Webinar: Value-based care at home - trends in skin health related diagnoses

Meaghan DePeter (00:00:30):
Hi, everyone. My name is Meaghan DePeter. I’m a senior product trainer with Definitive Healthcare. I work across all our verticals, making sure clients understand our product and best how to utilize it. Thanks, Kevin.

Kevin Dubuc:
Absolutely. So again, we’re focused on 15 minutes here. I want to make a conscious effort to get through this and make sure we’re getting the meat of the presentation for you folks. I’m going to dive right in. Again, topic that we’re going to be discussing today is this continued shift in the care from (00:01:00): the acute care space to home health agencies specifically is what we’re going to be talking about today. Multitude of factors and reasons around why those things are happening in particular, two though, that we wanted to highlight on this particular webinar. The first being PDGM, which is a patient driven groupings model. This is a new payment model implemented in January of 2020 to address what CMS believed to be a substandard outcome for home health patients at the time.

Now, why this is of importance to this particular group (00:01:30): is that there’s 12 new clinical groupings in this payment model. One of those in particular is vitally important is the assessment, treatment and evaluation of surgical wounds, as well as the assessment, treatment and evaluation of non-surgical wounds, ulcers, burns and other lesions. Now, without getting too deep into the details on the reimbursement piece, basically, (inaudible 00:01:52):  surrounding wounds is going to be increased for home health providers depending on the severity of the wound and the comorbidity adjustment based on the secondary (00:02:00):  diagnosis on the claim. That’s unhelpful. So what does that actually mean? In other words, taking on higher acuity patients can lead to greater reimbursement rates, leading some of these home health agencies to want to take on these higher acuity type patients. Second thing I wanted to touch on briefly here is these acute hospital care at home program. This is an expansion of the CMS Hospitals Without Walls Initiative. So that was something that was enacted in the late winter of 2020 as COVID (00:02:30):  hit. What CMS wanted to do is provide additional regulatory flexibility to acute care hospitals so that they could continue providing their services outside of the acute care space in the home environment during the pandemic to reduce the load in the hospitals at that particular time… .