The Advantages of In Home Healthcare

With value-based care agreements racing to the horizon of healthcare it has become imperative for payers to offer services that meet the needs of their patients. Organizations that think outside the realm of normal healthcare services to acquire higher reimbursement rates and lower patient readmissions is key to surviving in this new value-based landscape.

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To garner a higher reimbursement rate, it’s imperative to reassess what department should be quarterbacking your patient care. A model that is paying dividends at Vera Whole Health is taking primary care physicians into a comprehensive care role, Advanced Primary Care. Ryan Schmid, CEO of Vera Whole Health says, “Unless you build a care model that’s designed to treat the whole person as opposed to physical disease or infirmity, then it’s really not advanced primary care.” Their Advanced Primary Care model seeks to treat the whole person – social, mental and physical, in order to address all environments to enact a comprehensive treatment plan for each patient.

“I would stress the empathy piece of this whole deal. It’s a non-negotiable. The one thing we’ve nailed is empathy,” Schmid says. “Even when we didn’t have all the bells and whistles that we have today, we saw outstanding results. That is the secret to unlock this whole thing.” At Vera, empathy has been key to raising patient satisfaction and increasing payor reimbursements.

With empathy as a focus, an Advanced Primary Care model helps to expand value-based agreements to include a homebased treatment plan. This allows providers to send nurses into patient’s homes to connect with primary care physicians through telemedicine as they act as an extension of the office. Under the value-based agreement, the provider is reimbursed not just for the treatment they provide, but for the costs of the management services – meaning the technology, time and expense.

In-home care is key to reducing readmissions, which impact every fifth hospitalization in the Medicare fee-for-service population. “We have found it’s essential to augment the reach of the PCP with holistic, in-home care services for their recently discharged patients within the first 24 hours of their homecoming,” Humana’s Chief Medical Officer Roy Beveridge, MD says. “Value-based care has been around for a while and, even a number of years into this, there are still continued improvements,” he said. “This is not just going into value-based medicine, changes occur, and then it's static. What this means is that there should be continued quality improvement, which should then continue to improve the health of our patients, our members.”

The aim of value-based care is to achieve the goal of creating higher quality medical care for a lower cost, but if healthcare organizations are unwilling to think outside the box, they may see their revenue and reimbursements dwindle. Helping keep track of your payments, reimbursements and metrics is key to understanding where you can increase emphasis in your practice. Employing a third party service like ImagineBilling and ImagineDiscovery helps discover what insurance coverage patients have and what services they are eligible for, all while managing your claims, denials, and productivity. 

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