Top Trends in Home Health for 2021: A Q&A with Joseph Brence of AHN Healthcare@Home

As the healthcare industry continues to adapt to the widespread changes caused by COVID-19, the unique benefits of home-based care have been brought to the forefront. Many patients have come to prefer the comfort and safety of their own homes while receiving healthcare, and an increase in digital care adoption has expanded healthcare opportunities for these patient populations. With these impactful changes come new opportunities for innovation, so it’s now more important than ever for home health organizations to look to future trends when considering plans for the upcoming year.

We sat down with Joseph Brence, PT, DPT, MBA, FAAOMPT, Director of Innovation & Staff Development at AHN Healthcare@Home, to get his thoughts on upcoming industry trends, the future of remote care delivery in home care, the importance of upskilling, and the innovative projects and initiatives planned at his organization for the upcoming year. In his role, Joe develops technological and analytical solutions to solve complex problems for AHN Healthcare@Home, and keeps a keen eye on the pulse of industry trends and innovations.

Q: Of all the potential impacts on the home health market, what do you see as the top three trends emerging for 2021?

A: First and foremost, I think we are seeing a shift of various types of care into the home environment. We know that patients prefer to heal in the home, and I suspect we will see more acute care taking place there.

Second, I think we will continue to see an emergence of virtual visits and remote patient monitoring. While this may have been used sparingly in the past, we now have a consumer that has become accustomed to accessibility—we shop online, our entertainment is online, and we bank online. Even if we see COVID dissipate, I think virtual care models are here to stay.

Third, I think we will see a bigger focus on clinical specialization. As we see patients with a wide array of needs enter this market, we will need to ensure that we have staff equipped to manage those needs. I think we’ll see a shift from staff being home health generalists to a model blending generalists and specialists.

What impact do you predict COVID-19 will have on the home health landscape in the next three to six months?

I think it’s going to put a spotlight on the value of home health as a distinct area of post-acute clinical practice. I suspect this will result in significant market growth as more patients look for means of accessible care from the comfort and safety of their own homes.

Additionally, I think COVID has required all practice areas to re-evaluate new and innovative ways to reach their patients. I suspect we will continue to see the emergence of technology that will be blended into clinical practice.

How do you see telehealth and remote care impacting the future of care delivery in home health?

I think the leveraging of this technology is still in its infancy. That said, I do believe it is here to stay. If I had a crystal ball and looked five years out, I think we would see home health plans of care that take a hybrid or blended approach, such as blending on-site and virtual care. There are many interventions that require us to educate or observe a patient, and I truly believe this can be done remotely.

We are also beginning to see payers adapt by incorporating telehealth reimbursement into their payment methodology. We saw this with Medicare’s release of Waiver 1135 and other commercial payers offering a fee-for-service rate.

‘Upskilling’ is a word that comes up quite frequently, particularly when referring to managing different patients, transitioning to value-based care, or a need to focus on specific quality areas. Are there specific areas that drive the need to upskill your staff?

At AHN Healthcare@Home, we take a very methodological approach to identifying the need for upskilling staff in specialty practice areas. This approach blends the analysis of clinical data, along with discussions with various stakeholders across the network.

For example, last year we began to see an increased need for an unskilled workforce focusing on ostomy care. We had discussions with our local colorectal teams on what this could look like and identified a specialty program that met both the needs of our patients and referral sources. We then identified staff who were willing and interested to become specialized and invested in their training. This upskilling strategy ensured we could continue to evolve to meet all of our patients’ needs.

How do you actually act on upskilling your staff?

For our speciality areas, we invest in training through validated programs. This includes training from institutes such as the Wound, Ostomy, and Continence Nurses Society. We additionally hold annual competency training for all staff, focusing on areas of clinical practice that we see emerging each year.

How has AHN prepared clinicians to care for higher acuity patients?

We have spent a significant amount of time developing a robust training strategy that includes mentorship, synchronous, and asynchronous learning, and more. We are part of a vertically integrated health network, as well as having a horizontally integrated joint venture partner, which provides a wealth of resources to prepare our staff.

Over the past year, we set up an emergency-care-at-home model called Home Recovery Care, and nurses participating in this program received an onboarding approach blending home health and emergency department experiences.

How is AHN approaching new models like ‘Hospital at Home’ or ‘SNF at Home’?

Under the aforementioned model, a patient is triaged in one of our hospitals emergency departments and may be sent home with immediate nursing plus physician-telehealth services. We are beginning to scale this program across the network and really believe this allows our patients to heal where they are most comfortable: their homes.

What major projects or initiatives does AHN plan to focus on in 2021?

We are continuing to develop strategies focused around our core behavior of customers first. We’re achieving this through various innovative projects and models that take into account the needs of our patients. We really want to continue to challenge the status quo and demonstrate our drive towards clinical excellence. We are currently working through plans to set up programs focused on social determinants of health.

How do you envision MedBridge helping to address future challenges in the home health landscape?

We utilize MedBridge regularly for educational opportunities for both staff and patients. This platform has a wide range of resources that we have been able to leverage to help upskill our staff. I am excited to see that MedBridge has entered the virtual care arena, as I believe an all-encompassing solution will be valuable not only in home health, but all practice settings.