VNAA Blueprint: Driving Better Care, Driving Better Policy

As health care delivery continues to undergo fundamental changes—VNAA and its members are committed to ensuring that quality outcomes for patients are a priority.

The Affordable Care Act (ACA) advanced new quality goals and payment models, creating tremendous opportunities for home health care to support and align with primary and acute care delivery models.  VNAA and our member agencies are well prepared to seize these opportunities.

Launching the VNAA Blueprint for Excellence is a critical first step. This groundbreaking work demonstrates VNAA's vital role in working with its members to advance accountable models. Nevertheless, much work lies ahead.

As you know, the ACA provides incentives for primary and acute care providers to prevent initial hospitalizations and re-hospitalizations. Achieving this requires collaboration. Increasingly, providers understand this, and many now appreciate the vital role of home health care to improve outcomes and lower costs. Now, policymakers must appreciate it.

Policymakers are now considering post-acute care delivery reforms. VNAA must make our case clearly and forcefully: Home health care services play a critical role in achieving the fundamental health policy goal of reducing hospitalizations of vulnerable patients, whether post-acute or patients at risk for emergency room, hospital or institutional care.  We do this by maximizing  care coordination and enabling physicians to extend care outside hospital and office walls.

The need for home health will become even more pressing as more seniors enter Medicare, state Medicaid populations expand an average of eight percent in each state, and primary care providers expand their "teams" of allied providers within and across their communities.

Policymakers are beginning to recognize the value of  home health care providers as valued partners in transforming post-acute care, and we must always be ready to partner. One way we've demonstrated readiness is through the VNAA Blueprint for Excellence, which disseminates best practices and ensures providers are capable of delivering consistent, high-quality care across the organization.

However, we must address underlying challenges in the current home health system. Five strategic policy solutions could dramatically improve the current Medicare home health benefit, reduce hospitalizations, improve outcomes and save money:

  1. “Deem” home health as the recommended site of post-acute health care unless the patient's physician indicates otherwise.
  2. Promote community admissions to home health services in an effort to effectively treat chronic diseases at home and avoid hospitalization.
  3. Eliminate the requirement that Medicare beneficiaries be “homebound”.
  4. Provide funding for home health agencies to expand use of telehealth and health IT to ensure interoperability and connectivity with physicians and hospitals.
  5. Work with industry leaders to aggressively improve program integrity by addressing fraud and abuse among home health providers.

These reforms, combined with appropriate reimbursement for quality outcomes, will more closely align post-acute care models with emerging primary and acute care models.

For these reforms to occur, however, policymakers must understand the value of home health in general and of VNAA members in particular. That's why the VNAA Blueprint is so crucial. It underscores the significance of accountable, measurable, coordinated care in the home health setting. We've demonstrated our value to accountable care models. Now we need to ensure those who make the rules also recognize our value.

By offering–and using--these tools, we strengthen care transitions and underscore the significance of accountable, measurable, coordinated care in the home health setting.

The first step, of course, is to make these best practices part of your practice. Next, spread the word. Get the VNAA Blueprint in front of policymakers and other decision makers so they, too, will appreciate the value of home.

Healthcare delivery is changing. If we are to accomplish our policy goals and advance better care, better health and lower costs, we must act. Otherwise, change will happen without us, to our detriment to the detriment of those we serve.


By: Eric Berger
On: 11/21/2013 11:01:41
This is visionary leadership -- an excellent statement and truly meaningful effort!

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