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Home Health Adapts to Increasingly Complex Patient Cases

    Home health providers are receiving a growing number of patients with more complex medical needs, which requires more specialized care and attention. Overall, patients with higher acuity levels need additional services after leaving the hospital, which makes it more challenging for home health providers to ensure that they receive the right level of care.

    The Current Landscape

    For quite some time, home health providers have noticed a significant increase in patients with complex medical needs. According to data presented by the Research Institute for Home Care in 2020, among Medicare home health users, 45% have five or more chronic conditions and 17.3% have four chronic conditions. Only 13.8% have three chronic conditions, and 23.9% have zero to two chronic conditions.

    This situation became even more pronounced during the pandemic when acute care options were limited. As a result, home health providers have been taking care of patients who would typically be treated in hospitals or other acute care facilities.

    Home health agencies have observed that hospital stays have become shorter. This means that patients are being discharged home sooner after procedures like cardiac surgeries from heart attacks and strokes. Consequently, these patients are coming home with more acute medical conditions than before.

    This was supported by a report published by Wellsky company, Careport, indicating that patients discharged to home health providers in 2022 had more severe medical conditions compared to those in 2019. This analysis was based on data from 1,000 hospitals and 130,000 post-acute care providers. The report revealed an 11% increase in the average comorbidity score, indicating higher acuity and greater complexity in patient conditions. Some common comorbidities observed were congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), hypertension, neurological disorders, and diabetes. Additionally, patients with these comorbidities often have other health conditions. For instance, diabetes patients have non-healing wounds that also require attention.

    Home health agencies are noticing that the highest level of clinical complexity arises from individuals who are grappling with multiple comorbid conditions affecting one or more body systems.

    Getting the Clinicians the Support They Need

    Improving clinician skills to adapt to more complex patient needs is crucial in the healthcare industry. However, this task presents its fair share of challenges. For one, home health clinicians may already be stretched thin with the demanding nature of their job, exacerbated by staffing shortages. While additional training and education can be beneficial, it is a long-term goal that may not yield immediate results.

    Getting the necessary support for clinical administrative tasks can enable clinicians to prioritize direct patient care. This, in turn, allows for more time and resources to be allocated towards creating new programs designed to provide better care for complex patients. It also ensures that the improvements in patient care are accurately reflected in the documentation.