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Healthcare Public Policy to Accelerate Care in the Home


It’s time that policymakers and payers see the value of home-based care as more than the “piggy bank” for the U.S. health care system.

That’s according to Deborah Hoyt, senior vice president of public policy for Axxess. In this Future in Focus interview, Home Health Care News catches up with Hoyt to learn more about in-home care providers’ ability to lower costs and improve patients’ outcomes.

HHCN: To start, I’ll ask you to look back over the past few years to the very beginning of 2020. From then until now, how would you describe the overall progress home-based care has seen in the U.S. – and what are some of the best examples of that advancement?

Hoyt: It’s absolutely clear that home-based care has become the desired and established protocol to ensure the quality patient outcomes that CMS and payers are looking for. Our sector’s 125-year history, beginning with community-based VNAs, has always been centered around our nurses’ expertise at chronic care management. Recent interest by hospitals and payers to get a foothold in the home space just can’t replace the deep knowledge of our workforce and the people skills necessary to succeed in a decentralized home-based care delivery model. I believe that as an industry we’re well positioned to continue moving forward and lead in terms of the evolution of an even higher level of care at home.

In what ways has your own organization advanced during this period?

Axxess has grown exponentially since 2020 thanks to our people, partnerships, and solutions. Today we serve a greater number of home-based care clients of all sizes across all sectors. With our recent acquisition of Complia Health, Axxess is expanding our innovation which enables our provider clients to accept more patient referrals, improve their efficiency through automation and AI, reduce staff time and improve profitability. Our goal at Axxess is to partner with providers so they can leverage technology to streamline business operations in a way they’re saving any place they can across the business to maximize compliance and minimize expenses.

Looking ahead, what is the single most important thing that needs to happen in order to further accelerate home-based care in the U.S., and why?

Our sector really needs financial security. That means fair Medicare, Medicaid and Medicare Advantage reimbursement paired with regulatory predictability.

CMS’ process for developing payment and regulatory policy for home health and hospice based on MedPAC recommendations from outdated data is just unsustainable from the provider perspective. With unpredictable changes disrupting provider finances and business operations on an annual basis, there is no capacity for thoughtful long-range planning, workforce development or process improvement. This form of policymaking hurts our sector on many levels but most importantly forces us into a defensive posture and does not give us the breathing room for innovation to compete with new models like hospital at home.

In your view, what are the top 2-3 ways that technology specifically has advanced home-based care in recent years?

Technology is key to advancing any industry, and I think that we’re now seeing a real ability to create efficiency in provider documentation. I think that’s critical in this environment where good field nurses and QA are in short supply and audit scrutiny is increasing.

Handheld phone applications have been a game changer for clinicians out in the field who can complete their full documentation in real time, send it through to QA and to billing without the need to go back to an office, sync their device to a laptop or rely on a patient’s Wi-Fi access. Agencies need to get paid quickly and Axxess excels at revenue cycle management.

Lastly, one of the things we’re focusing on at Axxess is making sure that the providers can leverage their technology tools, get paid faster and free up the revenue they need. The end game is providers being able to care for more patients to meet the needs of their community and grow their business.

What emerging technology trend do you see disrupting home-based care most over the next 5 years, and why?

Health care is the only sector that hasn’t kept up with what consumers are demanding in terms of 24/7 access. Right now, it might take 48 hours or longer for a patient to receive an initial visit in the home after a referral.

That’s not good enough. People want 24/7 on-demand care, particularly in the home. With staffing challenges expected to be ongoing, efficiency enabled by technology is the only way we are going to get there.

Axxess created a mobile staffing solution modeled after how Uber revolutionized the ride share business. It has taken our team over 10 years, but it has reinvented the way that people can access home-based care. Licensed and vetted clinicians create a profile through the Axxess Care app much like Uber drivers. Providers can access this on-demand workforce to fill shifts, or the clinicians work independently to pick up available visits in their geography. Axxess has created a virtual workforce of more than 10,000 qualified individuals in all 50 states. With the growth in demand for home-based care, this bold tech move will transform the sector globally.

Editorial Note: This article was originally published on Home Health Care News. We are sharing this piece in two parts; this is part one.

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