If you run a non-Medicare Home Healthcare business and have only a baseline understanding of Value-Based Agreements (VBAs) you are forgiven. It is a topic that has somewhat flown under the radar for small- and medium-sized businesses. And that is how the big players in the space would like to keep it! Just as with all large shifts, everyone would do well to pay attention to what the market leaders do. They have been working to secure VBAs for years, and the effects are showing in the narrowing of networks for MCOs in several states.
So what is a VBA? A Value-Based Agreement allows providers to partner with a payor to measure metrics and receive payments based on positive outcomes. You get paid for value rather than just sending a warm body with a license. Your company most likely delivers value right now, but as they say in home care: “If there’s no documentation, it didn’t happen.” So what do you do?
You are probably tracking things such as Hospitalizations, Infections, Staffing/Auth ratios, and Missed Visits. That’s a great start! Now you need to learn from the soon-to-be-implemented Home Health Value-Based Purchasing (HHVBP) Model for Medicare home health agencies. Much of the convoluted formula is based on patient improvement, hospitalizations, and client satisfaction. So far you are probably only getting good data on hospitalizations, and your patient surveys are getting a low response rate. Outcomes are notoriously hard to measure in pediatric and long-term care populations. Nobody said this would be easy!
Medicare-based EMR systems will build workflows and data reporting around the HHVBP Model to comply with CMS requirements. Non-Medicare companies using these systems will have to manipulate data designed around OASIS and HHCAHPS, which are rarely the basis for measuring Medicaid patient populations. You will need to find ways to get more client feedback, aggregate field staff performance, and be ready to integrate with other systems to capture the kind of information VBA Payers will expect.
Do your systems work together? Do you have a Mobile App for field staff and clients? Is your documentation based on data points (checkboxes and drop-downs) rather than blocks of text? If you answered “No” to any of these, it is time to upgrade or get left behind.
Cubhub is the only Home Healthcare EMR built for Pediatric companies. We specialize in State Medicaid and MCO compliance, requiring us to stay ahead of the changes. Our system is poised to be at the forefront of Value-Based care models because the entire platform is designed to capture relevant data and leverage it for better outcomes. Our Mobile App allows field staff and clients to capture clinical data, communicate, and offer feedback on their experiences in real-time. Our development team, which is 100% based in the US, is adept at integrating with other systems and creating new modules based on changes in regulations or opportunities. At Cubhub, you don’t have to run reports intended for Medicare home health. We partner with you to capture, aggregate, and leverage the right data to put your company in a position to negotiate Value-Based Agreements just like the big organizations.
Schedule a demo today to see how we can prepare your business for the opportunities of tomorrow!