NAHC’s Vice President of Technology Policy Delivers Presentation at Briefing for Congressional Staff
March 3, 2015 01:01 PM
Last week, NAHC’s Vice President for Technology Policy and Government Affairs, Richard Brennan, delivered a presentation during a briefing for Congressional staff held in the Russell Senate Office Building. Mr. Brennan’s presentation, “Adopting Information Technologies for Post-Acute and Long-Term Care: Achieving Care Continuity a.k.a. Longitudinal Coordination of Care,” was one of several presentations that were part of the briefing, which was organized by the Institute for E-Health Policy and supported by Senators Thune (R-SD) and Klobuchar (D-MN) on the role health IT plays in long-term and post-acute (LTPAC) care.
In his presentation, Mr. Brennan mentioned that home health care is playing an integral role in the new models of care – citing the statistics that 18.7 percent of home health agencies participate in Accountable Care Organizations (ACOs), 6.4% are involved in Bundled Payment Partnerships, 12.3% are part of Patient-Centered Medical Homes, and 20.3% participate in Transitional Care Programs. Given these new approaches to care, he suggests, new models of care for LTPAC providers would require a common health IT infrastructure that promotes interoperable health information exchange and longitudinal coordination of care across the spectrum of providers and settings.
Each year approximately 15 million medically complex and/or functionally impaired individuals receive long-term and post-acute care (LTPAC) services in nursing facilities (SNFs), home health agencies (HHAs), and other settings. Not only is LTPAC - and especially home health care - becoming an important setting to reduce rehospitalizations as a key component of new care delivery models, but home health is also serving to enable seniors to age in place and avoid unnecessary rehospitalizations and emergency room visits.
With many of the individuals who receive LTPAC services in the top 10% of patients that account for 70% of all Medicare health care spending, home health care poses a financially responsible alternative to more expensive care settings – and one that is preferred by patients. The average per day cost to Medicare for a 90-day episode of care is $58 for home health care, $453 for a skilled nursing facility, and $2,178 for hospital care.
Despite the high-quality and cost effective care that home health provides, its adoption of EHR – while increasing – lags behind the rates of adoption by other care settings. This lag is due in part by the fact that home health agencies do not receive incentive payments from ONC to adopt EHRs and no certification programs exist, essentially leaving home health agencies on the outside looking in with respect to health IT implementation and adoption.
Despite home health agencies’ not being incentivized to adopt health IT into their practices, the statistics on health IT’s benefits – as cited in Mr. Brennan’s presentation – offer optimism for continuing to help reduce costs and improve both the quality of care as well as its outcomes.
Specifically, health IT has been found to lead to:
72.9% increase in overall quality
64.4% increase in care coordination
64.2% increase in patient satisfaction
56.1% increase in patient self-care
69.8% lower unplanned hospitalizations
65.1% lower emergent care admissions
“Adoption and use of health IT needs to be personalized to the setting. It’s not a one size fits all proposition,” said Mr. Brennan during his presentation. “Incentives, payment reform, and the business case for health information exchange is necessary to achieve a higher degree of technology adoption and use in LTPAC and home health care. Rather than rely on new care and payment models to support the cost of health IT adoption by LTPAC, HHS should consider other specific strategies to encourage the adoption health IT - including EHRs and telehealth - and health information exchange.”
Such strategies, Brennan suggests, may include direct incentive payments at the federal and/or state level, reimbursement of a broader array of telehealth services, health IT grants, and no/low-interest loans in addition to no/low-cost technical assistance on planning and implementation, by HITRECs for example.