Healthcare at Home: The Rowan Report

December 5 — BURLINGAME, California — CareLinx, a nationwide online home caregiver network, today announced the national launch of “Medicare At Home,” a product designed to pave the way for Medicare Advantage (MA) plans to safely and efficiently enhance their supplemental benefits with non-skilled home care. [This article provides an overview and update of healthcare delivered through what is becoming the most increasingly popular insured plans for seniors– MA plans– and the work of Carelinx and its national launch of ‘Medicare At Home.’

While reports indicate that MA plans will move cautiously into the non-medical home care space, following the CMS announcement that new rules will permit them to reimburse for benefits such as adult day care services and in-home and caregiver support services, CareLinx is taking steps to encourage MA entrance into the area of ADL support and the social dimension of health. An interview is provided with Carelinx’s Founder and CEO to indicate the broader reach that the company aims for; it summarizes what Sheik has explained about his company as follows;  “We believe that quality in-home care support is an integral part of managing and maintaining good health and positive well-being, and we’re thrilled to see that the Centers for Medicare and Medicaid Services agree,” he told us. “We are looking at 270 MA health plans that have already begun incorporating non-skilled home care in their Medicare products. As we see more MA plans looking to incorporate non-skilled home care into their plan designs, CareLinx is looking forward to becoming a trusted partner for the payers that manage those plans.” Details are provided about the company’s intentions to ‘enable non-skilled independent caregivers to supplement home health skilled workers coming into the home.  There is also a ‘connectedness’ capability shared by these caregivers through the company’s ‘mobile App (CareLinx), promising lower costs and more targeted delivery of care services.]

©2018 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

Should Home Care Invest in Dual-SIM Phones? Home care field staff use phones more than tablets and laptops these days. The cost savings and convenience are without question but when they use their personal phone, questions do arise. How to identify personal vs. professional use time and how to accurately reimburse are two of them. These identification tasks can result in more accounting effort than it is worth. [Rowan provides details in this article about multiple types of phones that can be used by healthcare at home nurses. One described is the Dual-SIM phone; another is the Huawei P20 Pro. A range of other mobile telephones and their features are also described, including: a; Samsung Galaxy Note 9; Pocophone F1; Asus Zenfone 5Z; and Honor 10 / Honor View 10.  Rowan concludes this article with an overview of uses and promise of the iPhone, about which he notes Apple’s executive, Tim Cook touting its extensive planning use by 2019.  It’s noted in this article: “the iPhone is soon to catch up with international Android makers. A dual-SIM iPhone is now available. A 256Gb version can be obtained for around $900 but there are 128Gb and 64Gb models as affordable as $799 and $749, respectively.“]

Honor 10 / Honor View 10

The reviewers we read agree that the Honor 10 is built for performance. It comes with the same processing package, RAM, and built-in storage as the Huawei P20 Pro but comes in at half the price. The Honor 10 comes with dual-SIM (dual standby) capabilities. While the device isn’t officially available in the US, an international version is listed on Amazon for around $450. If you want the U.S. warranty, you are better off getting the Honor View 10 (also with dual-SIM) that has been launched in the US and is priced at $429.99.

What About iPhones?

Surely it will have been noticed that all of these products are Android phones. Not sure most home care operations find themselves in the rarefied air of Apple prices, we almost left this section out. However, on September 12 of this year, Apple CEO Tim Cook announced that the iPhone is soon to catch up with international Android makers. A dual-SIM iPhone is now available. A 256Gb version can be obtained for around $900 but there are 128Gb and 64Gb models as affordable as $799 and $749, respectively.

In the announcement, CEO Tim Cook did not specify a release date but said that dual-SIM will be supported “with an update to iOS 12 coming later this year.” It’s unclear when that will be, as Apple has also said the same with Group FaceTime. Ideally, we could see both features in an iOS 12.1 or iOS 12.2 update before 2019.”

At the close of this article, Rowan asks HCTR readers:

Have you moved toward dual-SIM phones for your mobile staff? Tell us about your experience selecting and using them by writing to editor@homecaretechreport.com.

©2018 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 

Do Medicare Home Health Agency owners and administrators understand the synergies that could come from private duty partnerships? I have been asking myself this question ever since I began to exhibit at home care conferences earlier this year.

Over and over again I speak with Directors and Administrators from Home Health companies and I ask them if they provide Private Duty services. When they say “no,” as they usually do, I follow up with, “Out of the 200 or so patients you have, do none of them ever want or need non-medical services between your nursing and therapy visits?” [The author recounts how often he hears from home health providers that additional or private duty care is not necessary after a home health patient’s assignment to home health services.  The author is certain that a good number of these patients–recovering from a broken hip, for instance–still may need non-medical, patient-pay services with performing ADLs (like, showering, toileting, etc.).  It is in the home health agency’s administrative staff’s best interest to branch into providing non-skilled health services to these clients. he says:”if you own a Home Health company and are not providing non-medical, patient-pay services to at least 30% of your Home Health patients, you are losing a revenue source! But it is not just a mercenary issue. I am pretty sure that most, if not all, of us got into this business in the first place because we care about frail elderly and sick children and new mothers. Why would we not give them all of the services they need?” The author concludes by noting that home health agency administrators must 

Even though I have been hearing that home health must migrate toward getting patients better with fewer and fewer visits, a great majority of these owners tell me that their patients do not need private services. I am too polite to press the question but I ask it here. “How is that possible?”

They are telling me that a patient who is receiving skilled nursing and therapy services at home, perhaps following a CVA, a recent heart attack, or a broken hip after a fall needs no assistance with bathing, toileting, and dressing, or shopping, cooking, and vacuuming? The answer is obvious, isn’t it? Of course these people need assistance!

The question, then, is what could make skilled providers believe their patients do not need extra help? Are they scared of Private Duty providers? Are they lacking knowledge on how to offer such a service themselves? Are they unwilling to get into the business of hiring non-skilled workers? I do not know the answers. I am sincerely asking.

If you own a Home Health company and are not providing non-medical, patient-pay services to at least 30% of your Home Health patients, you are losing a revenue source! But it is not just a mercenary issue. I am pretty sure that most, if not all, of us got into this business in the first place because we care about frail elderly and sick children and new mothers. Why would we not give them all of the services they need?

I am not suggesting you should give referrals away or, even worse, ignore that the need exists. With never-ending Medicare reimbursement reductions, you are trying to serve your patients with fewer in-person visits. That is all well and good but many of these patients may want, need, and are able to afford Private Duty care as a supplement to your skilled services. In many cases, these extra services can be paid for with little to no out of pocket for the patient. There are financial sources including Long Term Care Insurance and VA programs such as “Fee for Service,” “Aide and Attendant” and many others.

I carry with me a saying I learned from my folks, “What you focus on grows!” If it is not growing, you are not focusing on it. For example, Medicare agencies that do also provide Private Duty service, if they are not converting over 40 percent of their clients to the other side, they are not focusing on it.

Are you struggling to grow sales? Look within your own book of business! Look to see whether you are leaving revenue on the table and leaving patients in the lurch. Do your clients benefit from your company giving them all the care they need? Or are you focused on your own need to provide the kind of care you are comfortable with? You know how hard it is to get each referral in the first place. Now that you have it, don’t lose it to another company that does provide both levels of service.

This is a tough time in post-acute care, both for skilled and personal care providers. Regulations continue to tighten and, along with them, so are margins. We cannot afford to be reactive, we need to be proactive, which means fighting simultaneously for our patients and our businesses. Stop losing sales that are already in your house! Make every referral count!

John Corrigan is a former executive with a Florida home health agency and now the Chief Customer Officer at Paradigm Claim Services. He can be reached at John@Paradigm-Claims.com

©2018 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

(For background, see the ResMed press release in our November 5 special edition.) 

[Rowan also provides pointed details about MatrixCare’s acquisition focuses and ResMed’s links with SNF software company AOD and private duty software vendor Soneto (which is a leading player in the private duty and Medicaid home care arenas). One  overall goal of MatrixCare’s acquisitions is to ensure that each acquisition, according to MatrixCare’s owner, Raj Sodh,  must “be an appropriate technological compatibility, a good cultural fit, and the target has to be a good business in its own right.”That means SNF software company AOD and private duty home care software vendor Soneto will also join Sodhi’s division at ResMed. Soneto is one of the leading players in the private duty and Medicaid home care arena, growing steadily in customer base and positive reputation since its founding in 1999 by the brother and sister team of Joe Kraus and Linda Donev.

“We look for three things when we decide on an acquisition,” Sodhi explained. “There needs to be an appropriate technological compatibility, a good cultural fit, and the target has to be a good business in its own right. MatrixCare meets all three of those standards.”

Connectiveness among various medical device products’ acquisitions is a key  concern, as Sodhi explains…It’s simply one way to  bring value to our customers .”  Many such examples are provided such as MarixCare’s connecting respiratory solutions, our smart ventilators, with Brightree.  By connecting a sleep apnea device to a home health care plan and billing system, we know in real time if there is a need to adjust a respiratory program or suggest a doctor visit. We will continue to take a balanced approach with our strategy to create cross-platform solutions.”]The focus will be patient experience and outcomes, Sodhi emphasized. With an array of home health, home care,[private duty care,] hospice, and non-medical EMR products to work with, ResMed will be promoting its ability to help avoid hospital readmissions by building communication among a patient’s care team and with software interoperability. “]

©2018 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

©2018 Elizabeth E. Hogue, Esq.  All rights reserved. ©2018 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article appeared in Tim Rowan’s Home Care Technology Report. homecaretechreport.com No portion of this material may be reproduced in any form without the advance written permission of the author. editor@homecaretechreport.com

By Tim Rowan, Author and Publisher of Home Care Technology Report

Optima Healthcare Solutions has published survey results that shed light on the challenges hospice providers face in meeting their compliance obligations. 46 percent of respondents showed a lack of full confidence in their ability to survive a federal audit without facing potential penalties, fines or loss of productivity that could financially impact their business. Similarly, 42 percent expressed a lack of full confidence in their ability to successfully respond to Additional Documentation Requests (ADRs), which are used by federal auditors to review hospice claims.

“The findings show that clinical documentation is a key area of vulnerability for many hospices,” said Josh Pickus, CEO of Optima Healthcare Solutions. “Addressing this vulnerability requires taking a close look at the underlying problems that inefficient documentation is causing, and evaluating how technology, best practices and other approaches can reduce risk.”[Findings from this survey found that the majority of respondents said they needed improvement in their clinical documentation, and that inaccuracies caused excessive time to be spent on these tasks.  A majority also said that increased use of technology would increase efficiencies. and users’ confidence levels.]

©2018 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