Innovative Tools States are using in Long Term Care and the Implication for HCBS

Transcription

1 Innovative Tools States are using in Long Term Care and the Implication for HCBS

2 State Risk-Mitigation Strategies Strategies states are using to mitigate the inherent risks of logistically dispersed home based programs Assure beneficiaries receive care during the early transition from institution to community Improve the level of data from the field and provide these systems while co-opting the service providers as strong and cooperative stakeholder partners. Stop fraud, abuse, and waste Future!: Examine the impact of social media in homecare

3 Moving LTC into the Home and Community The People: Recipients, Beneficiaries Basic HOUSING HOME AND COMMUNITY BASED SERVICES Pillars of Care MEDICAL CARE TRANSPORTATION +IT

4 Leveraging Technology Efficiencies Improve data Accountability for service plans Cessation of FAW

5 Moving LTC into the Home and Community Costly Readmission Rates = Need ACT

6 Acute Care Transition Care Transition Program designed to coordinate and manage the transition of individuals from the Acute Inpatient setting to the Home & Community Setting. Not case management, discharge planning or home health. Is patient advocacy, education, communication and coordination. Driven by a Coach and supported by Care Support Representatives with technology. Interaction with patient: Face-to-face during inpatient admission Face-to-face at Home post discharge (48 72 hours) Telephonic, day 2, 7, 14 & 30 post discharge

7 Managed LTC Objectives Improve LTC statistics Incremental rather than sweeping change Improve program funding cycles Reduce confusion Expand services Benefits / Outcomes Align incentives Encourage home and community based care rather than LT institutional care. First year nearly double services in HHC Patient-centric model

8 TENNCARE TENNCARE Outsources administration of Medicaid program to three MCOs SPM Program funded jointly by the state and the MCOs State uses SPM to: Review activity across all three MCOs Audit trails Benchmarking Reporting and analytics Managed Care Org s Each MCO contracts directly with Sandata MCOs include: MCOs use SPM to: Review activity across all contracted providers Manage safety net Audit trails Reporting and analytics Home Care Agencies 300+home care agencies 600 concurrent users Agencies use SPM for: Scheduling Verify visits Billing Payroll

9 FL AHCA In 2009, the State of Florida passed a bill for a pilot mandate to monitor home health services in Miami-Dade County The bill requires Medicaid home health care agencies to utilize electronic claims submission and verification of visit records telephonically, using voice bio-metrics Solution was called: Delivery Monitoring and Verification The bill also required a third party assessment process Miami-Dade, Florida has systemic and high levels of fraud and abuse Based on a competitive RFP process, independent vendors were selected The pilot involves 369 home care agencies and 14,000+ members Program launched on time July 1, 2010, 90 day implementation and without change orders

10 Does Social Media Play a Part? National EHR, HITECH, electronic exchange, SW and IT HW infrastructure spending Seniors are a savvy technology population Increasing reliance on technology in order to optimize resources Meet government regulations Meet consumer needs Social networking is a key component within US business and the home health arena

11 Key Statistics 60 million consumers now use new media to share their health experiences online 391 US hospitals have You Tube channels 132 US hospitals maintain Twitter accounts 631 US hospitals have Facebook pages Approximately 1,200 Facebook communities advocate for cures for chronic illnesses 72% of e-patients search for medical information right before or after a doctor's visit 93% of e-patients say the Internet has made it possible to get the medical information they need

12 Social Media allowed, but the public interactive features of social networking sites must be disabled (if PHI content is included). Interactive features such as chat, messaging, blogging, or wall discussions Features encourage ongoing interaction with beneficiaries which, by their nature, are not reviewed by the plan sponsor in advance and could not receive CMS prior approval. Sponsors cannot use social networking sites as a means to initiate unsolicited contact The bottom line: Information posted by health care companies should be prepared for public consumption and each organization engaging in social media should have policies and guidelines related to social media and online communications in place prior to deploying these technologies.

13 Some Organizations Social Media Policy Block all social networking sites Protecting HIPAA and IP: i.e. Tweets that are HIPAA violations creates risk for the organization. Detracts from productivity Protect against cyber warfare Social Networking Worms Botnets Phishing Advanced Persistent Threats Trojans Cross Site Forgery Data Links Impersonation Shortened Links Trust

14 An Unstoppable Trend Highly-qualified Millennials (born between 1980 and 1995) simply won't work for companies that don't allow networking. Cell phones have overtaken computers as the most popular means by which people connect. Peter Sondegaard SVP of Research for Gartner innovation today happens at the user level; it's an unstoppable trend, and policies that try to inhibit access to the Internet are losing strategies.

15 Blogs Blog: Allows you to publish content and distribute that content to social media sites and other URLs. Communities can share your content with their friends, driving traffic back to your blog and website organically Legal and policy issues in home care Care blogs to watch

16 Social Media

17 Facebook Excess of 550 million active users Users with an account can follow and engage personally as well as with your company Some examples: Illinois Homecare Counsel Kansas City Homecare Home Sweet Home

18 Twitter Twitter: Micro blogging (140 characters); can be used to broadcast news and information about your company, foster two way communication, recruiting, and building brand awareness Over 145 million user accounts with 40 million new accounts in the past 4 months I use Twitter to stay in contact with my peers, referral sources, and local contacts. I read articles and post information about events we take part in, company news, and networking opportunities Noelle Kurth, Marketing Director for At Home Personal Care in Mesa, AZ

19 LinkedIn LinkedIn: A worldwide professional network (75 million users) to share content, post job openings, research prospects, join industry groups, participate in forums, scan industry news 149,949 people are in Home Health people search 689,887 people are in Healthcare people search

20 YouTube YouTube: Exceeds 2 billion views a day 24 hours of video uploaded every minute Average person spends 15 minutes a day on YouTube More video uploaded in 60 days then the major networks created in 60 years 70% of traffic outside US

21 A small sample of the social networking sites out there

22 Best Practices Provide value through social media Develop a social media strategy with policies Understand you cannot control the message, but you can monitor it Understand that social media involves two way communication Except the reality of social media Welcome participation, feedback and co-creation High Standards, Strong Outcomes, Clinical Best Practices and Quality Process Improvements Operational Excellence and Financial Growth SmartPhones, SmartTools, Clinical PDA.best practices help us shape that future.

23 Getting Started Check out blogs where your colleagues and stakeholders hang out. To find blogs that are the favorites of your potential interest areas, do a search of your keywords on Google Blog Search. Set up a personal profile allow someone to be the face of the agency or departments. Become familiar with the way these sites work learn where your stakeholders are communicating. Set up user profiles for your organization at all the major community social media sites. Include a link to your website and a short introduction to what your business does in your bio. Keep it informative and friendly. Once you've set up your organization profile on a site, do searches there to find users and groups that relate to your organization, mission, and vision. An easy way to do this is to enter keywords into the search bar and see what comes up!

24 Getting Started Add yourself to communities that share common interests with your business by joining groups, and "following" like-minded people or requesting them as "friends." Spend some time checking out what types of conversations and discussions are going on between your new friends, and in your new communities, then join in the discussion when you've had a chance to gauge the tone and activity there. Social Media is an amazing yet overwhelming tool use it!

25 Social Networking What exactly is social networking and how does it affect Home and Community? If utilities, could we measure a return on investment? In what instances would Social Media and Networking make sense and create value? How would stakeholders react to our new plan?

26 Live Great!