While the medical industry learns to operate during COVID-19, HealthPRO Heritage at Home believes there has never been greater demand for home-based care options or recognition of the power and benefits of care delivered in the home, whether in person or through telemedicine.
The nationwide outbreak of COVID-19 has had a major impact on our healthcare system, and home health agencies across the country have been working hard to continue providing quality health care and services to their patients. Alongside the cost pressure of the 2020 Patient-Driven Groupings Model (PDGM) pressures, Medicare (CMS) continues to grow, with around 10,000 new individuals added to their roster every day.
We are also seeing the home health industry shrink in terms of the number of agencies each year. However, the overall size of the market is very likely to expand at a faster than anticipated rate due to those daily individual additions to Medicare.
Senior Adult Population Faces a Serious Risk
Adding to this current stress, recent studies and medical experts tell us that the senior adult population is one of the largest groups facing the most serious risks, threats, and challenges during this COVID-19 public health emergency. Although all age groups are at risk for contracting the COVID-19 virus, senior adults face a significant risk of developing severe illness due to physiological changes that come with aging and existing underlying health conditions. It is critical that these senior adults can access healthcare services during this pandemic for both their emergent and primary health care needs. However, nearly all home health agencies have seen a severe decrease initially with in-person visits during the COVID-19 crisis. About 67% of agencies have seen LUPAs double, according to data from NAHC HealthPRO Heritage realized early on that our home health resources had to include innovative approaches to reach home health patients through telemedicine, technology, and best clinical practices in order to provide the quickest and highest quality of care.
Increase in Cases; Mild Clinical Presentations
As the number of positive cases are continuing to rise, in certain areas of the nation, we have seen an increase in home health patients presenting with either acute or post-acute COVID-19 illnesses. Patients who present with a mild clinical presentation, mainly fever, cough, headache, and general weakness, did not initially require hospitalization and were safely managed in their own homes. Current data and medical expertise suggests that most of those cases will spontaneously recover without complications. HealthPRO Heritage at Home was diligent in making sure those particular home health patients would receive education, infection control, and a narrowed focus on prevention of the transmission to others in the home setting.
Our clinicians provided uniform monitoring for clinical deterioration with these particular patients, which could prompt hospitalization. Alongside our medical experts, we identified, for example, that pulmonary symptoms – including persistent cough, difficulty breathing, and dependency on supplemental oxygen – are common and ongoing for senior adults recovering from COVID-19. Also, researchers have found that frailty – a clinical condition signified by a loss of reserves, energy, and well-being that leaves patients vulnerable to sudden changes in health, at higher risk for hospitalization, and the need for long-term care – has been associated with poor mortality outcomes. Likewise, patients who required intubation in acute care settings may experience difficulty swallowing and with speaking (resulting from bruising or inflammation s/p intubation). In addition, those who spent days or weeks in a hospital acute care unit or Intensive Care Unit (ICU) may suffer from Post-intensive Care Syndrome and/or present with muscle atrophy, major muscle weakness, cognitive dysfunction, and mental health problems.
HealthPRO Heritage at Home: Turning Data into Action
HealthPRO Heritage's own medical advisor, Dr. Avery stated: “We must not discount the deleterious effects of isolation: loneliness, pain, deconditioning, falls, weight loss, pressure ulcers, insomnia, fatigue, anxiety, depression, and fear.” We are also seeing isolation having a negative effect on home health residents in the assisted living arena. With all that information HealthPRO Heritage at Home was able to develop a home health COVID-19 clinical pathway and other inclusive tools to help combat patient facing isolation and depression throughout quarantine.
Home Health's Role in Healing the Nation
Home health provides a vast number of services that can be delivered in a patient’s home safely, including IV meds, injections, post-operative and chronic wound care, disease education and management, physical-occupational-speech therapy, labs, etc. These types of services can be impactful and life changing especially for vulnerable patients who could increase their risk of contracting COVID-19 if they go out in the public arena. According to a recent William Blair survey, 81% of physicians responsible for discharge planning now prefer to refer their patients to a home health agency versus another type of facility. CMS estimates that home health care saves at least $378 million a year through reduced hospitalizations, based on the nine states participating in the Home Health Value Based Purchasing (HHVBP). CMS data also suggests that for each hospitalization that is mitigated, it saves the Medicare system around $10,000 each time. Home health can definitely serve as an alternative to placing family members in a long-term care facility or rehab hospital, which have been hotspots and high-risk areas for the virus.