HEALTHCARE AT HOME:
THE  ROWAN TECHNOLOGY REPORT

Serving the home health, home care and hospice industry since 1999.

Tim Ashe, Chief Clinical Officer WellSky and Andrew Olowu, Chief Technology Officer Axxess share how PDGM will impact our industry

by Darcey Trescone

In our ongoing commitment to bring awareness and insight about the new Home Health PPS payment system taking effect next January, we spoke with two more industry leaders about the anticipated impact of PDGM and each company's plans to help clients adapt to the change.

What are the essential differences between PPS and PDGM?

Tim Ashe, RN, MSN, MBA, Chief Clinical Officer, WellSky
"Clinical groupings and comorbidity adjustments will be based on the diagnosis on the claim and not on the OASIS assessment. However, the fundamental clinical assessment and the resultant meaningful plan of care are key to creating the defensible chart that CMS will require to validate reimbursement. The PDGM approach is transformational to the industry, and it requires sound processes that begin at intake. Most agency leaders understand PDGM and the shift from volume based to value-based care, but they need technology-based tools and services to help them better manage and prepare for this shift towards value. Applied analytics and interoperability are core to CMS's charge for value-based care. Efficiently and accurately sharing data across health care venues to promote better care coordination continues to be a critical focus for the WellSky team."

Andrew Olowu, Chief Technology Officer, Axxess
"PDGM is the biggest regulatory change for our industry in more than 20 years, so the features we provide to help our clients prepare for the changes under the new payment model are extremely important. Understanding the imminent payment changes and then implementing the operational strategies necessary to survive will be critical." 

How are you preparing your customers for PDGM?

Ashe:
"At WellSky, we are working to provide strategic and tactical information to our clients regarding the changes they will need to make internally. We've had an internal PDGM taskforce in place since CMS first announced these changes. Our PDGM taskforce meets every other week, and they’re responsible for our product and services roadmaps. They work closely with our operating team that delivers on these roadmaps. We also publish vital thought leadership content from industry experts, including white papers, tip sheets, and webinars to ensure providers can stay current, successful, and deliver the highest quality care. Our knowledgeable team is available to assist our clients with this transition. We're focused on providing the industry with the most comprehensive suite of software and services that helps our clients solve operational and clinical problems, so they can ensure high-quality patient care and improved outcomes."

A deep dive into the WellSky website provides examples of what Ashe is referring to:

"Our team of home health experts has developed the WellSky PDGM Resource Center, giving clients and their staff free access to education and insights from the industry's most renowned educators."

Tools listed include:

  • PDGM Financial Impact Report
  • PDGM Process Audit
  • Outsourced Coding
  • Outsourced Billing
  • HHCAHPS Services
  • Learning Management System

Similarly, according to recent Axxess press release, the Dallas-based EMR vendor has its own PDGM resource center as well:

Olowu:
"Our leadership in helping our clients get ready for PDGM is a continuation of the innovation leadership that drives our company every day. We have every confidence Axxess clients will be prepared to thrive under the new PDGM payment model in the years ahead.

"The Axxess PDGM Resource Center provides on-demand videos, step-by-step guidance on the new PDGM solution features, FAQs about PDGM and much more. In addition, Axxess industry experts have shared valuable insights and thought leadership in a series of webinars and PDGM blog articles that are available through the company website."

How has PDGM spurred innovation?

Ashe:
"It is WellSky's goal is to create technology solutions complemented by professional services that work cohesively to drive better outcomes for providers and patients. We provide a range of solutions, including electronic health record (EHR) technology, advisory consulting, education, analytics technology, coding, and revenue cycle and clinical expertise that clients need to ensure their success under PDGM and well beyond.

"With the extensive technology and industry expertise of our WellSky and Fazzi team, we deliver more than just software to address PDGM. With the diagnosis on the claim driving reimbursement under PDGM, we know that outsourced coding delivers a high level of expertise, faster turnaround times, and a cost-effective path for agencies. And coding is one of many services available within WellSky's consulting division, Fazzi Associates. Additionally, our Applied Insights data science initiative is creating analytics tools that use data to create meaningful intelligence for our clients. Our predictive analytics group helps our client's better position themselves for growth in the market, while continuing to provide cost-efficient, high-quality care." 

A review of the WellSky website points to some of the Applied Insights tools Ashe mentions:

"Predict your patients' risk of rehospitalization with WellSky Home Health Applied Insights. Our Applied Insights technology automatically analyzes hundreds of data points from each of your patients' records to determine which of your patients need increased attention. Review your patients' risk levels on a dashboard, identify at-risk patients, and provide your clinical team with the insight they need to take preventative action."

Olowu continues in the Axxess press release:

"Our in-house engineering team is proud to have developed and delivered valuable tools to help our clients thrive under PDGM. Among several features Axxess clients can use are tools that use their own data over the past three years to analyze the revenue impact PDGM will have on the agency for specific episodes of care, and how the agency's current case-mix will be impacted under the new payment model. Axxess also has provided a PDGM modeling tool that enables agencies to model key PDGM components during the intake process to assess what impact the new referral would have on reimbursements."

Our series will continue with interview with leading EMR vendors through the first several months of 2020.

 

Darcey Trescone, RN, is a Healthcare IS and Business Development Consultant in the Post-Acute Healthcare Market with a strong background working with both providers and vendors specific to Home Care and Hospice. She has worked as a home health nurse and held senior operational, product management and business development positions with various post-acute software firms, where her responsibilities included new and existing market penetration, customer retention and oversight of teams across the U.S., Canada and Australia. She can be reached at darcey@tresconeconsulting.com.


©2019 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan's Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com