Healthcare at Home: The Rowan Report

by Tim Rowan, Editor

Cyber-security experts are concerned, if not alarmed, by the rapid adoption of one video communication service, Zoom, over all others. For one thing they warn, it makes life easier for hackers, who only have to learn how to break into one platform. The system designed by Eric Yuan, after he and his partners sold WebEx to Cisco, was transformed overnight from a handy tool for casual family and small business conversations into an inexpensive, unsecure business meeting space. Experts are even more concerned when Zoom is used by healthcare. (more…)

— Smartphone app detects vital signs, touch free
— Home care software firm releases screening tool
— VNA of Omaha cares for hospice patients, new moms, from afar (more…)

by Brian Malthouse, CPA & Emir Hodzic, CPA

Yes, there are emergency payments available to Medicare providers. No, they are not all grants, some are loans. Know the rules; know the differences between the two; know the consequences of accepting your payment. (more…)

The Federal Government Department of Health and Human Services is providing support to healthcare providers fighting the COVID-19 pandemic. On March 27, 2020, the President signed the bipartisan CARES Act that provides $100 billion in relief funds to hospitals and other healthcare providers on the front lines of the coronavirus response. This funding will be used to support healthcare-related expenses or lost revenue attributable to COVID-19 and to ensure uninsured Americans can get testing and treatment for COVID-19. (more…)

by Darcey Trescone, RN

Trescone notes that revenue recognition guidance in home healthcare varies under PDGM among CPAs and consultants, as was the case during planning for payment reform not long ago under PPS.
A new issue is that under PDGM, an episode of care can last 60.days and many in the home health field (such as CPAs and consultants) are aligning their practices with 1/30th bases over each 30-day period. Trescone asks: “Who is right?” Currently, CPAs and consultants involved with NAHC are reviewing the generally accepted accountiing principleS (GAAPA) in relation to PDGM.
Two key questions that Trescone poses at the end of her article are: “What do my CPA and consultants perceive about possible changes in revenue recognition?” and “Does my current EMR operate within the revenue recognition method?” Trescone notes that ensuring that your EMR can support your chosen revenue recognition accounting methodology will be an important step tward keeping your accountant happy.

To assist revenue cycle and finance leaders in a continuously evolving industry facing unparalleled challenges and opportunities, Libman Education has released a white paper titled: “Does Your Coding Team Deliver on Your Promises To Your Clients? Four Principles to Help Your Coding Team Succeed.”
Clinical documentation and coding are often cited as two of the areas of greatest revenue cycle opportunity. The white paper provides a road map for revenue cycle management[RCM] organizations to carefully plan, evaluate and improve their coding function, providing an immediate impact on the value proposition they offer to clients.
The white paper asks RCM organizations to consider the following:
Are your coders meeting your exacting accuracy rates and productivity standards?
Having hired qualified coders, how do you ensure their skills stay sharp and up-to-date?
Are your coders fully versed in the rules that govern accurate and complete coding resulting in proper reimbursement?
Are your coders continuing to develop their skills and expand both their areas of competence and their value to your organization?

by Tim Rowan, editor & publisher of Home Care Technology Repor</em>
Citing a recent analysis by Axxon newserver services,newsswe:that”two-thirds of 68 health care companies that went public in 2019 traded above their IPO price by the end of year.”
Rowan notes that the “vast majority of health care companies that go public are biotechnology firms. According to an analysis by the Axios news service, two-thirds of the 68 health care companies that went public in 2019 traded above their IPO price by the end of year.”
The vast majority of health care companies that go public are biotechnology firms. Several of those biotechs in the 2019 class benefited from some promising, but extremely early, clinical trial data. If you bought an equal amount of shares of every health care company that went public last year and then sold before the calendar flipped, you would have gotten a 47% return on your money. Sixteen companies saw their stock prices double between their IPOs and the end of the year.
Winners: Karuna Therapeutics made the biggest leap, as the biotech company’s stock price almost quintupled by the end of the year. Early clinical trial data showed that Karuna’s schizophrenia drug relieved many symptoms.
NextCure and Turning Point Therapeutics also saw their stocks rise after releasing early-stage drug data.
Two medical device firms — ShockWave Medical and Silk Road Medical — and fertility benefits company Progyny were the exceptions to the biotech-heavy list.
Losers: SmileDirectClub, which mails teeth-straightening kits, and a handful of biotech startups like Stealth BioTherapeutics saw their stock prices fall by more than half from their IPOs.
The bottom line: Biotech stocks are notoriously fickle. Poor clinical trial data can derail an entire company, and some of these firms inevitably will fail, given the nature of science. However, initial signals indicate investors still have plenty of money to throw at health care startups of all stripes.
For further research: One Medical firm was one of the first health care IPOs of 2020, but should post-acute care get involved?

©2020 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article summarizes a news release published by Axios.

by Tim Rowan,publisher and editot of Home Care Technology Report
[12/4/99]
Complia Health announced today the acquisition of the company’s Procura division by Montreal based AlayaCare. The combined business will offer enterprise solutions for home, residential and community care in Canada, Australia and New Zealand is noted. AlayaCare will acquire all Procura assets, people and customer contracts and under the AlayaCare brand. Procura will continue to operate in Victoria, British Columbia under the direction of the same executive and product management team. The two CEOs were in that office today and spoke with us separately. [The remarkable Medicaid-funded post-acute home health markets in Canada, Australia and Bew Zealand is noted. The company now services over 200 clients which include some of the largest healthcare at home agencies in Canada, the U.S. and New Zealand.]
Mr. Ambrose told us he has been looking for a new home for the Procura product since taking over the reins at Complia Health last May. “Our strength is in the U.S. Medicaid arena, including state waiver programs, with full Medicare and non-medical functionality for those customers who need it,” he said. “So we wanted to focus our resources on serving that market, plus the hospice market with our Suncoast division.” From Complia Health’s Boca Raton office, Brad Caldwell added that Medicaid waivers and patient-directed payment systems are the fastest growing sectors in post-acute care in the U.S.
The Procura division has delivered home, residential and community care solutions since 1989, becoming the dominant home care software provider in Canada and a strong player in Australia. They also serve a number of U.S. home care agencies. CEO Schauer acknowledged that Procura has been AlayaCare’s main competitor north of the border since he launched his company in 2014. (See Canadian Startup Poised to Enter U.S. Healthcare at Home Market (The Rowan Report, 2/10/2016) Schauer pointed out that combining the two former competitors positions AlayaCare as an industry leader in the pre- and post-acute care markets in Canada, Australia and New Zealand.
AlayaCare’s acquisition of Montreal-based Procura and AWZ from Complia Health provides home and community care in Canada, Australia and New Zealand, and is Medicaid focused.

Inc., Colorado Springs, CO. All rights reserved. This article is a summary of vendor press releases. homecaretechreport.com. editor@homecaretechreport.com

by Tim Rowan, editor & publisher of Home Care Technology Report

If the home care staffing shortage is a problem from coast to coast, it is a disaster on the coasts themselves, or wherever the cost of living is well above the national average. In California’s Bay Area, some in-home care workers commute an hour or more from their relatively affordable neighborhoods to the homes of patients and clients in the cities and suburbs around “the San’s:” Jose, Francisco and Rafael.
[Having tackled the staffing crisis in the Bay Areas where her home care company was located, and costs began to soar during the economic recovery that began to take hold in 2010, recruiting and retaining in-home care workers became more and more of a challenge. After successful efforts to create an attractive, positive employment experience mitigated but did not solve the problem, Dr. Andrews investigated other solutions. After a great deal of research, Dr. Andrews decided to enter into a strategic partnership with Honor.
“I tried everything to attract and retain in-home workers,” she told us. “We were doing a good job but it still wasn’t enough. We had one of the highest percentages in our area of people who were with us for ten years or more. That speaks to our commitment to our people and our clients but, even with loyalty and longevity, we still stopped growing. We turned people away when we couldn’t staff a new case. It seemed we were always playing catch up.”
In an Honor partnership, the San Francisco-based company takes over management of an agency’s office and field staff, leaving agency owners free to focus on business development. Partnering with a number of agencies in a market area gives Honor the ability to load balance staffing, serve more clients and keep caregiver schedules filled.
“I started to look at the disruptors out there,” she continued. “Disruption brings about change and I have always thought of myself as one who seeks change.” She said she had watched Honor over the years and finally began to believe a partner like that might be what was needed to allow her agency to grow again. Honor brings to the partnership a full complement[ation] of technology for agency management, personnel scheduling, payroll and billing, a level of sophistication [thaT] At Your Service did not have and was not likely to develop on its own.
Though implementation of the Honor staffing system began only recently, Dr. Andrews said At Your Service has already been able to say ‘yes’ to more clients. “We have the capacity to fill hard-to-fill shifts,” she said.
With the time and resources the Honor partnership affords her, Dr. Andrews plans to devote more time to her first passion. Her doctorate in Nursing Practice with Specialty in Dementia has taken a back seat to running an agency for the last 16 years but she is happy for the opportunity to dust it off and provide workshops and coaching to dementia patients and their families. She wants to add a dementia specialty to At Your Service as well.
“We’re excited that Dr. Andrews is partnering with us to transform non-medical in-home care for the growing number of older adults who want to age in place,” said Nita Sommers, president of Honor. “The home care expertise that Lucy brings, along with her vast experience advocating at both the state and national level, will have a positive impact on our ability to help more agency owners. It’s great to partner with industry innovators such as Lucy who share our vision for creating a quality caregiver workforce and experience for both clients and caregivers alike.”
About At Your Service Home Care
Since its inception in 2003, At Your Service Home Care is the North Bay’s premier non-medical home care agency providing care in Sonoma, Napa, and Marin counties. In addition to providing home care services to help older adults maintain independent living, the agency also provides specialized services such as dementia and Alzheimer’s care, hospice, and respite care. Dr. Andrews continues to maintain the home health agency that provides case management and concierge nursing services.

©2019 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com