With new rules and regulations from Electronic Visit Verification (EVV) to a full rollout of the Home Health Value-Based Purchasing Program (HHVBP), the home health care landscape is ever-changing, with industry leaders consistently challenged to maintain compliance.
With added pressures due to staff shortages, leaders today need to ensure they are on top of meeting those compliance requirements — without significant disruptions for their teams. Many providers are leaning more heavily into their technology partners to help reduce the complexity of changing processes and procedures and ensure compliance is built with data in mind. Providers are also finding that even incremental changes can improve outcomes.
“Some technology platforms focus on compliance to the detriment of ease of use,” says Tim Ingram, Senior Vice President of Interoperability for Axxess. “Compliance can be a linchpin where nothing happens until new functionality is part of compliance. The way we approach it is to focus on ease of use so that compliance happens without you even realizing you’re being compliant.”
Be Proactive
Compliance shouldn’t be reactive. Providers of any size need to leverage all available data in order to model scenarios under each new rule or regulation. This may mean:
- Modeling the impact to payments, such as in the recent update to the Patient-Driven Groupings Model (PDGM)
- Understanding the impact on quality outcomes reporting, as is the case for the shift to Outcome and Assessment Information Set E (OASIS-E)
- Aligning with value-based care programs such as HHVBP
This proactive approach is still catching on. Following the shift to PDGM in January 2020, some organizations waited for the rule to take effect before preparing, while others proactively modeled the existing business under the changes before they took place. For those proactive organizations, taking that early initiative led to certainty and success during a time when many agencies were scrambling.
Operators that take a proactive approach to compliance generally will see similar benefits. Rather than changing to accommodate regulatory updates and the need to adjust to a new technology system, proactive operators can evolve as regulations do.
“When PDGM hit us a few years ago, some organizations were just devastated,” says Tammy Ross, Senior Vice President Professional Services for Axxess. “They thought they weren’t going to make it. We had a PDGM modeling tool — and still do — that shows how they can survive and thrive using the new reimbursement model.”
Ross notes the experience of one customer who didn’t believe her organization would survive the shift to PDGM. Ultimately, through a proactive technology approach, the customer was able to not only survive, but double her presence from one agency location to two.
Incorporate Staff
With checks and balances embedded in compliance training and monitoring systems, stakeholders and employees are working together to improve regulatory preparedness on an ongoing basis, rather than simply gaining a certification or completing a quarterly or annual training. This also means incorporating compliance and training into an agency’s daily operations via its technology platform.
“It’s in every patient visit, and it’s in every new admission,” says Jeni Kendall, Regional Vice President of Sales for Axxess. “We have it seamlessly built-in so that many of our nurses and agencies don’t even realize it’s being covered.”
As the industry adapts to the new OASIS-E assessment that took effect in January 2023, industry advisors, consultants and stakeholders from the field are all weighing in to equip technology platforms.
“Part of ensuring compliance is making sure we hear from people who have been in the industry,” Ross says. “Nurses, therapists, occupational therapists and others who have worked in the industry.”
Editorial Note: This article was originally published on Home Health Care News.
