The Post-Acute Care world is changing right before of eyes!! The formation of new approaches to insurance products and the development of Accountable Care Organizations (ACO) is changing how care is delivered. Is your organization up to the challenge?

I own an in-home care company in Michigan called Homewatch CareGivers and we are receiving more referrals than ever that look like this:

• Tube feeding 3x day
• Track cleaning every day and replaced once a month. No vent but is oxygen dependent.
• Foley care
• Bed bathing

A very challenging complex personal care case. This specific case exhausted her eligibility status for Skilled Home Care. The client did, however, meet hospice eligibility and accessed her Medicare Hospice Benefit. Her family wanted a personal care giver in the home 4 hours a day/ 7-days per week to assist.

My staff was very apprehensive to take this case because it was so complex. They were uncomfortable because they had not managed a case like this before. While I wanted to support my staff I also wanted to help this family receive the care they required. What to do???

The first thing I did was call upon a certified skilled home care company that we have a strategic partnership with and spoke with their Director of Nursing. She agreed to help us manage the case by providing the three CNAs we assigned to the case. This collaboration was a great way to both meet the family’s need and help my staff get comfortable in accepting these type of cases thus allowing us to grow. Further, we were able to provide a care setting that was less expensive and become an attractive option to Care Managers.

The second thing we did was use this case as a learning lab so we could be better prepared for the next such case. We started a process to recruit qualified LPNs and CNAs who could manage these complex personal care cases. We also started to focus on training and education of our existing caregivers who wanted to improve their skill sets and competencies.

Here is how the economics worked on this case. We charged the client $30 per hour. We paid our CNAs $12/hour and I shared the remaining revenue with our strategic up to 6%.

Our next effort in my company will be working more closely with hospice companies. This will help us both advance our mission objective of helping people age more comfortably in their home and help us advance our business objective of growing billable hours. There are several empirical studies which show that people who are in house live longer. So, by addressing our mission will we grow our billable hours without starting a new case of care!

The lessons learned for me and my staff is how to work more collaboratively with our skilled home care and hospice colleagues.

The Best