The healthcare delivery system is transforming from an institutional acute care based model to a community post acute, and even pre-acute, population health based model. But the transformation is more complex than that. When there are value shifts in any economic sector, certain assumptions can be made and applied to healthcare.

• When risk shifts from the payer to the provider, a cycle begins that shifts power from the provider to the customer.
• With such a shift, the Value Chain is reengineered, accompanied by mergers, acquisitions, divestitures, closures, and rising customer expectations of service.
• As this occurs, standardizing clinical processes necessitates the responsibility for health care to be downloaded: doctors to nurses, nurses to technicians, technicians to paraprofessionals, etc.
• New Information Technology continues to generate rapidly expanding quantities of data which, coupled with advancements in data analysis, allow for identification of patterns of disease, gauging efficacy of treatments, and spotting links between causes and symptoms.(BIG DATA)
• Advances in Technology represent the “breakthroughs” in cost and quality which occur when the value-added chain is restructured, leading to innovative, elegant changes which create a new paradigm where existing methodologies become superfluous.

So, how to lead through the economic deregulation of healthcare? What leader characteristics are required to “pull it off”?

Economics 101: those who benefited most from the old order are the slowest to adapt. The leader of tomorrow must:

• Have Vision; be able to paint the picture of the new hardscape of healthcare for the organization while dealing with the realities of today – the proverbial one foot in the present and one foot in the future.
• Be a Paradigm Buster; don’t wait for a shift to react. Stay ahead. As hockey great Wayne Gretsky said, “Skate to where the puck will be”.
• Be Customer Focused and Patient Centered; it is more important to own the customer than the product.
• Now, More Than Ever, Maintain Focus on Reducing Costs while Increasing Quality Outcomes.
• Create the Leverage to Forge Strong Partnerships for Fitting into a Chain of Value and a Distribution System.
• Be Data Driven and Invested in Technology; watch where value is shifting and shift with it.
• Have Faith in the Future and be Willing to Challenge the Status Quo.

How should providers prepare for 2015?

Organizations should prepare for 2015 by retooling themselves into a partner whose performance characteristics make it sought after by Bundled Payment projects, Accountable Care Organizations, Transitional Care Models for Value Based Purchasing and Chronic Disease Care Management, etc. That means developing and delivering the care programs of the future today. This translates into the following mandates:

• Demonstrate Outcomes via transparent data specific to the potential partnership
• Develop a Utilization Review Approach to Care Modeling for Home Care – Proportional and Acuity Safety Based
• Employ Data Integration and collaboration across the partnership
• Ensure Dynamic Patient Risk Stratification with associated algorithms for care management
• Shift Care Focus from Patient Dependence to Self Management
• Emphasize Population Health Management – Chronic Disease Transitional Care

The Chinese curse, “May you live in interesting times”, certainly applies to health care today. These are the most interesting and exciting of times. A new generation of health care professionals and leaders have been handed the challenge of a lifetime. They just might pull it off!

As interviews of industry leaders continue, NAHC urges its members who have yet done so to sign-up. Please register and take part in this important national study. The State of the Industry Study will address current practices and future strategies in the areas of IS/EHR, telehealth, new health care models and operations.

The interview will last less than twenty minutes. Participating agencies will be among the first to receive in-depth reports plus strategic recommendations from the findings. The results will also include insights into what practices the top agency, those with the best financial and quality outcomes, are using and planning.

Researchers at Fazzi Associates, the firm responsible for managing the study and reports, estimate that 1,000 industry leaders will be interviewed. If you did not register during the pre-study period, you have an opportunity to do so now.

The Study is sponsored by NAHC, CHAP, The Joint Commission, the Forum of State Associations, Delta Health Technologies, HealthWyse and Fazzi Associates. Results are expected to be released in late May or early June of this year. A major presentation on findings will be presented at NAHC’s Annual Meeting & Exposition, October 31 – November 3, 2013 in Washington, DC.

To participate in the study interviews, your agency must meet the following three criteria:
• Medicare certified
• Medicare revenues of $500,000 or higher
• Home Health Compare scores for two or more reporting periods

In back to back news releases last week, Delta Health Technologies LLC introduced its new VP of sales, announced that it will underwrite the “2013 National State of the Industry Study,” and proposed a new name for the industry it has served for nearly 45 years, the care-at-home industry.

“In an effort to help the care-at-home industry both manage and provide quality outcome-driven care in the new reform environment,” Delta’s first release explains, the Altoona, PA-based software firm launched on January 28 a national study “designed to provide agency leaders with critical insights and best practice information in the areas of IT/EHR, telehealth and operational practices.”

Co-sponsored by the National Association for Home Care and Hospice, the Forum of State Associations, and national best-practice research firm Fazzi Associates, who will design and facilitate the national effort, the research has been designed to uncover and spotlight the strengths of the nation’s leading homecare agencies. Delta added that it anticipates additional participants will support the study.

“Patient treatment does not always end with a hospital discharge, as the choice has traditionally been a rehab or skilled nursing facility,” said Delta President and CEO Keith Crownover. “Today, thanks to a growing shift toward home- and community-based services, along with population health management and fiscal awareness, increasing numbers are being referred to home health agencies, which was a major impetus for this study.”

Methodology will include three phases. Phase I included a web-based input survey allowing anyone in the field to suggest issues and questions they would like to see addressed in the study. Phase II, scheduled for February and March, will involve in-depth phone interviews with nearly 1,000 agency leaders. The final phase will include distribution of free national reports and webinars, and a presentation on the findings during the NAHC Annual Meeting in Washington, DC next October.

“Healthcare reform has elevated the importance of caring for patients outside the acute care environment,” said Crownover. “Combine that with the possibilities of telehealth, the impending EHR deadline, and the advent of ACOs and other delivery networks. By uncovering ‘what’s working’ with the top ten percent, we will be able to develop guidelines that will help the entire industry maintain positive outcomes, high quality scores and fiscal responsibility.”

Previous studies sponsored by Delta and conducted by Fazzi Associates includes the OASIS-C Best Practice Study, the National Excellence in Therapy Project and the Delta Study to Reduce Hospitalizations.

New Sales VP arrives with 15 years experience
Delta also announced the hiring of Monte Ruder as Vice President of Sales. Formerly with iPractice Group, Ruder will be responsible for expanding, managing and training Delta’s sales organization and continuing to drive growth in the home health, hospice and private duty sectors.

Ruder has a microbiology degree from the University of Dayton and 15 years of experience in health information technology, specifically in leading sales teams and developing strategic partnerships. Prior to iPractice group, he also held sales executive and management positions with Allscripts, Dialog Medical and NextGen Healthcare Systems.

“The healthcare industry and health IT worlds are changing,” CEO Crownover said.” Today’s sales force must understand not only the business needs of care-at-home organizations but also the unique challenges and innovative advancements that are part of today’s healthcare reform environment. We believe that Monte will be able to equip and inspire our team so that our customers will have the knowledge and tools necessary to deliver efficient, cost-effective patient care.”

This article originally appeared in Tim Rowan’s Home Care Technology Report, February 6, 2013. homecaretechreport.com Reprinted by permission. Further reproduction by permission of the publisher only. Write to Rowan Consulting Associates, Inc. at editor@homecaretechreport.com.