Home Health Strategic Management (HHSM) has produced progressive consulting and clinical services to healthcare Providers for more than 30 years. With a history of rehab management and delivery across the care continuum during the PPS era, HHSM views clinical programming as an evolving model, continuously improving patients faster through focused and efficient care. By embracing efficient delivery of the PPS model in respective care sites, HHSM produces unmatched levels of clinical and fiscal results for Post-Acute Providers. Today, as Health Systems prepare for the Affordable Care Act and the episodic care management of the future, HHSM acts as a Post-Acute Consultant to multiple Pioneer ACOs.
In conjunction with the Detroit Medical Center (DMC), a Pioneer ACO system, HHSM developed the application and programming model for the CMS Innovation Center, Bundled Payment for Care Improvement (BPCI) Pilot Program. In 2012, they were awarded the Model 2 Bundling Pilot for MS-DRG 469/470 - Lower Extremity Total Joint Replacements. The resultant Episodic Bundling Program, JUMP, the Jump Utilization Management Program, has produced savings of greater than 40% through this exciting Care Redesign model. HHSM currently manages the Post-Acute Care Utilization for the CMS Pilot, as episodic-based savings are derived by managing PAC costs, using clinical indicators for acuity-based patient movement.
When working directly with Post-Acute Providers on a national basis, HHSM installs progressive care management protocols derived from CMS models from across the care continuum. HHSM's Home Health UR care protocol, SURCH - Service Utilization Review for Care in the Home, is based on the MDS, the CMS-produced UR program for SNF care volumes and programming. SURCH allows for Provider-managed Plan of Care production before the admission visit is completed; returning fiscal and clinical control of the homecare program back to the agency, who is ultimately responsible for episode outcomes. SURCH clients report elevated Case-Mix results greater than 35% from use of this progressive clinical protocol, minimizing the effects of the CMS Case-Mix Rebasing efforts, all in an entirely PPS-compliant manner. In addition, SURCH positively affects clinical outcomes due to the focus on acuity-based care management; HHSM clients employing SURCH post 4-5-level Star ratings. Virtually all SURCH engagements have posted fiscal returns in excess of the cost of the actual installation; producing real-time ROI for Providers employing this value-based protocol. Home Health Providers seeking to improve clinical and fiscal outcomes while preparing for ACA reforms should contact HHSM for more information on SURCH.
Recent ACA redesign efforts outline the continued movement towards the Alternative Payment Models (APM) that will define >90% of CMS payments by 2018. Based on the value content and focus of HHSM's work throughout the PPS era, HHSM have become industry leaders and experts regarding the new Care Models being introduced. In 2016, Value-Based Purchasing (VBP) arrives for Home Health Providers in nine states, decreasing payment levels 5-8% unless quality stats demo value on an agency-to-agency basis. The CCJR Episodic Bundling model represents the first mandatory APM program since the passage of the ACA. Based on the BPCI Model 2 Pilot programs, the CCJR initiative creates a 90-day Bundled model for Total Hip/Knee replacements. Seventy-five geographical areas have been identified to develop CCJR networks to begin on January 1st, 2016. As a result, more than 700 hospitals or heath systems will become both Provider and Payer for all costs incurred within 90 days of discharge for joint replacement patients. HHSM works with hospital systems nationally regarding CCJR program development based on our previous work with multiple Model 2 Bundling Pilot Programs.
HHSM have become leaders in the development and management of these new APM Care Models that require efficient, clinically-oriented care programs for success. Contact HHSM today; don't be left behind as progressive Providers seek the inroads to the efficiencies and outcomes of the care programs of the future.