering if there's really someone else on the other end of the line.
2. The software doesn't meet their needs
Big EMR vendors frequently take a one-size-fits-all approach to the design of their systems. As a result, many small- to mid-sized home health agencies are finding that their current EMRs are just not meeting their needs, whether that's because of insufficient reporting or a lack of support for compliance. The customers we spoke to also voiced concerns about growing pains with their EMRs, noticing that the software just can't keep up with them.
3. Lack of flexibility
EMRs exist to support a home health or hospice agency – but too many customers these days feel like their EMR is dragging them down instead of lifting them to new heights. They feel they have to conform to the software – instead of the software conforming to their policies and procedures.They can't do the things they want and need to do, like share patient data efficiently with partner providers and health information exchanges.
4. Vendor uncertainty
There's a growing fear among home health agencies and hospices, affirmed by 2016's spike in sector M&A activity, that their EMR vendors will be acquired by larger companies or venture firms and the acquisition will put their current systems in jeopardy. They worry they'll be forced to scrap their long-term EMRs in favor of lesser-quality products from the acquiring companies, or that efforts to merge two companies' operations will cause these vendors to lose focus and create a chaotic environment for their customers. Agencies want to feel secure that their vendors are here to stay and dedicated to their success.
These conversations had us shaking our heads: We believe that when home health and hospice agencies are investing big money into EMR vendors, they shouldn't get anything less than superior service, top product and total confidence. Maybe that's why our customers helped name us "Best-in-Klas" in the Homecare segment for the fourth year in a row. If you're tired of complaining, contact the helpful team at Thornberry today and see how our award-winning EMR and customer service can support your agency.
Mergers and acquisitions are shaking up home health and hospice agencies across the country. In 2016, there was a 12 percent spike in M&A activity in the sector, according to Sheppard Health Law. Behemoth health IT companies buy out smaller firms, two vendors decide to join forces, or a corporate giant decides to diversify its portfolio – whatever the specific circumstances, M&A activity has the potential to cause significant changes to an agency's operations.
For example, post-acute care software provider Brightree was recently acquired by medical device company ResMed in an $800 million deal. In a poll conducted by HME News, 60 percent of respondents said that they were shocked by the acquisition. Many customers expressed concern that the deal means they'll have to change their current systems and workflows.
"I'm worried this will steer Brightree to becoming exclusive with ResMed, and affect our relationship and integration with other vendors," one individual said. "As someone who primarily doesn't use ResMed, I am not a fan of this at all."
It's not just Brightree. Last year it was Netsmart acquiring the Allscripts homecare business, and just last week Kinnser announced its "merger" with private-equity based Mediware.
When choosing a home health and hospice EMR vendor, it's important to consider whether the vendor is backed by private equity investors or is privately owned in order to make the smartest purchasing decision.
Weathering the storm
Some independent home health and hospice EMR vendors are able to continue offering their products and services with minimal interruption after a merger or buy-out – this is the best-case scenario. However, the risks are great. Many firms have a hard time maintaining acceptable levels of quality with respect to product and service after such a significant and often disruptive change. And while the vendor may have received a pretty penny for the sale, it's the customers that often pay the price. An EMR that an agency spent thousands of dollars implementing, training its staff to use and maintaining over time may suddenly become obsolete, abandoned by the acquiring vendor in favor of its own system. The agency must then begin from scratch, investing time and money into a completely new EMR, jeopardizing the quality of its patient care in the interim.
The benefits of privately owned firms
With such uncertainty on the horizon and M&A activity on the rise, home health and hospice agencies are well-advised to work with privately owned EMR vendors, opposed to those backed by private equity or venture capital. Private ownership means that vendors don't have to answer to others with money in their pockets, be swayed by market fluctuations or focus on quarterly earnings instead of their customers. They are resilient, backed by a legacy of self-funding, and give customers the confidence that they can depend on their EMR and on their vendor's support for years to come.
Thornberry Ltd. is a privately owned EMR vendor that has supported home health and hospice agencies across the country for more than 20 years. Schedule a conversation today to learn more about why you can feel confident investing in our industry-leading, Best-in-KLAS NDoc® software solution and superior customer service.
Valentine’s Day is all about showing others how much you care for them. A kind word here and a generous gesture there can make someone’s day. Even the smallest and simplest acts can have the biggest impacts.
Caring for one another is an integral part of home health and hospice, too. Homecare agency clinicians and staff do the best job they can for their patients so that they can have the highest quality of life possible.