onehome’s Coordination of Preferred Home Health Providers takes the Burden off Referring Practitioners

March 5, 2024

Summary: onehome is transforming the coordination of home health care by eliminating the administrative burden on referring providers and ensuring patients receive timely, quality care. Utilizing a coordinated care model, onehome secures, coordinates and monitors a full range of home health, DME, and infusion care services through its vetted preferred payer agnostic provider group. This […]

Summary: onehome is transforming the coordination of home health care by eliminating the administrative burden on referring providers and ensuring patients receive timely, quality care. Utilizing a coordinated care model, onehome secures, coordinates and monitors a full range of home health, DME, and infusion care services through its vetted preferred payer agnostic provider group. This approach streamlines and coordinates the referral process under a single source, offering greater transparency and adherence to high standards of care, while still preserving patient choice in the referral to home health services.

A smooth transition to the home setting for patients requiring post-acute care after being discharged from the hospital or other care facility is essential for ensuring good outcomes and preventing readmissions. The move towards value-based care (VBC) in the home health industry is a significant trend in this context, and onehome is well-positioned for this shift, supporting more than two million patients under risk-based contracts. This holistic approach aims to deliver significant benefits to patients receiving care at home by transitioning from volume-based reimbursements to a model focused on the quality of care.

Currently, the quality of home health care can be impacted by the challenges involved in securing those services, a major obstacle to providing a seamless shift to care in the home. In fact, 37% of Medicare beneficiaries with home health referrals after a hospitalization, never receive the services prescribed. This issue partly stems from the enormous burden placed on referring providers and their teams in securing, coordinating and monitoring necessary home health services.

“Depending on a patient’s needs, referring provider offices may be reaching out to dozens of agencies to actually find one that is covered by the patient’s insurance and has the capacity to provide the needed care for that patient,” says Alex Rodriquez, Vice President of Account Management for onehome. “Even once an agency is secured, visibility into the quality and timeliness of the selected agency’s care can be difficult.”

Alleviating those burdens, onehome’s coordinated care and benefits management model enables referring providers, and ultimately the chosen home health agencies, to focus on patient care rather than home health coordination. onehome ensures patients receive appropriate and prompt home health, DME and infusion care services through its preferred, curated provider group based on a rigorous selection process.

Selecting the best in home health

Home health agencies in the onehome provider group are evaluated according to their claims and utilization data to understand their capacity as well as patient return rates and quality of delivering effective care utilizing OASIS data. onehome’s reporting requirements, including STARS ratings and rehospitalization rates, provide added transparency and oversight of an agency’s responsiveness and the quality of care patients are receiving for the duration of those home health services.

“The providers in onehome’s group understand our model and are willing to follow service agreements and meet our standards, which can be higher than what is set by CMS,” explains Alex Rodriguez, VP of Account Management for onehome. “We put a great deal of weight on the prompt delivery of services given the impact that it has on patient outcomes.”

Delayed initiation of home health services following a hospital discharge has been shown to increase the risk of rehospitalizations and emergency room visits.

Training that benefits patients and providers

Southwell views training as an essential piece of onehome’s curated provider group model that differs from wider networks under contracted health plans. During the onboarding process, onehome conducts both in-person and remote training to help clinicians understand what is considered proper care, utilization and turn-around times. Additionally, follow-up training occurs throughout the year when needed, based on utilization, payment and other pertinent trends observed.

This training process helps bolster knowledge of qualified services and the guidelines determining whether pre-authorizations and additional visits and services will be approved. That understanding can relieve the administrative headaches that come with denials and appeals. It has also led to onehome’s high clean claims rate, meaning accelerated payments for agencies in onehome’s provider group, and avoids health plans recouping those payments months later due to administrative glitches.

By reducing the administrative burden on referring providers and enhancing the operational efficiency of home health agencies, onehome is setting a new standard in home health care coordination that ensures timely, high-quality care for patients, reduces overutilization of services and enables referring practitioners to focus on their important job of patient care.

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