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Home Health Value-Based Purchasing: Advocacy to Improve Care at Home

Since the COVID-19 pandemic, the home-based care space has seen remarkable advancements. The ensuing public health emergency acted as a catalyst that underscored the critical need for high-quality health care accessible within the comfort of one’s home.

As a result, at-home care emerged as a lifeline and organizations like Axxess were ready to answer the call.

In this Future in Focus interview, Home Health Care News goes one-on-one with Axxess CEO John Olajide to learn about the transformative impact of the pandemic on health care, the role of technology in advancing home-based care and the critical need to reshape policy to meet the evolving needs of a changing landscape.

HHCN: When we think about advancing home-based care, we can talk about moving the needle with a variety of key decision-makers and gatekeepers. Looking exclusively at the policy space, what are some home-based care advancements you’d like to see turn into reality?

John Olajide: I want to investigate how policymakers think about our space. How do they understand care in the home? Why is it that in some cases the policy positions or regulatory positions are at odds with what you and I understand to be the preferred place to receive care? It’s the lowest cost, high touch, surrounded by family members and technologies are enabling better outcomes.

I’ve had several visits with policymakers on both sides of the aisle to understand that and one thing that I realized is that policymakers are thinking about it from a solvency perspective of the entitlement system.

They have data that says it’s a three-year solvency or a five-year solvency. In our industry we say, “Let’s fight for more payments.” But the policymakers only have so many finite resources. The conversations shouldn’t be about, “Give me more, give me more.” They don’t have enough to give.

Now it’s about extending the solvency of entitlement systems where we can call on more people and add more value. Beyond this reactionary engagement on a year-to-year basis about a new rule coming out and then we’re all up in arms about it with lawsuits and marches on the Hill. What I have found is that policymakers are open to solutions. How do we come up with solutions that can increase quality services for more people?

I think there’s a need to shift that conversation and have a value-based conversation about the value that we can provide.

Then there’s also advancing home-based care and advocating on behalf of providers in the context of payers, including managed care. What degree of progress has the home-based care field made in communicating their value to payers, in your view?

Axxess has been at the forefront of advocating for the industry with policymakers, regulators and engaging payers as well. The reason is this: in some sense, we have an advantage because we see a large section of the entire industry.

What payers want is to provide the best coverage for as many members of their population in the most cost-effective way. Care at home is a very important part of that engagement. We shouldn’t be just about cost cutting — it should be a more holistic perspective and care at home providers bring a lot to the table. Beyond saying, “I’ve allocated a certain segment of reimbursement to care at home.” Why don’t we open everything up and say, “How can we put the patient at the middle?”

The care at home providers know the patient better than all the other providers because they’re going into the patient’s home. They are in the medication cabinet and understand all the social determinants of health. In our case, the benefit of the scale we can provide includes giving pointers to partners to show how they can achieve better outcomes through benchmarking data. We can actually engage with those metrics instead of engaging anecdotally.

It’s a service that we take very seriously to make sure we’re advancing what we believe deeply, which is the future of health care being delivered in the home.

Looking ahead again, what’s on your advocacy to-do list for 2024?

What I want to do is work with all stakeholders to increase access to quality health care at home for people by creating solutions that work. Not just saying, “Hey, give us more money.” I understand that there are finite resources — whether it’s Medicare or Medicaid.

Instead, we’re asking questions like, “How can we build healthier communities? How can we eliminate the waste that exists? How can we capture this waste and shift it to value creation? I want to make sure we’re continuing to educate and engage with our policymakers.

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


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