Author: Ali McCowan

Open post

HHCN Future Leader: Michael Martin, VP, Network Management

HHCN Future Leader: Michael Martin, VP, Network Management

By Andrew Donlan | October 11, 2024

HHCN Future Leaders

The Future Leaders Awards program is brought to you in partnership with Homecare Homebase. The program is designed to recognize up-and-coming industry members who are shaping the next decade of home health, hospice care, senior housing, skilled nursing, and behavioral health. To see this year’s Future Leaders, visit https://futureleaders.agingmedia.com/.

Michael Martin, VP of Network Management at tango, has been named a 2024 Future Leader by Home Health Care News.

To become a Future Leader, an individual is nominated by their peers. The candidate must be a high-performing employee who is 40 years old or younger, a passionate worker who knows how to put vision into action, and an advocate for seniors, and the committed professionals who ensure their wellbeing.

Martin sat down with Home Health Care News to discuss how reimbursement structures can positively change the future of home health care.

What drew you to this industry?
My mother has worked for post-acute and home health companies for several decades. I was exposed to that at a very early age.

So when I came of age and was able to come around her office, I got a chance to get additional exposure that way. I always had just an understanding of the health care industry, specifically the post-acute industry, through her. After college, I kind of experimented in sales and a few other industries, but I just fell back on what I knew, which was home health. And so my first job, my first real salary position, was working for a home health company. And my career took off from there.

What’s your biggest lesson learned since starting to work in this industry?
The biggest lesson that I’ve learned is that if you are wanting to transform the way providers service their members, I think you have to take a hard look at how they’re reimbursed.

Sitting on this side, where I oversee a network of providers, it’s really important that the way we reimburse providers shifts behaviors towards outcomes versus anything else. I learned that lesson working for VillageCare, where I oversaw their bundled payment program, and I just watched how that transformed the entire facility. I helped manage that program on their behalf, and at the time, I think they were managing about 11 bundles.

And you just saw how a capitated payment model, where you’re taking full risk, changes things. You see discharge, length of stay drop. You see partnerships in the community improve, things like starting the discharge planning process at the point of admission became a familiar sight. And it improved outcomes in a major way.

If you could change one thing with an eye toward the future of home health care, what would it be?
I would change the way providers are reimbursed. If I could, I would orient them all to ideally a full-risk arrangement, and at the very least, an upside arrangement, where they’re getting bonuses based on the value that they’re creating.

In a word, how would you describe the future of home health care?
Bright.

What quality must all Future Leaders possess?
I think it’s multifaceted, but I would say patience and empathy, those are incredibly important. It’s important that we have diverse backgrounds. I think that although the future is bright, we live in a very fragmented environment. And I think that just health care in general is very complicated for the common person. It’s also very dynamic and complicated to health care professionals.

It’s changing all the time, and if you get too lax, you get left behind. Leaders that are at the forefront of this, that are able to keep up, and frankly, pave new paths, have to have the patience to bring everyone else up to speed. And part of that is being empathetic about not only your team, but your clients, your partners in the community – putting yourself in their shoes. That’s vital for any sort of innovation.

To learn more about the Future Leaders program, visit https://futureleaders.agingmedia.com/.

Read Original Article

Open post
Patients

“Robotic-based” Home Care is Actually More … Human

“Robotic-based” Home Care is Actually More … Human

By Raman Padmanabhan | July 10, 2024

Patients

Woven into the deepest strands of healthcare’s DNA is the word - human. From the immaculate invention of penicillin to cutting edge transplants, decade upon decade, millions and millions of caregivers have come and gone. It all comes back to the visceral want of preventing pain and providing relief to fellow humans. Healthcare is an art, in many ways the kindest of acts we bestow upon the human race.

But what if “human” is facing a daunting potential foe? An emotionless, silicon and titanium one? While at first blush it may seem that way…AI is actually going to make care, particularly in-home care, more…human.

In 2023, AI crashed into the general lexicon…becoming one of the hottest and most debated topics. Nvidia’s stock blasted through the roof, you couldn’t go five minutes in the corporate world with someone talking about AI-strategy. Halfway through 2024, AI shows no signs of slowing. It will likely be bestowed Time Magazine’s ‘Person of the Year’. While AI technology is nothing new, including in healthcare, its front-page cacophony is rivaled only by say, Taylor Swift.

But, while AI was a niche use case a decade ago, five years ago even, and people viewed it as a far-away technology akin to self-driving cars, eVOLTs etc. It is here, in full force today. Whether we like it or not.

There are two potentially competing narratives being shouted across the healthcare continuum.

On one hand…care has devolved to become cold, dollar-driven, quick and assembly line like and lost the aforementioned human touch infused into its essence. There is a huge rallying cry to enable patients to feel more human, with more humane care. This is vividly visible in the growing trend of in-home care and aging in place. “Home is where the heart is” and other euphemisms depict the space we hold most sacred in our lives…home. That’s where we want to have preventative and post-acute care…not endless revisits to the time-consuming hospital system. There are plenty of documented case studies proving the point that patients receiving healthcare at home experienced lower risk of long-term care admission including depression and anxiety. The psychological and emotional support of the home environment in the presence of their loved ones offers an unparallel advantage of comfort that cannot be achieved in a hospital care setting.

On the other hand, there is the AI-tsunami. All the automation that’s going to enlighten the healthcare industry, if you ask proponents, or make matters worse to the naysayers. Regardless, every corner of healthcare is dancing with, exploring, and implementing AI in some capacity as we speak.

Is it possible to be pro-human and pro-tech at the same time when it comes to our healthcare?
Traditional AI applications are immensely useful to analyze patient data, identify patterns, and inform care decisions. This technology enhances care delivery by providing clinicians with actionable insights and decision support tools. But the ongoing evolution of generative AI is a bit different. While traditional AI plays a crucial role in healthcare, concerns regarding regulatory compliance and maintaining patient trust necessitate a cautious approach to adopting generative AI technologies.

Here is one use case. Data-driven insights generated through AI and machine learning enable home health care providers to optimize care pathways and personalize treatment plans for individual patients. In today's healthcare landscape, data transcends traditional acute care settings and permeates throughout the entire continuum of care, including skilled nursing facilities (SNFs), inpatient rehabilitation facilities (IRFs), long-term acute care hospitals (LTACs), and home health agencies. Recognizing the multifaceted challenges faced by the industry—ranging from care accessibility and quality to cost efficiency—it's imperative to harness the power of data across this continuum. By leveraging data analytics, we can optimize patient care journeys, improving both the quality and accessibility of care while simultaneously mitigating the cost burden. For instance, facilitating swift transitions from acute care settings to home environments not only enhances patient comfort but also reduces the likelihood of hospital readmissions, thereby contributing to overall cost containment efforts.

AI is a perfect assistant, but it can’t be the end all be all.

The preservation of human touch in healthcare, even as technology advances, is absolute. While AI enhances decision-making and efficiency, human involvement remains essential for empathetic patient care and building trust between clinicians and patients.

Read Original Article

Open post
senior and caregiver

Post-Acute Care and Enablement of the Home, An Industry in Flux

Post-Acute Care and Enablement of the Home, An Industry in Flux

By Brian Lobley | March 22, 2024

senior and caregiver

Post-acute care is the process of enabling functional recovery, following an acute or inpatient admission. Many settings can be used to support post-acute care, including skilled nursing and rehabilitation facilities, but often, the most preferred setting for care is the home.

Older Americans, with Original Medicare and increasingly Medicare Advantage health insurance coverage, represent the lion’s share of patients seeking post-acute care. While their preferences for recovery at home are clear, there are barriers to fully enabling the home, despite data that suggests the home can be a more efficient and higher quality site of care for recovery that also improves total cost of care, including costly re-admissions and inappropriate emergency room utilization.

So why then, has post-acute care, particularly the use of skilled home health, lagged consumer preferences, especially the wishes of senior Americans? The answer is complex, but there are several factors working against this goal.

Though skilled home health has been around for decades, labor pressures, especially following the pandemic, continue to rise, and nursing shortages remain at an all-time high. Quite simply put, there is not enough skilled labor to support the demand for home health. Because many home health agencies are understaffed, they are unable to take on as many patient referrals. This leads to longer wait times for placements, leaving the discharging care providers to conduct multiple referrals until they can find an agency that can take a patient.

For Medicare Advantage members, access is even more complicated by reimbursement issues. Today, Traditional Medicare is generally a better payer for skilled home health services compared to Medicare Advantage plans, which are private plans offered by health insurance companies as an alternative to Traditional Medicare. Medicare Advantage plans often include low-cost to no-cost premiums, with additional supplemental benefits such as vision, dental and health care allowances. These disparities in reimbursement are a conundrum the industry must solve, as Medicare Advantage enrollment and market penetration is at an all-time high of 48% and expected to go as high as 60% by 2032. The industry must do better to ensure that these Americans do not slip through the cracks and can be offered similar level of access and service as traditional Medicare beneficiaries.

The accelerated expansion of value-based reimbursement solutions to post-acute care is a significant opportunity to reduce disparities in payment between Traditional Medicare and Medicare Advantage members and offer more meaningful solutions for increasing MA access to home health care. By rewarding providers for reducing total cost of care and sharing savings from lower readmissions and inappropriate ER utilization, the industry can take meaningful strides to not only drive better alignment for performance but reduce disparities in access to home health for Medicare Advantage members.

The path to get there, however, will take work as the home health care provider landscape is fragmented. While several large national home health agencies exist to help serve certain markets, an enormous amount of regional and local agencies are also required, making the process of building value-based networks laborious.

The evolution of new tools and technology to better support how we deliver home health care and support agency success in value-based arrangements will also be important. Enabling home health care providers, particularly given the labor pressures they face will be paramount, and tools that help refine our understanding of patient needs, simplify documentation, and reduce administrative paperwork will be key. For example, two patients with similar home health needs, but with different comorbidities, caregiver, or socioeconomic needs, may require a different number of home health care visits and extra care coordination support to ensure they recover successfully in the home, such as assistance with appointment setting to ensure they have a ride back to their provider’s office for a follow-up visit.

The ability to predict a patient’s potential for an adverse outcome and to monitor their risk and health needs throughout their home health care episode, and in the period immediately following the conclusion of their home health episode, is also essential. Data collected from discharge notes, start of care assessments, progress notes, along with remote monitoring devices and historical patient health data can all be harnessed more effectively to help us better understand member needs, treatment plans and risks.

Advancements in AI will also significantly boost stakeholders’ efforts across the industry and improve the way post-acute care is delivered. Imagine a world where large amounts of data can be summarized in near real-time to derive insights that could influence and inform more personalized treatment plans and recommendations for patients, such as referrals to hospice and palliative care, or to care coordinators to help patients obtain nutritious meals needed to bolster their recovery. Improving our understanding of a patient’s needs not only offers opportunity to improve care, outcomes, and patient satisfaction, but also allows the industry to better staff and plan for the care that is needed, ensuring that precious resources are optimized and deployed in the most effective manner.

While all these challenges may feel insurmountable, there is tremendous momentum already underway in the industry to tackle many of these problems. Collaboration across key stakeholders, including home health agencies, providers, patients, health plans, and post-acute care solution providers will be critical to fully enabling the home as a preferred place of care, and for ensuring that all seniors, including Medicare Advantage beneficiaries, can utilize home for their recovery and health care.

Read Original Article

Open post
tango and WellSky

tango and WellSky® Partner to Revolutionize Post-Acute Care Benefit Management With End-to-End Program to Manage Care and Outcomes

tango and WellSky® Partner to Revolutionize Post-Acute Care Benefit Management With End-to-End Program to Manage Care and Outcomes

Business Wire | February 29, 2024

tango and WellSky

With this first-of-its-kind collaboration, health plans will be better enabled to drive improved outcomes and patient and provider experience through a next generation value-based program across acute, post-acute, and home settings.

OVERLAND PARK, Kan., and PHOENIX, Ariz. — February 29, 2024 — Today, leading healthcare technology and services firms tango and WellSky announced they have partnered to deliver a fully integrated, post-acute care (PAC) episode management program for health plans, focused on facilitating high quality, end-to-end post-acute care management. This innovative partnership is intended to align incentives for health plans, risk bearing entities, providers, and patients across the post-acute continuum. Together, tango and WellSky aim to enable higher quality care, enhance provider experience, reward providers for quality outcomes, boost patient satisfaction, and deliver guaranteed cost savings.

The partnership combines tango’s market-leading, value-based home health enablement platform and networks with WellSky’s industry-leading acute and post-acute technology, analytics, and services. Together, the partnership will address key marketplace challenges, such as limited or delayed access to optimized transitions within post-acute care, disjointed incentives, lack of effective integration and connectivity, and reimbursement issues.

“By joining forces, tango and WellSky are at the forefront of revolutionizing post-acute care enablement,” said Andy Eilert, president of payer and emerging markets at WellSky. “With the seamless integration of powerful technology, rich data, and advanced services capabilities, our collaboration provides the opportunity to optimize the patient's journey. This program facilitates effective and timely access to appropriate and high-quality post-acute services for each patient, resulting in a ‘win-win-win’ impact for patients, providers, and health plans.”

The partnership provides a modern solution for health plans and risk-bearing entities to improve medical outcomes and reduce the total cost of care by enabling care and coordination across home health, skilled nursing, inpatient rehabilitation, and long-term acute care facilities in a unified model. This program allows health plans to take a holistic approach as opposed to managing services separately, which many health plans do today. Additionally, it enables providers to be aligned and incentivized appropriately for achieving superior clinical and total cost of care outcomes.

“Optimizing post-acute care tailored to patients' conditions and preferences is paramount. Our decades of experience in home health and curated value-based networks enable us to confidently help ensure patients get the quality care they need, when and where they want it. The tango and WellSky partnership positively impacts the patient and provider experience through our ability to transition a member seamlessly and quickly from acute and post-acute facilities to home," explains Brian Lobley, tango CEO.

This collaboration can facilitate significant financial benefits for health plans through a delegated model coordinating and managing the PAC episode with guaranteed cost savings and shared savings. This partnership simplifies outsourcing for health plans, as the risk and management are maintained under one partnership.

Read Original Article

Open post

Q+A with Wendy Coyle, tango’s Chief People Officer

Q+A with Wendy Coyle, tango’s Chief People Officer

Wendy Coyle Chief People Officer

February 2024 marks Wendy Coyle's two-year anniversary as tango's Chief People Officer. In a recent interview, we had the opportunity to explore Wendy's impactful contributions over the past two years, particularly in the realm of Diversity, Equity, and Inclusion, and her enthusiasm for shaping a robust company culture.

Tell us about your role at tango!
Wendy: I lead the strategic function of human capital and the employee experience to meet the needs of the business, overseeing our Human Resources and talent functions. This encompasses a spectrum from hiring, onboarding, employee relations, management, rewards, retention, and development, to culture, compliance, diversity, equity, and inclusion efforts. Additionally, I manage benefits, payroll, and compensation.

What led you to join tango?
Wendy: I did not start my career in this space but I have a passion for healthcare since my mom was a nurse. I knew I wanted to help people just like her but I was not interested in needles, ha! Therefore, when I moved to Arizona, my first role was with a health plan, which eventually led me to tango. Even though I am not patient facing, I am part of the journey in patient care. When I met our CEO and COO, I knew this was where I wanted to be. I love having the opportunity to ensure our teams are connected to our overall mission.

What initiatives at tango are you especially proud of?
Wendy: I am proud of the teams that I have built and the success in our employee engagement, diversity and culture. tango was featured in Vistria’s 2023 Annual Impact Report for our efforts in DEI with our respect to recruitment. The HR team also started “Coffee Chats” this year, and our first conversation was centered around Black History Month. We can’t wait to have more!
We established our Culture Committee in 2022, which is comprised of dedicated individuals who are passionate about fostering an inclusive workplace. We work together to organize monthly events and initiatives. We’ve done everything from an online Secret Santa exchange to creating chat channels to discuss various topics such as Chinese New Year, Valentine's Day, Presidents Day, St. Patrick's Day, and more. The aim is to create a fun, engaging, and entertaining environment where everyone feels valued, heard, and included.

How have you kept a strong company culture with most of the team being remote?
Wendy: Even though the majority of our company works across the country, from the west coast to the east coast and in 26 states, we feel like a family. We are very intentional with getting together regularly in person to foster connection and collaboration. Our executive and senior leadership teams meet in person quarterly, and we love having teams visit our tango headquarters in Phoenix, AZ. When together, we always make sure to enjoy time with each other by doing team building events. It keeps us connected!
We also initiated “tango talks” in the middle of 2023 to improve company culture since we are 95% remote. The purpose of these talks is to get everyone to learn more about their leadership teams. Our CEO, Brian, attends every discussion. We have received great reviews from employees who attend. Everyone seems to value the quality, personal time with our CEO and leadership team, as well as getting to connect with team members they don’t interact with as frequently.

What are you most excited about when it comes to tango in 2024?
Wendy: I am excited to be a part of our continued growth and what we are becoming!