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Change is in the air - is your agency ready?

M&A activity, trust and the hospice market

Mergers and acquisitions in the home health care sector have seen an increase in activity in recent years, and that's got a lot of agencies and staff members worried.The hospice sector is also seeing a spike in M&A activity, particularly as more health care providers – in and outside of acute care – consider expanding their services to include palliative care

With providers giving hospice a more central role, there are likely to be some big changes for acute care organizations in the near future. Amid the turbulence it's critical that agencies have EHR software they can depend on to help them continue providing care and receiving payment. 

Hospice M&A activity on the rise 
Interest in the hospice sector is rising, with many companies, such as Amedisys Inc., expanding their focus on this area of care, Home Health Care News reported. 

"I don't know of any [provider] looking to remain exclusively as a home health provider," said Mark Kulik, managing director of advisory firm The Braff Group, in an interview with the news source. "If you're a provider of Medicare-certified services, traditional episodic home care, I can't think of anybody of size that's not trying to also provide hospice services, as well."

Costs are driving part of this growing focus on hospice, which is often less expensive than other care delivery methods, and CMS reimbursement has generally been more favorable and steadier for hospice care, as Home Health Care News noted. 

hospice More providers are focusing on hospice care.

Expanding palliative care 
There are other factors at play, too, that have pushed many providers to look more closely at hospice. CMS has restricted what can be considered outside of the hospice benefit while at the same time increasing compliance standards, squeezing agencies and in effect forcing them to do more with less. As a result, many providers are introducing palliative care programs that enable them to provide a more comprehensive continuum of care, letting them capture patients who aren't hospice-appropriate and effectively care for those who are. 

Trust amid change 
Reorganization within health care to place more focus on hospice can present challenges for acute care agencies. Mergers and acquisitions, while growth opportunities, can create internal turbulence. Staff members can become unhappy because they are forced to adopt a difficult-to-use EHR or follow confusing new workflows. The change can create gaps in administrative support, with calls going unanswered and follow-up care and appointments failing to be scheduled. The agency can face hefty costs to re-establish partnerships with hospitals, labs and other providers. And the new EHR vendor may not provide the transparency needed to help the transition go smoothly and ensure that patient care is not disrupted in the interim. 

"Weather the tides of change with confidence and minimal disruption to care."

That's where trust comes in. Acute care agencies need to have the dependable support from a trusted EHR vendor that can help them weather the tides of change with confidence and minimal disruption to care. 

Thornberry's NDoc® solution has been named Best in KLAS in the homecare segment for a record-breaking five years in a row. NDoc® is a logic-based EHR that is designed to anticipate and accommodate change, avoid downtime during transitions and ease burdens on staff. NDoc® is also fully optimized for hospice care, and can help your agency expand its current services or implement a new palliative care program. And NDoc® is backed by Thornberry's dedicated customer support team, which is ready to help you whenever you need. 

As acute care priorities evolve, achieve the trusting partnership you need by choosing the Thornberry team and its award-winning NDoc® solution. 

These six tips can help you attract top talent.

6 hiring tips for home health care

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. 

application Creating a great candidate experience helps you keep top talent interested.

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 it comes to sepsis, prevention is the best medicine for this deadly condition.

5 things to know about sepsis

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. 

sepsis Hospitals are seeing a growing number of sepsis cases. 

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

Home health spending is slated to increase more than any other health care category.

Home health spending to skyrocket

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. 

home health Home health spending is rapidly increasing – invest in the best technology so you don't fall behind.

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. 

When it comes to reducing patient readmission rates and avoiding financial penalties, infections can be a home health agency's worst nightmare.

Improving infection control protocols to comply with CoPs changes

When it comes to reducing patient readmission rates and avoiding financial penalties, infections can be a home health agency's worst nightmare. One particularly dangerous type of infection, sepsis, has grown more prevalent in recent years and often leads to rehospitalization. 

What HHAs need today are robust infection control policies and procedures. While some agencies were previously not required to implement such programs, the new Medicare conditions of participation (CoPs) have made it mandatory that all HHAs have a comprehensive infection control protocol. 

Let's take a closer look at what this new mandate means for your organization:

Understanding infections in the home health – hospital relationship
Researchers from the Columbia University School of Nursing conducted a study of 199,462 patients at 8,255 home health care agencies. They found that 3.5 percent of patients developed infections during their stay, and that 17 percent of unplanned hospitalizations were due to infections.

The study was published in the American Journal of Infection Control in 2016. While it found a relatively small incidence of infections in HHAs, there has been a notable surge in sepsis in hospitals. As a referral partner, this increase presents a greater need for sepsis monitoring and vigilance in home health agencies. 

health Evidence-based protocols can improve infection control at home health agencies.

The rise of sepsis in hospitals
The number of sepsis cases in the U.S. has been rapidly rising in recent years. Between 2005 and 2014, the incidence of hospital stays due to sepsis nearly tripled, according to a report by the Healthcare Cost and Utilization Project published in June of last year. Sepsis is now the No. 1 reason for hospital stays, according to new data from the Agency for Healthcare Research and Quality, Bloomberg reported. 

To deal with the rise of sepsis, New York State now requires all health care agencies to implement new evidence-based screening and treatment protocols. As a result of the new processes, sepsis mortality has decreased nearly 16 percent in the past two years. Other states have followed suit, with Illinois, Wisconsin and Ohio implementing infection protocols modeled after the New York program. 

Thornberry Ltd. also updated its NDoc® solution to better address sepsis, adding additional patient screening questions and expanding the Signs and Symptoms table to capture more detailed information relating to the condition. With these tools, providers can institute more effective evidence-based treatment protocols. 

Changes to the Medicare CoPs
Infection control has always been a part of HHAs' provisions of care, as mandated by their state's requirements. Those that were accredited by the Joint Commission or CHAP already had to have infection control policies and procedures in place. However, CoPs changes have now made it mandatory that all HHAs have an infection control program. Read the release on the final rule here

"CoPs changes have now made it mandatory that all HHAs have an infection control program."

Enhanced infection protocols in EMRs
The sepsis protocols highlight a need for HHAs across the country to have more robust infection control programs in place. Many EMRs only give nurses the option to document Yes/No as to whether the patient exhibited signs of an infection, and reports simply gave the the option to show if the patient had a catheter and if they were on an antibiotic.There was no report to calculate the number and type of infection. 

However, Thornberry Ltd. has introduced enhanced infection control protocols. In NDoc®, clinicians can now fill out a new section that captures more information about current and potential infections and easily coordinate additional lab work and cultures. Then, they can run a report for the number and types of infections for all of the agency's patients to quickly get a better idea of infection risk and trends and determine whether the infection was likely agency-acquired. 

These new processes give a more detailed picture of what an agency has done to prevent and treat infection. This information can then be used for performance improvement initiatives and staff training. 

The number of documented sepsis cases has been increasing, but with improved infection control protocols now mandated for use by all providers by the new CoPs, HHA are better equipped to identify, treat and ultimately prevent infection. 

It's not pleasant to think about, but you need to have a plan in place for dealing with emergencies at your agency.

Complying with the new CoPs rule on emergency preparedness

Disaster striking your home health agency is not a pleasant scenario to imagine, but one that's necessary to think about. It's essential to have an emergency plan in place ahead of time so that you can quickly pivot operations and continue providing care to patients. 

Being prepared for a disaster is all the more relevant in the HHA industry at the moment because emergency preparedness is now a part of the Medicare conditions of participation (CoPs). HHAs are now required to have an emergency program. 

Here's what you need to know about developing emergency preparedness at your agency:

Understanding the CMS rule 
The Centers for Medicare & Medicaid Services now mandates that all agencies must have an emergency preparedness plan. Such a program should protect patient health in the event of an emergency that affects operations, and covers both natural and man-made events, according to CMS. 

CMS says the emergency plan should be based on four main areas:

  1. Risk assessment and emergency planning. 
  2. Policies and procedures. 
  3. Communication plan. 
  4. Training and testing. 

CMS requires that continuous testing of the plan is performed to see if it needs updating or changes from lessons learned. Read more about the rule here

Creating your plan 
Keeping these four guidelines in mind, your emergency plan should specify what steps to take in the event of a disaster. Think about potential scenarios, such as what should be done if there is a water main break, gas leak or shut off, blackout, fire or loss of power. How will you communicate with patients if a phone system is down? Are there steps you can take to prepare for an impending natural disaster, such as a hurricane or wildfire? What actions should be taken in the event of man-made event, such as a robbery or active shooter? How will the authorities be contacted? These and other questions need to be extensively explored. 

"Key to effective disaster preparedness is having constantly up-to-date information on patient needs."

Establishing a priority list 
Another important issue is determining how you will prioritize patient care in an emergency. How will you manage those patients whose care relies on electricity and water?

An EMR with disaster preparedness features will provide essential triage support. Using Thornberry's NDoc® solution, nurses can run a Priority List report which tells them which patients on oxygen need to be seen, those who can be called and those with support who do not need to be called or visited during that time. 

Having the information you need ready 
The key to effective disaster preparedness is having constantly up-to-date information on patient needs. In NDoc®, nurses can add to a patient's emergency plan at any time to specify what may be needed for the individual's care in a disaster. For example, the nurse can note that the patient needs bottled water, batteries, matches, flashlights, enough medications for two weeks and so on. This data then pulls to a report that can be instantly retrieved in an emergency. Reports can be run daily and weekly so staff and clinicians have the most updated information on patients. 

With an in-depth plan and an EMR enabling up-to-date patient priority reports, your home health agency can comply with the CoPs and be better prepared in the event of an emergency. 

2018 marks the fifth year in a row that Thornberry has won the coveted industry honor.

Thornberry awarded ‘Best in KLAS’ for record fifth year in a row

LANCASTER, Pa. (Feb. 1, 2018) – Thornberry Ltd.'s homecare and hospice EMR software, NDoc®, received the Best in KLAS award for the Homecare segment for a record-setting fifth year in a row.

For 2018, Thornberry was awarded a score of 93.1, surpassing all other vendors in the Homecare EMR segment by 9 points. The Best in KLAS designation is reserved for vendor solutions that lead the software and services market segments with the broadest operational and clinical impact on healthcare organizations. The recognition marks the first time in KLAS history that a vendor has been named Best in KLAS in the Homecare segment for five consecutive years.

"We are beyond excited to be named Best in KLAS this year," said Thornberry President and CEO Tom Peth. "We are thankful to our customers for their loyal partnership that allowed us to receive this recognition, and to our team for all their hard work day in and day out that enables us to achieve this success."

For the past 20 years, Thornberry has led the way in innovation in the home health and hospice EMR industry with its cutting-edge NDoc® software solution. With a suite of intuitive interoperability, compliance and protocol functions, NDoc® empowers clinicians and administrative staff to provide outstanding patient care. In a healthcare landscape of increasing change and data dependency, Thornberry supplies the smart tools and superior customer support providers need to improve clinical and financial outcomes.

2017 was an exciting year for Thornberry, with the company unveiling new protocols for treating CHF and other conditions, introducing support for complying with the new Medicare conditions of participation and developing functions to help providers reduce hospital readmission rates. These and other product innovations demonstrate Thornberry's commitment to ensuring NDoc® always helps providers navigate changes in care, reporting and reimbursement processes.

"We're excited about what 2018 will bring, and are working hard to deploy more innovative features in the year ahead that will empower our customers to meet new challenges," said Peth.

KLAS Research, a widely respected healthcare research firm, determines the Best in KLAS ranking through extensive surveys and interviews with current and previous customers of EMR vendors, gathering feedback on the efficiency and quality of health IT products. KLAS uses a stringent methodology that ranks vendors according to their ability to meet certain current and future expectations. The Best in KLAS score is based on key performance indicators that include sales and contracting, implementation and training, functionality and upgrades and service and support. The firm also evaluates vendors based on their ethics, transparency and commitment to customer service. Providers may request a report at the KLAS website.

"Best in KLAS is more than a ranking. It is a recognition of vendors committed to delivering superior solutions, said Adam Gale, president of KLAS. "It gives voice to thousands of providers who are demanding better performance, usability and interoperability in healthcare technology."

Thornberry will be recognized for its record-breaking win at the annual "Best in KLAS Award Ceremony" at the Rio Resort in Las Vegas on Monday, March 5 from 7-9 p.m.

About Thornberry
Founded in 1992, Thornberry Ltd. is the creator of NDoc® – a complete homecare and hospice management information and electronic medical record application. NDoc is a CCHIT Certified®2011 Long Term and Post-Acute Care (LTPAC) EHR additionally certified for Home Health. NDoc's key functional elements include clinical documentation and compliance, workflow management, financial management, business intelligence and document management. Powered by rapid information exchange technology, NDoc is a connectable application able to quickly share data with healthcare providers across the continuum. NDoc helps agencies increase clinicians' efficiency, improve patient outcomes, enhance employee morale and grow profitability. Learn more at ndocsoftware.com. "NDoc®" is a registered trademark of Thornberry Ltd.

About KLAS
KLAS is a data-driven company on a mission to improve the world's healthcare by enabling provider and payer voices to be heard and counted. Working with thousands of healthcare professionals, KLAS collects insights on software, services and medical equipment to deliver reports, trending data and statistical overviews. KLAS data is accurate, honest and impartial. The research directly reflects the voice of healthcare professionals and acts as a catalyst for improving vendor performance. To learn more about KLAS and the insights we provide, visit www.KLASresearch.com

Media Contact
Linda Peth
lpeth@thornberryltd.com
(717) 283-0980

If you're buying something online, it pays to do your research - and that's where KLAS comes in.

What is KLAS and why should I 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. 

reviews Whether you're buying home goods or health IT software, it pays to read reviews.

Honest reviews 
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. 

Client-provided feedback 
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. 

To guide your New Year-strategizing, here are seven tips for preparing your home health agency for 2018.

7 tips for preparing for 2018

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!

We've compiled a list of helpful questions and answers.

Q&A: What home health agencies need to know about palliative care

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. 

palliative care Palliative care can help patients with chronic conditions have a higher quality of life.

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.