home health & hospice value proposition using data › _documents › ... · value proposition...
TRANSCRIPT
1
November 8, 2018
CPAs & ADVISORS
Raymond BellesManaging [email protected]
Home Health & Hospice Value Proposition Using Data
M. Aaron Little, CPAManaging [email protected]
Learning Objectives Define the environmental factors that are changing behavior in the continuum of care
Understanding the key components of an influential value proposition
Outline key data elements in building a value proposition to drive relationships across the continuum of care
2
2
November 8, 2018
Define the environmental factors that are changing the behavior in the
continuum of care
3
4
3
November 8, 2018
Environmental Factors Accountable care organizations (ACO’s)
Alternative payments
Physician alignment
Hospice proposed payment rule for 2020
Payment driven grouping model (PDGM)
Collaboration across the continuum of care
5
6
4
November 8, 2018
Alternative Payment Model Structure Risk Based Model
o Retrospective reconciliation for hospitals
o Target price
o Inclusions/exclusions
o Anchor stay +90 days post‐discharge
o Collaboration dependent
7
Physician Alignment Development challenges
Consensus on protocols and standardization
Skepticism in data and measurement
Concern with clinical decision making
Perception of profit sharing
Lack of trust
8
5
November 8, 2018
Hospice Proposed Payment Rule 202 Rebasing of continuous home care (CHC), Inpatient respite care (IRC), & General inpatient care (GIP)
An estimated annual payment update of ‐2.7 percent/elimination of the one‐year “lag” in use of hospital wage index so that hospices are not a “year behind”
A proposed FY2020 aggregate cap amount of $29,993.
Significant changes to the patient election statement and addendum to ensure greater transparency regarding non‐covered services and safeguard patient rights
9
Hospice Proposed Payment Rule 202 A request for information on the role of hospice and coordination of care at the end of life, (how to include hospice into other care delivery models like Medicare Advantage)
Updates to the hospice quality reporting
10
6
November 8, 2018
Payment Driven Grouping Model (PDGM) 30‐day payment periods
Therapy utilization removed from payment model
Addition of admission source
12 clinical groupings based on diagnostic category (from claims)
Comorbidity adjustment (from claims)
Case‐mix weight / LUPA thresholds
11
Hospital Drivers Oversight of Medicare spending
o Two‐sided risk model with hospitals bearing the financial responsibility
Continuum of care qualityo “Preferred provider”
o HH and SNF compare websites
o Increased use of “navigators” for enhanced patient hand‐off and coordination
Physician engagement
12
7
November 8, 2018
Collaboration
13
Maybe Biggest Environmental Factor
DATA
14
8
November 8, 2018
Understanding the key components of an influential value proposition
15
What is a Value Proposition? An innovation, service, or feature intended to make a company or product attractive to customers.
What does that equal for the Health Care Continuum of Care…….
16
MB24
Slide 16
MB24 Melissa Belles, 12/9/2018
9
November 8, 2018
Source: https://www.wordstream.com/blog/ws/2016/04/27/value‐proposition‐examples
17
18
Improve the
Patient
Experience
Improve
Outcomes
TRIPLE AIM
Lowering the Cost of
Care
The Home Health & HospiceValue Proposition
10
November 8, 2018
The Landscape Is Changing…
19
The Landscape Today Availability of information, increased focus on quality, and new payment reform models, is substantially changing referral relationships and patterns.
o Star Ratings (Homecare Compare)
o Quality Assurance & Performance Improvement (QAPI)
o Narrowing Networks
o Evaluating Payment Patterns Electronic Report (PEPPER)
o Continuum of Care Spending Data (CMS Claims Data)
20
11
November 8, 2018
Target Audience & What They Care About Hospitals
Physicians
Skilled Nursing Facilities
Community groups
Other actual or potential partner agencies
Patients/families
Payers
21
What is Important to the Audience? Timeliness
o Response time
o Yes we can attitude
o Hours of operation
Thoroughness
Communicationo Internal/external
o Frequency
22
12
November 8, 2018
Outline key data elements in building a value proposition to drive relationships
across the continuum of care
23
Building the Home Health & Hospice Value Proposition
Assess the organizationo Identify strengths, weakness, opportunities, & threats (SWOT)
Build a plan o Leverage strengths
o Outline action to be taken on weaknesses
o Build on opportunities
o Define how threats will be monitored
Leverage data
24
13
November 8, 2018
Identifying Key Data Elements Ask yourself is your organization a
data centric organization
Market intelligence (landscape)
Continuum of care spending
Operations
Quality/Patient Satisfaction
25
Improve the
Patient
Experience
Improve
Outcomes
TRIPLE AIM
Lowering the Cost of Care
IS YOUR ORGANIZATION DATA CENTRIC
14
November 8, 2018
Core Values Of A Data Centric Organization Data belongs to everyone in the organization
Data is an asset
Buy ‐ in from top down
Transparency and information sharing is KEY
Data quality is a number one quality
Setting KPIs are critical to success
Be data harvesters
Practice an analytic culture
Sanchita Lobo, The 8 Core Values of A Data Centric Organization, Analytics Training.com, May 2017 (http://analyticstraining.com/2017/core‐values‐of‐data‐centric‐organisation/
Key Value Proposition Components Market analysis
Quality/patient satisfaction
Continuum of Care spending
Collaboration
28
15
November 8, 2018
Analyzing the Market
29
Analyzing the Market – County Level
30
16
November 8, 2018
Analyzing the Market – Home Health Market Share
31
Agency A
Agency B
Agency C
Agency D
Agency E
Analyzing the Market – Hospice Market Share
32
17
November 8, 2018
Analyzing the Market – Hospital Discharges
33
Identifying Physician Opportunities
34
Physician A
Physician B
Physician C
Physician D
Physician E
Physician F
Physician G
Physician H
18
November 8, 2018
Building the Home Health & Hospice Value Proposition
Quality / Patient Satisfactiono Star rating
o Patient satisfaction
35
36
Hospital F
Hospital A
Hospital B
Hospital E
Hospital D
Hospital C
Hospital G
Hospital I
Hospital H
Hospital J
19
November 8, 2018
37
HHA 1 HHA 2 HHA 3 HHA 4 HHA 5 HHA 6
38
20
November 8, 2018
39
40
21
November 8, 2018
Building the Home Health Value Proposition Collaboration
o Internal
o External
41
Internal and External Collaboration Communication – across the organization
o Lead with data
o Get buy‐in from top down
o Describe your organizations place in the market
o Define why quality and continuum of care spending are equally important
o Hospitals have your data
o Everyone in the organization is marketer
42
22
November 8, 2018
43
44
23
November 8, 2018
CPAs & ADVISORS
Raymond BellesManaging [email protected]
Home Health & Hospice Value Proposition Using Data
M. Aaron Little, CPAManaging [email protected]