Recently we gathered home health & hospice leaders for a COVID-19 forum to discuss the pandemic and its impact. Agency leaders, consultants, and vendors all came together to share their insight on changes to patient care, financial operations, and overall agency operations.
Home Health & Hospice Leaders: Risks and Opportunities from COVID-19
In this session, we discussed the risks and opportunities that have evolved for home health & hospice agencies as a result of COVID-19 as well as their hopes for the future of homecare.
Biggest Challenges from COVID-19
- The combination of COVID-19 and PDGM has proven difficult for agencies that were not already prepared for PDGM. Those who were already effectively managing PDGM were able to solely focus on the challenges presented by COVID-19 alone.
- Overall operations, including coding and billing, have been affected by COVID-19. It’s affected clinicians who are afraid of exposure, marketing efforts are minimized and creative ways to gain referrals need to be explored. Additionally, patients have been afraid to be seen by clinicians as well and have refused service.
- In areas most hard hit by COVID-19, referral numbers have dropped and those who are being referred are the most difficult patients.
- Many agencies weren’t equipped to manage virtual visits. They found it challenging to rapidly deploy technology to help them still see their patients. Early on, it wasn’t clear if virtual visits would be reimbursable so agencies were having to document the visits in case they were.
- Data collection surrounding COVID was difficult for agencies as well. What type of data did they need to collect and who was going to need to see the data?
- Financially, agencies were faced with what the “new norm” was going to be. What about LUPAs? How do you predict revenue? How is this going to affect the bottom line? How will outcomes be affected?
- Many agencies experienced an increase in DSO, or daily sales outstanding. They didn’t realize they had an aging AR until much later.
Opportunities from COVID-19
- Communication among agencies has been phenomenal. Organizations have helped each other by sharing resources, sharing successes and failures, and just overall helping each other when in need.
- Agencies have been able to learn by doing. They have learned lessons from how they’ve had to take care of patients, how they’ve managed their staff, and how they’ve managed regulatory changes that seemed to happen on a daily basis.
- COVID-19 has shown that remote working can work. Be willing to have flexibilities with staff and they will give their best. While challenges will be presented, such as kids going back to school, the jobs are getting done, and they’re getting done really well.
- Human resources has been a challenge for many agencies. With greater uncertainty about the situation, it’s been important to create a safe space and address employee emotions respectfully and emphatically. One agency has created a COVID support group to help employees sort through their feelings and share their experiences with social workers.
- It’s imperative to make sure that staff feel safe during the pandemic. Whether that means they have the right PPE, or knowing that if they get sick and must take time off, they’re taken care of. Make them feel as though they are part of a greater community.
- Many agencies were short staffed and some had to take on 25% – 30% more visits in order to make sure patients were seen. The team effort was important in making sure operations continued.
Advice for the Future
- Stay in the know about how the IRS is going to be handling the paycheck protection program (PPP) funds. You’ll want to know exactly what is expected of you.
- Take a closer look at policies and procedures. This was a time that nobody expected, and many weren’t prepared with written policies to help them through it. How do you make sure clinicians are properly screened before seeing patients? What if a clinician gets sick?
- Communication is key. Make sure that everyone on the team is aware of what is going on with agency, with patients, and with the virus. This is a new norm, and it’s important that everyone is aware.
- Be flexible with the services offered. Keep an ear out and keep a pulse on the community regarding what it is they want and need. Consider expanding beyond what you currently offer.
- Also be flexible when it comes to your employees. Understand that this is new territory for everyone and a little bit of grace goes a long way.
- Consider outsourcing coding and billing services. During times like these, having one less thing to worry about can make the difference between success and failure.
- Have a Plan B for everything. If normal marketing efforts aren’t fruitful, have something else to lean on. Have backup to help you if you’re struggling.
- Look at processes from intake to claim submission and review the workflows. Identify where you can make improvements and make those changes now. If you see work arounds or hear, “that’s the way we’ve always done it,” push back to ensure you’re operating most efficiently.
COVID-19: Hopes for the Future of Home Health & Hospice Patient Care from Home Health & Hospice Leaders
- The experts firmly believe that home care will emerge as a strong component of the health care system. Opportunities for success will be plenty if we just weather the storm right now.
- The need for home care is greater now than ever before. COVID-19 has proven its value as the most cost effective care available.
- When our hospitals and our health care system struggle to provide beds or care for the sick, it’s a symptom of the failure of the community or public health to prevent transmission of the disease. Home health and hospice can play a huge role in the health care crisis by providing sustainable costs and quality care at home.