A new study that reflects data from over 1,000 home health agencies provides key insights into how agencies can optimize performance and operations. The study examined which agencies were performing the best clinically, operationally, and financially, focusing on technology, palliative care, staffing, and future care delivery models. The gathered data is of utmost importance because it provides guidance at a critical time when service demands are increasing amidst an evolving home health landscape.
Factors Affecting Quality of Care
A key insight from the study highlights how caseloads and telehealth negatively and positively impact the quality of care.
64% of the participating agencies in the study had case manager caseloads of 20 to 25 patients. The vast majority of the rest had 19 or less. According to the study, caseloads higher than 25 reflected a decrease in quality and patient satisfaction. On the other hand, those agencies with caseloads less than 25 were more likely to document while in the patient’s home, which resulted in timely documentation. Subsequently, those agencies also had the lowest number of days from the start of care to RAP (0-1 days) and had the highest profit surplus margins.
Another component that affected the quality of care was the introduction of telehealth due to the onslaught of COVID-19 and the Patient-Driven Groupings Model (PDGM) in 2020. 92% said they use telehealth, and a third of those agencies indicated recent implementation. Meanwhile, 44% of respondents continue to use telehealth after patient discharge as part of their population health initiatives. The study also suggests a correlation between an increase in telehealth usage and an increase in quality of care ratings.
Most of the home health agencies featured in the study had a conversion rate between 80% and 89%. Note that 93% of these agencies said they measure their conversion by the number of admissions.
On the other hand, agencies that did not have definite qualifications for what a referral requires – like a patient name or contact information – had an even higher average conversion rate between 90 and 100%.
Scheduling patient appointments from a referral is also necessary to home health conversion rates.
About two-thirds of the agencies surveyed have a dedicated scheduler to schedule the start of care visits while the other third utilize their intake team for scheduling. No home health agencies said they use a clinical team to schedule these visits.
Maximizing Clinicians and Outsourced Support
Keeping caseloads at the right level and leveraging technology just emphasizes the importance of optimizing staffing utilization amid the staffing shortage. The study read, “While we face a critical nursing shortage, study data shows us that agencies who are using non-clinicians for roles that are not clinical in nature are doing so successfully, without compromising quality.”
This means maximizing your clinical staffing for patient care. Aside from assigning certain functions to non-clinical personnel, agencies can also outsource clinical back-office functions to support their clinicians in maintaining quality both in the actual patient care and in the documentation.
Read the full study from LeadingAge and BerryDunn:
National Healthcare at Home Best Practices and Future Insights>