By Tim Rowan, Editor & Publisher of Home Care Technology Report

 Superior patient care. Preferred provider agreements with hospital systems. Investing in innovative technologies. This is the three-pronged strategy that has catapulted Healthcare Resource Solutions from startup to a dominant player in Cook and ten other counties surrounding Chicago in only 11 years. We spoke with co-founder Glenn Steigbigel this week about the third prong, HRS’s latest innovation deployment, a technology called Wanda.

A veteran of IBM’s “Global Services Strategy and Change” division with an advanced degree in Public Policy and Economics, Steigbigel is anything but a clinician. He knew that strategic hiring and technology deployment would be keys to competing in the overcrowded healthcare at home Chicago-area market. [Rowan proceeds to describe the development of new  health monitoring company Healthcare Resource Solutions  by co-founder Glenn Steigbigel and his intention to target “frequent flyer” patients at Northwestern and Loyola University hospital systems and others in the Chicago region (and far beyond).  He adds how Steigbigel and another co-founder  developed their company’s focus not only on remote patient monitoring but on the many needs of elderly at-risk patients (using software christened “Wanda”).  From this data,  the company provides predictive analyses of  patients’ needs and develops clinical pathways to help them maintain good health and reduce hospital readmissions. More details about the promise of Wanda software are presented in this article.]

“We set up our agency to take care of the patients that need the most help,” he told us. “That willingness to deal with so-called ‘frequent flyers’ helped us achieve preferred provider status with Northwestern and Loyola University hospital systems and others.”

He added that technology became a focus when he and business partner Robert Mikulak, an MBA but also not a clinician, saw a future with too few nurses for the growing senior population. Today their 11-year old agency is CHAP accredited and one of the largest privately-owned Medicare agencies in Chicago, serving eleven counties from one central office in the city’s western suburbs.

Launching Wanda
“We had been doing remote patient monitoring for several years,” Steigbigel continued, “interpreting and making use of the incoming vital sign data as best we could. Wanda adds an important additional layer. It adds the patient’s living conditions, demographics, and health and medication history to the mix and performs predictive analytics using all that data. It shows us not only what is happening but what is likely to happen next. Now we know not only whether the patient is at risk but why. With that knowledge, we can fine tune our own clinical pathways, tweak our visits and treatment plans, and see the results of front-loading visits. All of this contributes to reducing hospital readmissions.”

Developed after twelve years of research in conjunction with the Wireless Health Institute at the University of California at Los Angeles, Silicon Valley startup Wanda only recently released its patient monitoring analytics tool of the same name. It includes vital sign measurement devices but they are one small part of a data analytics system that the company says can identify high-risk patients before an adverse event occurs.

According to Chief Collaboration Officer Mark Heinemeyer, Wanda is not a device company but does incorporate vital sign measurements in making its predictions. “Wanda is able to reliably predict an adverse event seven days in advance,” he told us. “Investors were attracted to us when they saw our studies with diabetics. We required 60 percent fewer activities from hospital systems but gave them 70 percent more information. With that, we were able to help health systems confronted with readmission penalties.”

He cited one early test with an East Coast hospital system that resulted in 30-day readmission rates dropping to 6 percent. “We can’t claim full credit for that rate,” Heinemeyer added. “We were the catalyst but of course we relied heavily on care managers and home health agencies to respond to our alerts and take meaningful action in response.” (See study details elsewhere in this week’s issue.)

HRS set to expand Wanda’s reach
The two Chicago-area agency co-owners are already satisfied enough with early results to make plans to expand from their initial 30 monitors in order to reach more patients. Data analysts are looking at length-of-stay, number of visits, readmissions, patient outcomes, and patient improvements. “From those analyses,” Steigbigel asserted, “we will know if our treatment plans are helping to reduce hospital readmissions.”

He admitted that no one really knows exactly what practices result in the best care. But by analyzing the data he expects to be able to see the results of front-loading visits and exactly what flavor of front-loading is best for each patient. “Does this patient need three or four consecutive RN visits? Three or four consecutive therapy visits? Or three or four consecutive phone calls? By looking at more than just vital signs, we should be able to know these things.”

He concluded our conversation with an explanation of his and his partner Mikulak’s choice to include patient quality of life in his ROI calculation for this technology. “Wanda gives feedback not only to us but to the patient,” he said, “which helps them to be motivated to become more compliant. After two years, we will know the total impact of Wanda on our costs but, until then, we are drawing no quick conclusions. The failure of most home telehealth studies is that the study time is so short they cannot learn the real story, they cannot register the impact of adjusting care plans to the incoming data.”

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But I Am Not a Salesperson! … Oh, Yes You Are

by Michelle Boasten

 

In a recent article published in McKnight’s, consultant Betsy Rust writes “Fading fast are the days of post-acute healthcare providers viewing patients as their primary customers.” The bundling of post-acute services with hospital payments will transform the hospital — along with special managed care programs, health plans and accountable care organizations — into your real customer. [The author sends out this alarm to healthcare at home providers: “Ignore this payor shift from direct Medicare and Medicaid to other providers at your own peril. Doing so will certainly lead to decreased sales.”  She provides a solid argument for learning and implementing new sales techniques to package agencies services attractively and set it well apart from competitors. Details are provided about a new sales and coaching learning session offered by Sales Trainer Lewis VanLandingham of Sandler Training by Sharper Edge Advantage, LLC at the September 2016 meeting of the Ohio Council for Home Care and Hospice Annual Conference & Tradeshow.]

Ignore this payor shift from direct Medicare and Medicaid to other providers at your own peril. Doing so will certainly lead to decreased sales. This is because your agency’s revenue will be your new payor’s cost and they want to keep their costs low.

Think of it this way. A hospital admission day can exceed $5,000. Surely you provide in-home services for less than that. A Medicare episode rarely exceeds $5,000 for 60 days of care. Making that case may be easy but the key will be not only to package your services in a financially attractive way, but also to communicate what sets your agency apart from others, so hospitals will trust their patients to you instead of your competitor.

This means learning a new skill, how to play the “Game of Sales.” And it means every member of your staff, not your sales staff, your entire staff, must learn the game. Every person who sees patients, answers the phone, or explains to friends and family what their company does, can Learning sales skills will require education and coaching like any other new skill.

If you are attending the Ohio Council for Home Care and Hospice Annual Conference & Tradeshow on September 12-14, stop by the Home Care Technology Report booth and receive a ticket for admission to a sales training workshop being held in Dublin, Ohio on October 5, from 1-3pm. This type of training is essential for Home Health Administrators. Sales Trainer Lewis VanLandingham of Sandler Training by Sharper Edge Advantage, LLC will teach your agency administrators ldquo;How to Sell… Even If You Are NOT a Salesperson.” Many have paid as much as $250 for this workshop, but Lewis is offering this training session to our subscribers at no cost, so stop and see us at the Home Care Technology Report Booth # 600 to pick up your ticket.

Lewis VanLandingham

565 Metro Place South, Suite 300

 Dublin, OH 43017

614-440-0383

©2016 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. homecaretechreport.comOne copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com

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by Michelle Boasten, humanitarian and social entrepreneur, and founder of “You Can Care, Inc,”as well as founder of EVV (electronic visit verification).

Surely by now everyone has heard of the #BlackLivesMatter movement. It was started by three women (Alicia, Opal and Patrisse) who wanted to bring serious attention to the murder of 17 year old Trayvon Martin.  These women truly understood that there is a devaluing of Black lives which is tied directly to racism. Racism, like any other -ism (i.e. sexism, classism) at its core is a deliberate and intentional design to separate people.  One of the tools used to effectively continue this separation are constant and consistent negative messages about a group of people.  These messages eventually become a stereotype.

I know many of you reading this are thinking… what on earth does #BlackLivesMatter have to do with Home Health Care? Interestingly enough, there are some strong parallels. Over the last 30 years, Home Health Care has developed a net negative image at the Office of the Inspector General (OIG). Though we insiders know it is undeserved, the OIG stereotype has been well supported by the fraud cases that seem to be in the news every day.

Nothing demonstrates this stereotype better than the video produced by the OIG itself.1 If you are not aware of the official opinion of who we are, you will miss the parallel and not understand the consequences and power of a reputation. [The article reviews the negative reputation of the home healthcare industry to which many in the OIG and other federal departments ascribe. Theauthor strongly suggests home heakth workers/supporters ought to develop a new movement focusing on the value of home healthcare services, and call this movement “#HomeHealthCareMatters” A utube video by the OIG titled “Eye on Oversight: Home Health Fraud” is linked to at the end of this article.]

OIG is not alone
Home Health Care, as an industry, is viewed harshly and negatively by many people inside and outside the government. While the OIG may clearly know that there are thousands of good people working hard everyday to care for their patients, they focus on the crooks, thieves and swindlers. This might be difficult to digest when you run a good business and surround yourself with upstanding, hard working, honest people who are trying to serve sick and homebound patients. In fact, you may have been so busy doing that honest work that you missed the fact that there are some who are not doing this at all, who are instead busy stealing from Medicare and Medicaid coffers.

This systemic fraud, waste and abuse has led the OIG, CMS and the DOJ to respond with oversight measures such as moratoriums, targeted audits and now pre-claim reviews, not to mention occasional raids. These measures make it really difficult for the good guys to practice. But where did that come from?

It came from CMS and its contractors conflating criminal intent with sloppy clinical documentation as though both were the same act. Professional criminals may occupy only 4 percent of the industry, as some reports claim, but badly documented homebound status and medical necessity, side by side with multiple unjustifiable successive payment episodes, look like fraud even when the care provided is legitimate. This is what encourages the CMS and its OIG to believe 6 out of 10 of you, instead of 4 out of 100, are crooks. This is how our industry’s reputation has been tainted. Home Health Care is caught up in a stereotype brought about by an unwitting collusion between CMS auditors and agency documentation failings and recertification practices that produce a consistent negative message.

So how do you prove you are one of the 4 out of 10 good guys?
The first thing to do is acknowledge that you are aware of the 6 out of 10. Then realize the Feds and their contractors have a low tolerance for sloppy clinical and administrative practices. Now, more than ever before, Home Health Care reimbursement is threatened because our nation’s healthcare budgets can no longer sustain paying for unnecessary — or unprovided — patient care.

Agency leadership has to be more alert, scrutinizing every admission, dotting every i and crossing every t. And it wouldn’t be a bad idea to start a movement of your own. If you want to showcase your good work and the value Home Health Care brings to the patient, perhaps someone needs to create a #HomeHealthCareMatters movement. Otherwise you might find yourself suffering ever more heavy-handed oversight measures and greater reimbursement cuts.

A smart movement begins with rich, evidenced-based data using technology. The data needs to concentrate on how much Home Health Care keeps healthcare costs down by keeping people out of the hospital. Focus your efforts on successful outcomes and specific measures that can demonstrate evidenced-based practices that quantify your message of how much you really do matter to the payers’ bottom line. Perhaps it is your State Association leadership who need to mimic the work of Alicia, Opal and Patrisse, because…
#HomeHealthCareMatters.


1
OIG: “Eye on Oversight: Home Health Fraud” (YouTube)


Michelle Boasten is a humanitarian and social entrepreneur. She is the Founder of “You Can Care, Inc.” an IRS 501(c)3 non-profit. Michelle has invented and developed a web and mobile incentivized volunteer caregiving platform to tackle the twin issues of caregiving and student loan debt. www.OnlyOneNurse.com

Prior to “You Can Care,” Ms. Boasten founded EVV (electronic visit verification) in 1996. By 1998 the product was patented and today more than 50% of all home health agencies are required and mandated by law to use an EVV system to evidence accountable caregiving activity. 

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 By Tim Rowan, Editor & Publisher of Home Care Technology Report

The department of Health and Human Services Office of Civil Rights is charged with enforcing HIPAA privacy and security rules. Since the passage of the HITECH Act (2009) and the subsequent implementation of the HIPAA Breach Notification Rule, OCR has prioritized investigation of reported breaches of protected health information, investigating all reported breaches involving the PHI of 500 or more individuals.

Regional Offices also investigate reports of smaller breaches (involving the PHI of fewer 500 individuals), as resources permit. [A short listing is provided of recent settlements of cases where investigations of smaller breach reports where undertaken.  Rowan an notes  that as of August 2016 Regional Offices of OCR will more widely investigate HIPAA breaches.  A listing of some factors that Regional Offices will consider is provided.]

 

Recent settlements of cases where investigations of smaller breach reports include:

Beginning this month, OCR, through its Regional Offices, has begun an initiative to more widely investigate the root causes of breaches affecting fewer than 500 individuals. Regional Offices will still retain discretion to prioritize which smaller breaches to investigate, but each office will increase its efforts to identify and obtain corrective action to address entity and systemic noncompliance related to these breaches.  Among the factors Regional Offices will consider include:

  • The size of the breach
  • Theft of or improper disposal of unencrypted PHI
  • Breaches that involve unwanted intrusions to IT systems (for example, by hacking)
  • The amount, nature and sensitivity of the PHI involved
  • Instances where numerous breach reports from a particular covered entity or business associate raise similar issues

Regions may also consider the lack of breach reports affecting fewer than 500 individuals when comparing a specific covered entity or business associate to like-situated covered entities and business associates.

More information about OCR’s compliance and enforcement work with regard to breaches is available online athttp://www.hhs.gov/hipaa/for-professionals/compliance-enforcement/index.html. The OCR Twitter handle is @HHSOCR.

©2016 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. homecaretechreport.comOne copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com

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By Tim Rowan, Editor & Publisher of Home Care Technology Report

We have written in the past about the ZOE® Fluid Status Monitor and how it is being used in the home with CHF patients. (See HCTR 6/4/14: “Stabilizing Health and Reducing Hospitalizations via Noninvasive Zo Measurement“) Now we have learned that ZOE has sunk, literally.

Dr. Marc Ó Gríofa, an Irish-trained Las Vegas physician, is a former triage doctor for the shuttle program at the Kennedy Space Center. Currently, he works with the “NASA Extreme Environment Mission Operations, cleverly referred to as NEEMO. He spent eight days in July nearly 20 meters below the surface of the ocean inside NASA’s Aquarius Undersea Reef Base off the coast of Florida. The base is used to simulate conditions astronauts might encounter during long space missions or on the surface of other planets. While there, he monitored the entire NASA crew frequently with ZOE. [Details are provided about Dr. Ó Gríofa’s research scope and the ZOE Fluid Monitor’s research applications in the study of Alzheimer’s and Parkinson’s diseases and genetic disorders like Duchenne’s Muscular Dystrophy.]

 

ZOE Fluid Status Monitor

“The ZOE Fluid Monitor provides the capability of a portable, repeatable, objective indicator of fluid status that can be used in any conventional or unconventional clinical environment for the monitoring and management of any patient with fluid management problems,” Ó Gríofa told us. “Assuring accurate technology utilization, even when the home environment transitions to 90 feet underwater, is an expected clinical commitment to best care.”

ZOE uses two electrodes on the thorax, noninvasively assessing Zo (ohms) by passing a 2 milliamp current between the electrodes for thirty seconds. Within three to five minutes, it reports the amount of vascular fluid stability and whether it is on the increase or decrease.

One of the key reasons O Griofa is on the NEEMO mission is to see how Zoe performs. He will oversee the collection of multiple samples from each crew member to evaluate the impact of the NEEMO mission on telomere length. This research will be used to study Alzheimer’s and Parkinson’s disease and genetic disorders like Duchenne’s Muscular Dystrophy.

The ZOE® Fluid Status Monitor was developed by Noninvasive Medical Technologies Inc.
nmtinc.org

©2016 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. homecaretechreport.comOne copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com

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

It is a familiar experience for many. First, you get a taste of the healthcare at home field. The next thing you know, you are hooked. This is exactly what happened to Chelsea Stoner, Duncan Gills, and their colleagues at Battery Ventures, a private equity fund with operations in San Francisco, Boston, and Israel. First they engineered and underwrote the acquisition of CareAnyware by Brightree (HCTR, 1/4/13). A few years later, they exited the Brightree investment when that company was acquired by ResMed (HCTR, 2/17/16). Before long, they longed to get back into home care.

Today, Battery Ventures announced it found a way to satisfy its longing. 

 

SAN FRANCICO, CA – August 24th, 2016 – ClearCare, the San Francisco-based software company with an EMR platform used by over 3,000 non-medical home care agencies, today announced a $60 million growth-equity investment led by global investment firm Battery Ventures. The company also announced that noted technologist Bala Krishna (Balki) Nakshatrala, former vice president of engineering at Mastercard, has joined ClearCare in the same role.

The company will use most of the investment to continue to develop its core platform and to explore new strategic partnerships, CEO Geoff Nudd told us, though some of it was used to replace earlier investors. As part of the financing, Battery Ventures General Partner Chelsea Stoner and Vice President Duncan Gills will join ClearCare’s board. [Details are provided about Chelsea Stoner’s background in working with healthcare at home software and views on promise of ClearCare to effect further change in senior health market.  Geoff Nudd (CEO of ClearCare) presents his views on expectations to lead senior healthcare at hiome market as a result of his company’s recent partnership with Battery Ventures. Bala Krishna (Balki) Nakshatrala, former vice president of engineering at MasterCard and now in same role at  ClearCare.]

 

In addition, Ms. Stoner comes to ClearCare with experience in the software and healthcare-technology markets. Previously, she served on the boards of Brightree and Data Innovations, a provider of software for medical laboratories that was acquired by Roper Industries in February 2015. She will continue to serve on the boards of WebPT, a Web-based, electronic medical record (EMR) solution for physical, occupational and speech therapists; Avalara, which sells cloud-based, sales-tax software; and Intacct, the cloud-based ERP provider.

“We have been big admirers of ClearCare from afar since 2012,” Ms. Stoner told us. “When we invested in Brightree, we got to see home care up close. What we saw is that technology is driving change and we wanted to get back in through a technology leader. ClearCare was the obvious choice. It is our mission to support strong companies like that.”

The company’s end-to-end platform includes point-of-care tracking, integrated payments, family portals and quality of care monitoring. ClearCare serves four of the largest five national home-care enterprises, and six of the largest 10, representing roughly 250,000 caregivers and 150,000 seniors under care. (Editor’s note: for additional ClearCare background, go to homecaretechreport.com/search.asp and type “ClearCare” into our search field.)

“We are excited to partner with Battery Ventures as we aggressively pursue new opportunities to grow our market leadership,” stated ClearCare CEO Geoff Nudd. “Battery’s expertise in the home care market makes the firm an ideal partner for this next step in our growth story.”

He did add that some streamlining had to happen to put the company on a strong financial footing and that there were a small number of layoffs. “But there were also several new positions created, including the VP of Engineering (mentioned above),” he was quick to add.

“This sector still has a long way to go to fully serve our senior population,” Nudd summarized. “The Rand Corporation estimates that there are as many as 18 million seniors that need the support of home care in order to remain independent. Our customers serve about 150,000 of them. We will continue to support our growing customer base and to build exciting products for them.” 

About ClearCare
ClearCare Online is a cloud-based home care software platform supporting private-duty home care companies for efficient, cost-effective aging at home. ClearCare’s web and mobile platform helps home care agencies operate efficiently, scale services and improve the quality and documentation of care on behalf of their patients.
clearcare.com

About Battery Ventures
Battery strives to invest in cutting-edge, category-defining businesses in markets including software and services, Web infrastructure, consumer Internet, mobile and industrial technologies. Founded in 1983, the firm backs companies at stages ranging from seed to private equity and invests globally from offices in Boston, the San Francisco Bay Area and Israel. 
Twitter: @BatteryVentures
battery.com
Find a full list of Battery’s portfolio companies here.

©2016 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. homecaretechreport.comOne copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com

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by Audrey Kinsella, Home Care Technology Report’s Telehealth  Reporter

A new wound care service company, Corstrata, based in Savannah, Georgia, is using advanced tele-techniques well beyond simply capturing clear pictures of wounds and assessing their progression. “A picture is worth a thousand words” does not come close to expressing the clarity made available by teletools, nor the advantage of having them delivered to home health clinicians and analyzed by Corstrata’s certified wound care nurses. [Details are provided about the size of today’s woundcare  patient population in the U.S., and its need for advanced and precise wound care imaging and treatment.  Corstrada’s specific plans to extend telewound care delivery via hub sites operating throughout the country is described in the last paragraphs of this article.]

We recently interviewed CEO and cofounder Katherine F. Piette on the company’s first anniversary about her vision for the company, which is to push at-home wound care to higher levels. Corstrata is doing this with telecommunications-ready videography and a wide geographical delivery of needed care.

Old/New wound photo comparisonNeeded indeed
Currently, the U.S. wound care industry costs $33 billion per year, and it serves over 6.5 million patients, many living with complex, non-healing wounds. It is a population projected to grow to 8.7 million.

Piette’s focus on using telecommunications-ready tools and board-certified wound care experts is key to achieving its vision of providing expert wound care anytime, anywhere. These nurses will demonstrate the use of telehealth-focused services to:

  • achieve earlier detection of difficult-to-manage wounds;
  • prevent non-healing wounds’ progression; and,
  • develop new means for affecting curative techniques of complex wounds.

Reaching these ambitious goals requires that focused, tele-wound care educational segments be put in place, Plette asserted.

Educational segment 1
Corstrata-affiliated wound care experts teach healthcare at home nurses advanced wound care management techniques for targeting care for specific non-healing, complex wounds. Teaching tools used include:

  • Videography and still photographs, discussed and color-correlated over time, presented via a cloud-based telehealth platform.
  • Expert discussion about uses of telehealth techniques to address wound care solutions.
  • Focus on managing current non-healing, complex wounds actually suffered by trainees’ patients.

Educational Segment 2
A second tele-wound care educational segment must involve training in-home nurses in advanced wound care management techniques. These are wounds that include diabetic and venous ulcers, pressure sores, and other conditions. Videos and still photographs of a range of wounds are presented and discussed with learners by the experts.

Work in wound exacerbation prevention must also be covered. Trainees, for example, are shown where and how often body temperature of a diabetic patient’s foot should be measured and steps that need to be taken to prevent development of pain and the need for amputation.

Directions ahead for alternate site tele-woundcare
We can say with some certainty that Corstrata has the potential to move telehealth into the mainstream of wound care. Dozens, perhaps hundreds of earlier home telehealth projects were limited to relatively short-term, grant-funded demonstration projects, with small groups of persons with particular chronic diseases.

This is not the path that Corstrata intends to follow. Instead, the company’s leaders plan to develop hub tele-wound care sites with multiple agencies providing expert education and services, using their own trainers and
practitioners. Hub site participants will not spend valuable time seeing if tele-wound care “works,” but will instead be learning from proven cases where tele-wound care has been shown to work. The ultimate aim is to relieve the pain and wound progression of patients currently living with diabetic ulcers, pressure sores, and other wounds.

http://corstrata.com

Audrey Kinsella, MA, MS, is HCTR’s telemedicine reporter. She has written on home telehealthcare and new technologies for home care service delivery for 20 years, in 6 books, multiple web sites, and more than 150 published articles. Audrey can be reached at audreyk3@charter.net or 828-230-0895.

©2016 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

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Summarized by Tim Rowan, Editor & Publisher of the Home Care Technology Report

CMS has scheduled a special Open Door Forum on the subject “The IMPACT Act and Improving Care Coordination.” 

The conference call will be held Thursday, September 15 at 2:00 to 3:00 pm, EDT

The purpose of this Special Open Door Forum (SODF) is to provide information and solicit feedback pertaining to the Improving Medicare Post-Acute Care Transformation Act of 2014 (commonly referred to as the IMPACT Act). The IMPACT Act mandates the standardization of patient assessment data across post-acute care settings including Skilled Nursing Facilities, Home Health Agencies, Inpatient Rehabilitation Facilities, and Long Term Care Hospitals in order to improve quality of care and quality of life.

This SODF will offer discussion on the goals of the IMPACT Act, the expected outcomes of the Act, and potential roles post-acute care providers can play in improving coordinated care. This SODF will serve as a platform to update providers, consumers, stakeholders, researchers, and advocates alike on the work around the IMPACT Act and to solicit input on the ways the IMPACT Act can help you improve care coordination.[Details are provided about means for participants to join the Forum.]

]CMS invites questions, comments, and ideas from providers, patients, consumers, researchers, and advocates in advance of or during the Forum.

To submit questions comments, and ideas in advance, write to: PACQualityInitiative@cms.hhs.gov.

PowerPoint slides that will be used during the call have been posted to: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Post-Acute-Care-Quality-Initiatives/IMPACT-Act-of-2014/IMPACT-Act-Downloads-and-Videos.html.

Special Open Door Participation Instructions will be provided within 1 week of the call.

A transcript and audio recording of this SODF will be posted to the Special Open Door Forums website under downloads section as well as the IMPACT Act Downloads and Videos webpage.

©2016 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

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Medalogix applies analytics to care planning

Almost without taking a breath after the last product release, Medalogix has figured out another practical way to use the vast amounts of data the Nashville-based company has been collecting, mostly through its synergistic alliance with Homecare Homebase. We spoke with CEO Dan Hogan this week to get the inside details on the new product.

“SunLeaper,” as it has been dubbed, represents a leap forward to applying Big Data to healthcare at home uses, he told us. “We needed to answer the question that continues to come up over and over, ‘This is great information; now what do we do with it?’ The need that rose to the top was a clinical application.”[Hogan describes how the role of “SunLeaper”  help move healthcare at home users from patients’ descriptive data analytics to prescriptive data analytics. The goal SunLeaper users ought to aim for is using the system to plan specific, as-needed patient visits and so save costs significantly.]

As Medicare contract auditors focus more and more on finding documented evidence of medical necessity, care planning is no longer simple, he reasons. “Individual care analytics are the wave of the future. When there are not enough human and financial resources available to visit every patient every day, you have to know what care plan is best for every individual patient. You can no longer thrive on ‘one size fits all’ care plans. You can no longer say, ‘Oh, CHF; 10 visits.’ If one patient absolutely needs 12 you bite the bullet and accept the cost of 12 visits. If another patient can get well and self-manage after 7 visits, you cannot give that patient 10 just because your standard CHF protocol calls for 10.”

The role of SunLeaper will be to bring massive amounts of data to bear to enable a clinician to customize every care plan to each individual. “COPD may not be the same in Portland, Maine as it is in Portland, Oregon. We have pointed our clients to the top 10% of patients at risk of hospital readmission with our other products. Now, we can apply data analytics to show how to apply interventions, to whom and when, on what frequency and via what discipline and in what order. SunLeaper represents our expansion from predictive analytics to prescriptive analytics.

“This is a product that is anchored to value-based purchasing models. New clinical practices are required in the face of new payment systems. In early tests, we have compared our results to CMS models. Of the six they have published, we are more accurate on five of them. We are within 1.5% on the sixth but we are working on it.”

Hogan is upbeat on the work CMS has done to build a platform of ordinal answers to a set of questions that provide value-added clinical tools. “OASIS is a data set that provides value-added clinical tools. It has enabled us to combine predictive analytics with operational analysis.”

Today, SunLeaper is in the early stages of field testing with one of Medalogix’ largest clients. “These tests will show us how we need to train future users to use the tool,” Hogan explained. The product is set for general release during the second quarter of 2017. It will be available as a monthly subscription.

“What we have built for healthcare at home is much like what cities do in terms of formulating traffic plan,” Hogan concluded. “They study data to know where to put traffic lights, how to adjust their timing for traffic pattern variables such as time of day and days of the week. It is always about the data.”

He added that Medalogix is growing and recruiting data scientists.
medalogix.com


 

Libman Education Announces ICD-10 Code Update Courses
BEDFORD, MASSACHUSETTS – August 17, 2016 – To help coders and facilities prepare for the first ICD-10 update since last year’s ICD-10 implementation, Libman Education has released ICD-10 Code Updates authored by nationally recognized ICD-10 expert Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA.

The extensive upcoming ICD-10-CM changes include 1,943 new codes, 422 revised codes, and 305 deleted diagnosis codes — as well as changes to CC and MCC. The upcoming ICD-10-PCS changes include 3,827 new codes, 491 revised titles, and 12 deleted codes — as well as significant changes to Cardiovascular coding. The ICD-10 Code Updates courses provide an efficient process for coders to prepare for the update.

“It’s update time and the updates are huge!,” said author, Lynn Kuehn. “The ICD-10-CM and ICD-10-PCS Code Update courses provide coders with the information they need to prepare for FY2017. The courses are interactive and contain audio and video clips of my explanations, along with activities and quizzes. The ICD-10-CM course even identifies the CCs and MCCs for the inpatient coders.” [Details about Libman Education, Inc.  and its online training courses for the healthcare workforce are noted in this article.]

 

libmaneducation.com/store/ICD-10-Updates-Annotated-By-Lynn-Kuehn.html

About Libman Education
Libman Education Inc. provides training for the healthcare workforce. Libman Education offers self-paced online courses designed and developed by leading industry experts in Health Information Management (HIM) and Medical Record Coding. Courseware is designed for individuals as well as health care providers and institutions, public and private workforce development training programs, and professional and volunteer associations interested in preparing their employees and members for the challenges facing the HIM workforce.
libmaneducation.com

 

©2016 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

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By Tim Rowan, Editor & Publisher of Home Care Technology Report

Companies that provide in-home care services, including hospice, plus the vendors that provide products and software to these companies, do not exactly dominate this year’s Inc. 5000 list of fastest growing companies but our industry is certainly well-represented.

The list represents a unique look at the most successful companies within the American economy’s most dynamic segment — its independent small businesses. Companies such as Microsoft, Dell, LinkedIn, Yelp, Zillow, and many other now household names gained their first national exposure as honorees of the Inc. 5000.

Among familiar home care tech names are DeVero (1759), Kinnser (2300), Homecare Homebase (3508), and Quality in Real Time (1452), which has made the list four years in a row. HospiceLink, the Alabama-based HME operations optimization consulting firm is number 160 on the list. [Details about strides achieved  by these companies in this year’s  Inc. 5000 rankings are noted. Extended comments about these companies’ rankings and growth are provided by Steve Randesi, founder and CEO of the highly ranked  DeVero (an EMR vendor). He shares his thoughts on the emerging growth of wide ranging post-acute settings that require service companies like his to provide multiple services across the continuum of patient care. A number of high ranking healthcare at home providers on the 2016 Inc. 5000 list and their rankings are also noted in this article, including Sunny Days In-Home Care, Great Lakes Caring Home Health & Hospice, and Providia. It’s noted that the complete list of 5000 fastest growing companies can be found on the Inc. 5000 web site. ]

BlackTree Healthcare Consulting weighed in at number 942, posting 420% growth over the last three years on 2015 revenue of $7 million.

DeVero led the pack of EMR vendors with three-year sales growth of 212%, and ranked number 20 in the very competitive Silicon Valley (San Jose metro area). DeVero founder and CEO Steve Randesi credits the growth to DeVero’s cloud-based platform that adapts to the needs of the shifting healthcare landscape, as well as a highly-motivated and dedicated team of employees who are laser-focused on providing the best technology and service in the industry.

“We recognize that a major transformation is taking place in healthcare with more and more services now being provided in the home,” said Randesi. As a result, traditional EHR’s, designed to support a single healthcare market segment or service line are becoming obsolete. Such legacy applications are not adaptable to the emerging requirements of healthcare agencies that are broadening their scope to provide multiple services across the continuum of patient care. We’re proud to serve the market with DeVero’s simple yet powerful, adaptable and highly-scalable multi-service line healthcare platform that supports a wide range of pre- and post-acute care services from a single platform and single, consolidated patient record.”

Several Healthcare at Home providers are also on the list. Sunny Days In-Home Care is at number 489 in the U.S., 11 in Pennsylvania and 4th fastest in Pittsburgh.

Great Lakes Caring Home Health & Hospice, based in Jackson, Michigan, makes the list for the ninth time at number 4108. After 22 years in business, the company still managed a 69% growth rate over the last three years and posted nearly $189 million in revenue in 2015.

Providia, in Fort Myers, Florida, is at number 827, after a 3-year growth rate of 480%.

Capitol Home Health in Austin, Texas hit the 2015 list at number 1545, with a 247% growth rate over three years, even though it posted 2015 gross revenue of only $7 million.

A non-medical franchise newcomer in Cincinnati named FirstLight HomeCare is at number 2036 with 2015 revenue of $3.9 million.

Serving Los Angeles, Arizona and Texas, 24Hr HomeCare made number 2295 on $48 million in revenue and a 158% growth rate over the last three years.

The complete list of 5000 fastest growing companies can be found on the Inc. 5000 web site.

“The Inc. 5000 list stands out where it really counts,” says Inc. President and Editor-In-Chief Eric Schurenberg. “It honors real achievement by a founder or a team of them. No one makes the Inc. 5000 without building something great – usually from scratch. That’s one of the hardest things to do in business, as every company founder knows. But without it, free enterprise fails.”

©2016 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

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