The Future of Home Health Care: A Strategic Framework for Optimizing Value

Steven Landers, Elizabeth Madigan, Bruce Leff, Robert J Rosati, Barbara A McCann, Rodney Hornbake, Richard MacMillan, Kate Jones, Kathryn Bowles, Dawn Dowding, Teresa Lee, Tracey Moorhead, Sally Rodriguez, Erica Breese, Steven Landers, Elizabeth Madigan, Bruce Leff, Robert J Rosati, Barbara A McCann, Rodney Hornbake, Richard MacMillan, Kate Jones, Kathryn Bowles, Dawn Dowding, Teresa Lee, Tracey Moorhead, Sally Rodriguez, Erica Breese

Abstract

The Future of Home Health project sought to support transformation of home health and home-based care to meet the needs of patients in the evolving U.S. health care system. Interviews with key thought leaders and stakeholders resulted in key themes about the future of home health care. By synthesizing this qualitative research, a literature review, case studies, and the themes from a 2014 Institute of Medicine and National Research Council workshop on "The Future of Home Health Care," the authors articulate a vision for home-based care and recommend a bold framework for the Medicare-certified home health agency of the future. The authors also identify challenges and recommendations for achievement of this framework.

Keywords: home health; home-based care; hospice; hospital at home; palliative care; quality; technology; workforce.

Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Medicare value-based programs and authorizing legislation. Source. Avalere Health, 2016. Note. HHRP=Hospital Readmissions Reduction Program; HH-VBP = Home Health Value Based Purchasing model.
Figure 2.
Figure 2.
Medicare alternative payment models impact. Source. Avalere Health (2016). Note. ACO = accountable care organization; BPCI = Bundled Payments for Care Improvement Initiative; MSA = Metropolitan Statistical Area. aAvalere Analysis of BPCI participant list.
Figure 3.
Figure 3.
Strategy for innovation. Source. Eric Dishman, Intel Corporation (presented October 1, 2014, IOM-NRC Workshop on “The Future of Home Health Care”). Note. IOM = Institute of Medicine; NRC = National Research Council; ICU = intensive care unit.
Figure 4.
Figure 4.
Patients receiving home-based services and supports. Source. Bruce Leff and Elizabeth Madigan, 2014 (presented September 30, 2014, IOM-NRC Workshop on “The Future of Home Health Care”). Note. IOM = Institute of Medicine; NRC = National Research Council.
Figure 5.
Figure 5.
Spectrum of home-based services and supports. Source. Avalere Health, 2016.
Figure 6.
Figure 6.
The evolving role of Medicare home health. Source. Avalere Health, 2016. Note. APMs = alternative payment models; MA = Medicare Advantage; HH = Home Health Care.
Figure 7.
Figure 7.
Framework for home health of the future. Source. Avalere Health, 2016. Note. ACO = accountable care organization.
Figure 8.
Figure 8.
Capabilities of home health agencies for the future. Source. Avalere Health, 2016. Note. HIT = Health Information Technology.

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Source: PubMed

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