I can hear the wheels turning as I write this – BUT what is the catch? It is a pretty big catch as it relates to PDGM, wound care, and your nursing staff utilization. So, you could more accurately say that you would spend $2 to save $5 in costs within your current reimbursement. Have I lost you at this point?
CMS is continuing to drive to a value-based model with PDGM – de-emphasizing therapy, incentivizing for wound care, splitting reimbursement into two 30-day periods. Everything that you know, but some of which is causing consternation in your organization as you prepare for 2020.
Home Health agencies aren’t very good at wound care management. The average HH agency is pretty mediocre in this regard compared to Acute care facilities or outpatient wound care clinics. Rightly so – HHAs don’t have the same certified wound expertise, controlled settings, advanced technologies, better clinical support, etc. What if I told you that you could get to the same level of strategic wound expertise at the patient’s side with an Advanced Strategic Wound Care Model that includes:
- Advanced Dressings that require only weekly versus daily dressing changes (still less expensive than daily changes)
- Advanced Imaging Technology (improves accuracy in identification of etiology and staging dramatically)
- Better Utilization Model (30-50% of normal labor cost for wound management)
- Handle 3X the volume of wound patients with the same or less nursing resources (profitability)
- Optimized CarePlans (Faster healing times, fewer hospital readmissions, lower reoccurrence rates, lower total patient cost, and improved star ratings)
“Again, sounds great, but what is the catch?”
You need to be able to adopt a strategic approach to managing wounds. It will cost you $2 to hire an Advanced Wound Management firm to work remotely in conjunction with your clinical nursing team. You will save $5 in nursing labor if you can control your utilization and enforce compliance with the evidence-based Care Plans developed by the Wound experts. Your organization then will have to adjust the scheduling model to allow for the increased staff capacity resulting from the reduction in visits per wound patient. It will also require a collaborative relationship with the remote wound expert and your nurses who will follow the directed care plan.
Any change is hard and really has to be initiated from the top of the organization. Then it requires a methodical implementation program that enables educating the nurses on the new advanced wound management model, learning the mobile imaging application, learning how to apply some of the advanced wound dressings, and how to better document the wound so that an expert can assess properly.
The 10 side benefits which really are (truly a misnomer as they are really good benefits):
- Streamlined formulary that can be rationalized for cost – up to 20-30% reduction in total wound supply costs
- Reduced wound-related hospital readmissions and reoccurrence rates leading to better star ratings
- Fewer non-healing wound patients; which changes a losing proposition to a profitable one with wound patients
- Lower errors in staging and etiology (we have seen on average 20-30% error rates); which impacts your coding and hurts your reimbursement rates
- Improved wound documentation within the initial intake OASIS and subsequent visits within your EHR
- Ability to actually make money on wound patients given the anticipated 25% increase in wound PDGM reimbursement rates without relying on therapy
- Ability to service more wound patients with the same staffing team
- Ability to market for more wound patients from referral sources
- Ability to take more complex wound patient referrals with confidence
- Ability to swap more costly resources like RNs visits for lower-cost resources like LPNs and HHAs
Most of the organizations that we are engaged with who are implementing this Strategic Advanced Wound Management Program are piggybacking on the strategic value-based approach that they are deploying for PDGM. If this is interesting, reach out to us for a discussion. We have several ways to help your team get comfortable with this model:
- Chart Audits – we will audit a small sampling of your wound patient charts to assess how your team is doing with wounds.
- Leading Questions – we can provide your team with a short list of questions that highlight some of the process issues that we commonly see in HH agencies
- Pilot Program – we can pick a location for piloting – it can be your worst performing or one that has been heavily reliant on therapy that is about to turn unprofitable
- Strategic Scorecard – we can perform a more formal assessment that evaluates all aspects of your wound program for either self-improvement or strategic partnership
We enable Post-Acute Providers to become Wound Programs of Excellence with our Wound Maturity Benchmarking Scorecard, operational consulting, and Nurse2Nurse wound consults for the management of complex & chronic wounds for Post-Acute Providers in home health, hospice, rehab hospitals, and nursing homes.
Our senior-level, wound-certified nursing staff are some of the best and most experienced in the industry. We couple their expertise with the most advanced wound dressing technology, latest evidence-based research, and our Telehealth infrastructure to ensure that we deliver the right patient support at the greatest point of need – the bedside.
To learn more, contact Corstrata for a conversation to see how we can help make your wound management program easier and more profitable.