Therapy's role under PDGM (Part 3)

Is cost-effective therapy just a video chat away? Telehealth monitoring is being touted as one solution

EDITOR’S NOTE: Our summer series of blog posts on the future of therapy under PDGM continues today, as we examine how telehealth monitoring can assist agencies in providing cost-effective therapy services. Look for these posts each Monday.

Therapy has been the revenue-driver in the home health industry in recent years, but cost-effective therapy utilization is presenting a conundrum for home care providers looking ahead to next year.

For the most part, therapy will no longer pay as well under a new Medicare payment model as skilled nursing for patients with serious medical conditions, illnesses or wounds.

Consequently, many home care providers are looking to reduce therapy utilization when the Patient-Driven Groupings Model (PDGM) takes effect Jan. 1, 2020. A recent survey of 685 home health providers by the National Association for Home Care & Hospice showed that more half plan to decrease therapy utilization next year.

Industry experts are concerned that a significant industry move away from skilled therapy services could have a negative impact on overall patient care, as therapy has been shown to rehabilitate, restore mobility and deliver improved functional outcomes for homebound patients.

The solution may be in hand – literally – in the form of a patient’s smart phone, tablet or other electronic device.

“Telehealth monitoring is in the forefront of the discussions we’re having about cost-effective therapy utilization under PDGM,” said J’non Griffin, owner and president of Home Health Solutions. “As we move toward being able to more easily and efficiently integrate telecommunications into all home health services, its potential use in therapy is a priority consideration.”

About a quarter of the NACH survey respondents said they plan to replace costly in-person therapy visits with increased use of telehealth tools under PDGM.

“It makes sense to transition away from unnecessary visits and rely on increased use of technology to continue to use therapy as part of an effective overall process for better patient outcomes,” J’non said. (See our previous blog post offering tips for effective documentation and care coordination.)

Challenges and opportunities

"It's important to note that home health is still grappling with some important privacy, security and liability challenges in making efficient overall use of telecommunications," J'non said.

But increasing opportunities for connectivity and beneficial results are expected to drive much wider use over the next few years. Telemonitoring no longer requires particularly advanced equipment, since most smart devices are now capable of integration with telehealth networks or applications.

Video chatting offers opportunities for needs assessment, care planning and coordination, appointment scheduling, medication assistance, transportation coordination, support services from social workers and more.

It may be possible in some cases, for example, to augment in-home therapy visits with video chats in which the patient’s therapeutic exercises are monitored, J’non said.

Tech-savvy patients

While cost-efficiency in the delivery of services is an important consideration in the expansion of telehealth, patient expectations in an increasingly value-based market may ultimately drive the extent and frequency of telehealth monitoring.

“Today’s patient population is much more tech-savvy than just a few years ago,” J’non said. “We still tend to think of most of our elderly patients as a segment of the population largely unfamiliar with technology, but that is changing quickly as Baby Boomers age.

“Unlike the generation right before them, many Baby Boomers use smart phones and iPads and tablets, and many of them already have at least some experience in using video chats to communicate with long-distance grandchildren or family members.

“Our patients are increasingly ready for telehealth services. Re-thinking some of our therapy utilization in the PDGM era just may help push us a few steps forward in that area,” J’non said.

We can help! Does your home health agency need help in its PDGM preparations? Home Health Solutions is working with agencies around the nation to provide the guidance necessary for success during this important transition. We're friendly, knowledgeable and eager to help! Contact us today.