This article is sponsored by WellSky. In this Voices interview, Home Health Care News sits down with WellSky CEO Bill Miller to learn the full implications of the company’s acquisition of CarePort, how care coordination technology helps home-based care providers succeed in the battle for the home and why “interoperability” is more than just a buzzword.
Home Health Care News: What are the career stops that you look at that you draw most from in your position as WellSky CEO?
Bill Miller: I’ve been fortunate — I’ve had a bit of an eclectic background. I spent 10 years as a grassroots entrepreneur, starting my own businesses from the ground up. I draw most of my inspiration from that because it’s very real. It puts you close to the work. I learned a lot of lessons there about motivation.
Then I spent time at Cerner and Optum, both publicly traded health care companies. There, I learned how to scale things. I learned a lot about culture in those businesses, particularly at Cerner, and how to build a stronger culture for an existing company and grow things organically. Optum taught me a lot about how to grow things through acquisition, all of which has been instrumental in my tenure here at WellSky.
This is a unique company because, in relatively quick order, even though the company is better than 40 years old, it has built the widest set of platforms of post-acute assets and more client share than anybody else in the country. We have, for example, better than 4,500 home health agencies using our solutions every day. We have better than 20,000 organizations working our platforms worldwide. So, we are unique in terms of scale alone. I’d also say that the architecture we’ve built is innovative. It’s web-based, and it’s mobile, so it’s very flexible and able to be used on a lot of different form factors.
Anyone who uses our software can obviously do the clinical work that they need to do, and they can also do the administrative work, the billing work, the collaboration work. Our platforms are not only modern but comprehensive. Finally, we’re really good at building software that’s easy to use. This is a part of the industry that has traditionally not been well capitalized. Some of the tools that have historically been used in this space have been homegrown, without analytical capabilities and, sometimes honestly, difficult to use. At WellSky, it’s our goal to change that and transform care through our technology, analytics and services.
You made a major splash with your $1.35 billion acquisition of CarePort, which finalized this year. This has large implications for your care coordination capabilities. What do you see when you look at the home-based care industry’s ability to manage care transitions?
Miller: I would say two things. One, there’s an increase of volume coming into the home. Payers, both the federal government and commercial payers, want more care for individuals provided in the home. It’s more cost-effective, and frankly, it’s what consumers want. If you believe that and then you ask me whether I think that our country is prepared for that, historically, I would’ve said no. What is incumbent upon us as an industry is to make sure that those home health and post-acute applications are conversant with one another.
Fundamentally, what CarePort brings us is the ability to work upstream, to understand the discharge process better, to ultimately discharge patients to the best location, and then to help them progress through their various transitions with support from systems that actually can monitor and measure their progress.
That becomes really important, too, as payers and the federal government want to start paying for outcomes under value-based care — as opposed to the traditional treadmill that we’ve been on in fee-for-service models. That’s the transition the marketplace is going through now. That shift follows a similar transition that has already happened in large health systems and hospitals, so there’s a bit of a roadmap for that process. It’s just more fragmented in the context of post-acute care. CarePort provides that glue and connective tissue, so that we can all deliver on that promise of powering better outcomes.
Why are data analytics specifically important for skilled providers this year?
Miller: Useful data analytics are specifically important because they are the compass by which providers can figure out whether they can take on risk. Analytics come into focus when you’re trying to prioritize scarce resources and understand comorbidities, and you’re trying to understand and look at a patient’s record, their background and their vital statistics. Analytics can also give providers the information they need to know if patients are headed for a decline, if patients should be moved to hospice immediately or if the best patient care might be a combination of home health and personal care.
Those analytics provide actionable insights. That’s why we call our analytics suite our “insights suite.” It allows providers to understand where their costs and their threats are coming from and where their opportunities are to take better care of people and deliver a better outcome. In a world where you get paid for delivering care, that matters financially, but it also matters from an outcomes perspective.
On that note, WellSky deeply understands the importance of social determinants of health in each patient’s overall care journey. The combination of analytics around SDOH and clinical analytics are becoming vital to understanding and successfully delivering whole-person care and better outcomes.
You mentioned social determinants of health, and WellSky also has a personal care capability. How does the platform help non-medical home care providers, and why in the age of COVID is this care so important?
Miller: Home health providers of course must have all the clinical expertise to ensure that somebody doesn’t get readmitted, and must understand what the best suitability might be in terms of location. But if they don’t also understand the social determinants of health and what happens if that person doesn’t have any family or any caregivers, if they don’t know that the patient does not have a working thermostat and are subject to wild changes in temperature, all these environmental things can unwind even the best clinical care.
The reason we love personal care — also called private duty home care — is that it gives us another dimension to deliver in-home support and understand the environmental aspects that we need to know to provide the best outcome. Frankly, the interesting thing about the personal care market is that these caregivers are going into homes and delivering vital care at a rate significantly less than what we can provide clinical care. Personal care offers a low-cost way to ensure great outcomes.
What are the most important data points that home-based care providers should be tracking in 2021 to win in a value-based landscape?
Miller: They’ve got to understand hospitalization risk, and make sure that they assign the right clinical resources to support that patient, because they will get taxed as they experience people under their care getting readmitted. This is why we love CarePort. It puts patients in the best care setting for the outcomes that they’re trying to achieve. That means understanding comorbidities, the patient’s home setting, whether that patient is mobile or whether they could get more appropriate care at a facility-based rehab center. It just takes a little more research and understanding to make sure that we’re putting patients in the best environment for the best outcome.
I think we’re going to have to hold each other accountable so that we’re collaboratively using the right resources the right amount of times. Working together, we can better ensure that we’re being accurate in tracking our time and putting caregivers in an environment where they do what they need to do to improve care, and they’re not over-billing or doing anything that would create any inefficiencies. That’s what value-based care is about. Sometimes that gets viewed as care rationing. The reality is, I think with a little bit of introspection and prioritization, the industry, including WellSky, can always improve in terms of effective utilization.
We hear the word “interoperability” so often that it’s easy to gloss over it. What do you think people perhaps overlook about the value of interoperability?
Miller: There is immense value in legitimate interoperability. Yes, it is a buzzword, and it gets overused and in some context loses its meaning. In the world of post-acute care where you may have a patient traversing out of a hospital and into a rehab center, or into a sleep center, or into home health and then to hospice, these transitions are really important. They can even be scary or inefficient if not handled properly.
To think that there’s going to be some monolithic system that will create uniformity for all of those patients and all of those members is a fool’s errand. But that’s where interoperability comes in. Interoperability provides the fabric to connect and ensure that data is mobile and that patients stay safe, as a result of their health history being securely shared with the right caregivers.
One of Home Health Care News’s 2021 trends is that there will be “a turf war for the home.” How does care coordination technology help home-based care providers win that turf war?
Miller: I wouldn’t necessarily call it a “war.” I certainly believe, and our company certainly believes, that the home is sacred. We’ve been very focused on making sure that our systems are in and surround homes. We are number one in home care. We are number one in home infusion. We are number one in home-based hospice. We are number one in personal care. We’re focused on supporting services delivered in the home, because we know the future of health care is in the home.
As we think about how that landscape plays out, we think we’ve done a good job of getting to first or second base and establishing sophisticated systems that are conversant with one another, that can help patients effectively traverse from one setting of caregivers to another and provide visibility to payers, which is one of the ways that our providers will win. If providers have systems that allow them to do that, they will get more volume. Providers and payers will work with them. Health care stakeholders have to rely on good systems, and I believe we provide some of the best, if not the best systems in the home of any company in the United States.
2020 was a hard year to say the least. What makes you hopeful about the home health and home-based care industry in 2021?
Miller: In some ways, the pandemic has accelerated innovation and agility in the post-acute care space. I think it has changed and woken up our country to the fact that our hospitals can’t possibly deal with the next pandemic exclusively on their own, and the home and other post-acute settings are going to be critical for us to withstand and respond to those in the future.
It has also sped up reimbursement around telehealth and other scaled alternatives to the traditional way that we’ve delivered care, and some of that starts with the post-acute providers.
Frankly, I’m optimistic about the vaccine. I’m optimistic about the growing pressure put on our health care system and our country to embrace positive change for the good of patients. I’m optimistic that our post-acute care environments will gain increased respect and influence. I certainly am proud of the industry I’m in.
And I’m certainly proud of the clients I get to represent because they’re out on the frontline helping the people who need it most. Our clients are the ones delivering care, and they’re using WellSky systems to drive better outcomes.
Editor’s note: This interview has been edited for length and clarity.
WellSky is passionate about helping home-based care providers successfully increase their efficiency, grow profit, improve communication and coordinate care for patients. To find out how, visit wellsky.com/home-health-software.
The Voices Series is a sponsored content program featuring leading executives discussing trends, topics and more shaping their industry in a question-and-answer format. For more information on Voices, please contact [email protected].