The Top 4 Home Health Trends for 2023: What to Watch for and How to Thrive

Home health agencies are currently facing a number of dynamic industry changes, from regulatory and structural shifts like the home health value-based purchasing (HHVBP) model to ongoing capacity challenges. As agencies prepare and strategize for the coming months, we’ve identified four key trends that we think will shape 2023 for home health providers, along with best practices for adapting and thriving.

CMS FY 2023 Final Rule Payment Adjustments

The U.S. Centers for Medicare & Medicaid Services (CMS) released its FY 2023 Home Health Final Payment Rule on October 31, 2022. The CMS final rule for 2023 includes an estimated increase to 2023 home health payments of 0.7 percent—or $125 million—compared with 2022. CMS had previously proposed a cut of 4.2 percent to 2023 payments, which would have been one of the steepest Medicare cuts in years.

The CMS 2023 final rule is better news for home health agencies than initially expected, but major concerns exist about whether the CMS payment adjustment methodology is consistent with the Medicare law on budget neutrality and will allow proper access to care over the long term.

Strategies for success

Keep costs down and quality high by:

• Adopting digital technology that allows your agency to improve patient management and reduce the cost of care.
• Standardizing pathways of care with templated programs in key areas such as fall prevention, chronic conditions, and wound care.
• Using patient education and virtual visits or telephone visits to progress programs and focus on education, while using in-person visits for hands-on treatment. This visit mix provides the right level of care for patients.

Patient Referrals Significantly Exceeding Clinical Capacity

Due to the combination of more care shifting to the home and ongoing nursing shortages, demand for home health services currently far exceeds clinical capacity. According to the care coordination network CarePort, their hospital partners were averaging a referral acceptance rate from home health agencies of only 36 percent in June of 2021.

Strategies for success

• Attract staff to your organization with an integrated strategy that includes offering professional ladders focused on individual career goals.
• Build strong onboarding programs to reduce time to productivity and better prepare staff, resulting in cost savings, better employee satisfaction, and lower turnover.
• Leverage patient engagement and management technology that allows your agency to keep costs down while providing the right level of care at the right time.

OASIS-E

The upcoming OASIS revision is significant, with 25 percent of the assessment tool being revised. The changes include new assessment items and removals, updated guidance for current items, and a complete restructuring of sections and item numbers to match data assessments in other post-acute care settings.

Strategies for success

• Incorporate effective, expert-led OASIS-E training into your organization’s onboarding program to ensure that new hires have a strong foundation in OASIS-E principles.
• Implement an OASIS-E certificate program to improve overall proficiency and accuracy for all staff members and raise the bar on quality across your organization.
• Look for high-quality, engaging, expert-led course content targeted directly at staff members who use OASIS. Avoid using a “train-the-trainer” model, which can result in lost information.

Home-Health Value-Based Purchasing (HHVBP)

With the upcoming launch by CMS of the expanded Home Health Value-Based Purchasing (HHVBP) Model on January 1, 2023, home health agencies are facing an industry shift towards value-based care.

HHVBP transitions agencies away from volume-based reimbursement by providing financial incentives for improvements in quality of care and reduced payments to agencies with lower quality scores. Under HHVBP, your agency’s quality score will be determined by three main measures, weighted as follows:

• Thirty-five percent of the score will be based on OASIS accuracy.
• An additional 35 percent will be based on submitted claims for ED visits, as well as hospitalizations that occur within the first 60 days of a patient on service.
• Thirty percent will be based on patient satisfaction (the HHCAHPS survey).

Strategies for Success

• Create a QAPI plan for your agency. Designing and following a good QAPI program allows agencies to improve quality and performance overall, and results in a wide range of benefits such as improved patient care and outcomes, enhanced quality and efficiency of care, better staff satisfaction, and reduced costs.
• Boost OASIS accuracy. OASIS errors can inadvertently leave your agency without credit for having improved patient outcomes and without accurate benchmarks for measuring your organization’s quality. Improving OASIS accuracy can significantly impact your agency’s quality scores and reimbursement.
• Focus on patient satisfaction. To measure patient satisfaction at a particular agency, payers look at results from the HHCAHPS survey, including NPS^® scores. Improve metrics with tools to track satisfaction and remediate areas of low performance, train staff on person-centered care, and educate patients on how to better manage their own conditions.
• Improve patient management to reduce readmissions. By providing low-cost touch points such as home exercise programs, patient education, and virtual visits, you can better engage your patients and improve their ability to manage their own conditions while reducing the need for in-person visits.

How MedBridge Helps

By combining provider and patient education on a comprehensive engagement platform, the MedBridge Home Health Care Solution helps agencies holistically solve their largest challenges, including staff retention and onboarding, quality improvement, and patient engagement.

Agencies using our solution have reduced time to productivity for new hires, boosted staff retention, enhanced OASIS accuracy, lowered readmissions, improved patient engagement and satisfaction, and much more.