Top 5 Optimization Opportunities for your Home Health Organization


To offer premier coding and appeals services to our home health and hospice clients, we’ve teamed up with the experts at Gateway Home Health Coding and Consulting. When coding, they get an in-depth and unique look at what agencies are doing well and more importantly, where they’re missing the mark.

Gateway’s founder and CEO, Rob Drew (picutred left), took some time to analyze the top inefficiencies and solutions he sees in most small to mid-sized home health agencies. Here’s his guest blog post with the top five optimization opportunities for your home health organization:

1. Encourage outsourcing. Agencies spend valuable time and resources on tasks that are better outsourced. There is a well-known clinical staff shortage, yet agencies continue to try to accomplish everything in-house. We say, let your clinical staff do what they do best and what they’re passionate about doing — care for patients. In turn, you’ll experience less turnover and better patient care.

Further, outside experts are just that— experts. They work day in and day out on their specificity with handfuls of your industry peers. They know best practices and can bring them to you.

Lastly, external team members are less expensive overall, and you can convert what would be payroll taxes into profit.

With that in mind, we believe these services are best outsource by home health agencies:

  • Billing

  • Coding

  • Quality Assurance

  • Medical Review (ADRs;UPICs)

  • Policy and Procedure Writing

  • Statement of Deficiencies Responses

  • Staff Orientations

  • On-going Training Programs

2. React timely and appropriately to new rules and regulations. We get it. Home health agencies have so much going on, it’s often difficult to stay on top of the latest CMS proposal or rule. But, agencies that wait until the last minute to address these changes lose valuable time and money. We saw many agencies wait until the last minute to transition from ICD-9 to ICD-10. It cost them. We’re seeing a handful of agencies still don’t have policy and procedure manuals to satisfy new CoP requirements. The same thing will happen with PDGM (Patient Driven Grouping Model) that will begin in 2020. The lack of education and preparation on the side of the providers will be significant. Don’t let your organization be one of those that isn’t prepared. It will cost you more in the long run. Hire out help now. Getting ahead of changes helps your team, patients and bottom line immeasurably.

3. Create a Clinical Documentation Improvement (CDI) program. Hospitals and physicians have CDI programs. Most home health agencies do not. The lack of documentation in clinical records puts agencies, and patients, at risk. This documentation deficiency is probably the number one weakness we see in almost every homecare company in the U.S. Train and retrain your staff on proper documentation. Implement a CDI program. Need help? Ask us.

4. Sell and market appropriately. Most of the recent home health FBI raids have been related to the misuse of home health marketing. Instead of paying for referrals in one form or another (even the most innocuous of kickback can trigger an audit), offer the highest quality care and be the best partner. If you need help with marketing your organization, create compelling content, understand your differentiators, secure SEO help, implement a CRM and use your data. Home health agencies have to be savvier and smarter to gain new business. Again, if you need help, find a consultant. You may not require full-time assistance and could get some ideas from an industry sales and marketing expert and a reasonable cost.

5. Think outside the box. Agencies need to brainstorm non-traditional ways to improve STAR ratings and patient outcomes. We see many agencies leverage telehealth to accomplish this. Another suggestion that could put you ahead of the curve might be to prepare for PDGM by training for rehab nursing and thus eliminating the therapy add on.

Continuing to do what you’ve always done will not work in the future. Get smart. Make sure you’re up-to-date on regulations and come up with ways to deliver the best care more efficiently. If you need a partner to brainstorm with, get in touch with Gateway or Maxwell. We have experts on hand for whatever initiative you need an outside perspective on. We’re passionate about home health care and want to ensure the industry’s future success. Engaging consultants where appropriate will help your agency — and more importantly your patients — realize gains quickly.

For a limited time, Gateway is offering a free OASIS and coding audit to home health agencies. Sign up here.


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Email Us: info@maxwellhca.com

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