Executive Outlook: On California’s challenges in long-term care coordination

Mike Townsend, COO of HomeHero, joins us as a guest columnist.

Our new series Executive Outlook provides a forum for healthcare leaders to share insights. Townsend reflects on how technology is filling a gap in care coordination to give cost-effective benefits to millions of seniors in California. 

 

Mike Townsend: COO, Home Hero

Mike Townsend: COO, Home Hero

One of the biggest problems I see in the health care industry is a failure of many hospitals and healthcare providers to efficiently coordinate and utilize in-home health care services.

Although the Hospital Readmission Reduction Program (HRRP) provision in the Affordable Care Act penalizes hospitals with unusually high readmission rates (that is, patients returning less than 30 days after being discharged), there’s still plenty of work that needs to be done. For example, an analysis by the Kaiser Family Foundation showed roughly 78% of hospitals in the United States received penalties through the HRRP.

I see this very often when working with senior citizens.

According to the American Physical Therapy Association, nearly 1 in 5 Medicare patients discharged from hospitals are readmitted within 30 days. That’s 2.6 million senior citizens incurring a total of $26 billion in healthcare costs annually.

ACA introduces major changes to Senior Care

The Affordable Care Act (ACA) has brought about the most significant changes to the senior care space since the introduction of Medicare and Medicaid back in the 1960s.

There are a handful of provisions that directly benefit seniors’ quality of life and make it possible for more of them to afford in-home caregiving services.

First and foremost, the Community-based Care Transitions Program (CTTP) and the Hospital Readmission Reduction Program (HRRP) work in tandem to provide higher quality of care for seniors leaving hospitals and penalizing healthcare facilities with abnormally high readmission rates.

While in-home caregiving has always been beneficial to a senior’s physical and mental health, both before and after they enter the hospital system, there’s now an added incentive for hospitals to really address this issue.

Many seniors also have extra money in their wallets thanks to a provision in the ACA that provide subsidies to low-income individuals and another that closes the “donut hole” problem created by the Medicare Modernization Act of 2003.

Technology is leading the way in new coordination efforts

But perhaps the biggest change to senior care I’ve seen comes not from the healthcare industry, but from tech — specifically the introduction and increasing affordability of smart devices (such as phones and wearables). Every year, I’m seeing new software and devices making telehealth a very real and affordable option for many seniors.

When you decentralize healthcare services from their traditional brick-and-mortar institutions, it opens the door for marketplace disruptors to create streamlined solutions for everyone who engages the healthcare system.

For example, it may have taken families days — or even weeks — to work with an agency to find a caregiver and match them with their senior loved ones. But now companies like ours operate much more leanly, helping families find caregivers the same day they need them with a matching algorithm that finds a high-quality caregivers in a matter of minutes.

Due to the drastic changes brought on by the ACA and the increasing affordability of digital products, I expect to see hospitals and tech startups working together in new, interesting ways to address our nation’s biggest healthcare challenges. This is already happening in California.

Non-medical caregiving services are critical to preventing readmissions. When caregivers and healthcare professionals establish a dialogue, facilitated by technology, we’ll be one step closer to securing a sustainable, efficient healthcare system.