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When agencies take a hardcore look at what the culture of the agency is today, they will typically find that concern at monthly meetings revolves around drops in number of patients or drops in number of episodes or drops in average case-mix weight.  The real challenge is that Quality of Care is what payers are intent on future payments being based on.  This requires that we refocus our thought process regarding the financial success of the agency!  This includes the belief that without positive quality outcomes we are not going to be financially successful in home health.
When making the inevitable decision to refocus there are key components to be evaluated to determine where the agency is and where the agency has to move to:

  • Review Reports/Data/Benchmarks
    • o    Casper Reports
      o    Internal Vendor Reports
      o    Quality Review Internally
  • Drill Down Into the Data For Specifics
    • o    Which outcomes are we deficient in?
      o    Which clinicians were involved in the deficient outcomes?

      •     This may include clinicians providing less than desirable care not just OASIS clinicians
    • o    Identify any trends in the patients with deficient outcomes
      •     What diagnosis/disease processes are involved with the deficient outcomes?
            What is the agency average length of stay per patient and does that affect our deficient outcomes?
  • Determine Exact Outcomes that Need Attention
  • Develop Strategic Plan for Improvement of Outcomes
    • o    Never work on more than 2 or 3 at once
      o    Set Goals that include timeframes to reach the goals

      •     Make sure the goals are realistic and attainable within timeframes
    • o    Ensure that everyone is focused on the ultimate goal of making the agency a success
      •     Deal with staff that are not “on the bus”
    • o    Celebrate Successes – no matter how small

Agencies that are currently struggling with outcomes and star ratings need to realize that this situation must be corrected in order for the agency to survive.