Home-based care providers face increasing demands from payers and referral partners — but still must remain selective about which relationships fit their businesses while leveraging new technology.

Winning those relationships increasingly requires rapid referral responses, timely starts of care and granular data. But providers also need the clinical capabilities and compliance infrastructure to meet partners’ expectations without pursuing growth outside their areas of expertise.

Payers and health systems, particularly those selecting preferred providers, increasingly expect home health providers to accept referrals within seven to 10 minutes, start care within 24 hours or the same day and have the clinical alignment and expertise to manage their patient populations, Dean Alverson, CEO of LifeCare Home Health Family, said at Home Health Care News’ FUTURE conference.

“If you don’t have all the disciplines, you’re going to get left out,” Alverson said.

Irving, Texas-based LifeCare Home Health & Hospice Family’s services include skilled home health, private duty and personal care services and hospice care. It operates in Arizona, Texas, Florida and Nevada. It operates under several additional brands.

Payers and partners will want access to meaningful data, Alverson said, including how many patients are rehospitalized because of medication errors or voids. Without such data, providers can lose a seat at that payer’s table, he said.

“You’re going to have to get granular,” Alverson said.

Meeting those expectations also requires embedding compliance into everyday operations, according to Jamie Davis, owner of Cornerstone Medical Supply.

“A lot of people have their compliance week, they’ll have their compliance day, but it’s not embedded in the business,” Davis said. 

Cornerstone Medical Supply is a durable medical equipment supplier. The company provides medical equipment, orthotic braces and patient care supplies across the Midwest.

While providers aim to keep up with changing expectations, they must also be strategic in their relationships. It’s critical to not chase every payer source, Aaron Marcum, co-founder of Riverside Home Care, said.

This also comes into play when considering growth through M&A.

“We do a lot of private pay and VA, [so it’s] really making sure that we’re not getting too far outside our wheelhouse,” Marcum said. “And also for us in our de novo [growth], to make sure we stick to what we’re really good at.”

Fort Collins, Colorado-based Riverside Home Care provides personal home care, companionship, respite care and specialized care in Colorado and Wyoming.

Technology as a strategy

Providers are also using technology to improve patient care, create capacity and support performance under value-based reimbursement.

For LifeCare, AI technology has already made a meaningful impact. Scribe technology allowed the company to slash its start-of-care time from about two and a half hours to about 45 minutes, Alverson said.

“We want to reinvest a piece of that time savings back into the patient,” Alverson said. “Spend more time with the patient.”

Spending more time with patients improves customer service, he said, which affects value-based purchasing reimbursement. He also described the potential for clinicians to complete four or five starts of care a day instead of three. 

The technology also increases capacity, which requires business-wide coordination. Alverson said LifeCare has pushed its sales teams to generate referrals to fill that additional capacity. Clinicians can also benefit financially because LifeCare pays its home health staff per visit. 

“Anything we can do to create capacity has to be shared with the employees,” Alverson said.

While LifeCare currently uses AI technology not provided by its EMR provider, Alverson would prefer fully integrated tools within its electronic medical record system.

The company has also built flexibility into third-party technology contracts, allowing it to move to better solutions as they become available, he said.

Alverson expects current EMRs to eventually be replaced with more AI-friendly, fully integrated options.

Still, providers should look to current EMRs to maximize their investment, Marcum said.

“The first place to look when it comes to AI solutions is the EMR,” he said. “What are they currently doing?” 

Providers should understand both existing capabilities and vendors’ plans for the next three to six months before purchasing additional tools, he said.

“First, tap into what you’re already paying for, right?” Marcum said.

For Davis, the human element cannot be overlooked. Subject matter experts are essential to understanding AI compliance, risk and impacts, she said.