Post-Pandemic: The Rise of Post-Acute Care, Key Panel Takeaways

Published in Member Communities on September 30, 2020

“Don’t Let This Be Forgotten” 

Clint Geffert, President, VGM & Associates 

What an unbelievable time in history we are dealing with. COVID-19 has upended our economy, supply chains, public safety nets and the entire healthcare continuum. Across the healthcare industry, stakeholders have rapidly and drastically begun to respond by leveraging technology, refining workflows, and encouraging new behaviors. 

On one hand, this experience has revealed the profound risks of disconnected or disjointed systems and methods. On the other, it has amplified the demand for tools that help adapt to change or disruption. It calls for strategies that sustain a long-term effort of transformation with predictive, holistic views that can anticipate market demand and short-term pivots. 

While we all work together to prepare for another surge or recover from the immediate aftermath, it is without question that we are forever changed. Healthcare leaders have been grappling with industry overhaul for some time, but the danger and breadth of this pandemic has accelerated change at previously unseen speeds. As uncertainty abounds, leaders should look for key indicators with a comprehensive view that can best anticipate the future environment and guide intelligent action. 

I recently moderated a panel for the HME News Business Summit with the industry’s largest players that discussed the role HME providers played in keeping patients with milder cases of COVID-19 in their homes and acting as the pressure-release valve for overwhelmed hospitals. I was joined by Dan Stark, CEO of Apria Healthcare, Steve Griggs, CEO of AeroCare, Luke McGee, CEO of AdaptHealth, and Crispin Teufel, CEO of Lincare. Has the larger healthcare industry finally learned the value of post-acute care? What needs to be done to make homecare more of an option for more patients? How should providers position themselves in a post-pandemic environment?  

The panelists did such a nice job answering these questions (and more), I wanted to provide the key points that I took away from the session: 

Telehealth/Virtual Health 

One of the biggest changes seen in post-acute care since March is the embracement of telehealth through relaxed guidelines by CMS. Telehealth has been accelerated in HME through enabling patient contact through video or phone, virtual set-ups, home sleep testing, and remote patient monitoring. Everyone agreed that we do not want to see CMS put telehealth on the sidelines, nor do they see it going away. Telehealth can play a huge role in rural communities for access to care. 

PPE Lessons 

Early on it was clear that PPE would be something we’d look back on and realize was a miss all-around. While keeping, storing and using PPE prior to COVID-19 was more relaxed, this should not be the case in the future. The PPE learnings will make us stronger moving forward. 

Value of Home…and Local 

There are certain hot spots in the country where large hospital systems would have failed if not for the HME community. The HOME part of HME means something now more than ever, and the role the industry plays is more important than ever before. Collectively, we have proven that over the last six months. We found out in the process that supply chain independence, nimbleness, and local service mattered. HME providers are a vital part of the care continuum equation: monitoring patients in their homes, alerting others when to intervene, and connecting with patients as true partners in care for perhaps even multiple chronic conditions. HME is more than selling a product or shipping a box. During this pandemic, patients have proven that they are still yearning for connections and service, so providers need to continue to enable care in the home in whatever way a patient needs or wants it.  

Opportunity in Sleep, Supplies, and Other Chronic Conditions  

The COVID-19 pandemic accelerated trends that some providers were already persisting. This includes but is not limited to more at-home sleep testing and focusing on other chronic conditions that can be cared for in the home and have a resupply component, such as sleep apnea, COPD, and diabetes. Diabetes was mentioned several times by panelists as it presents an opportunity for resupply and can have comorbidities with sleep apnea. One panelist said, “We are choosing to do resupply really well.” Another said, “We help keep people at home that already have chronic conditions. We are no longer the equipment jockey as thought of in the past and we can make a point that we are more than that.” 

Digitization and Technology  

Digitization of your business should be a priority. Offer remote services and increase digital offerings, virtual set-ups, connected care and monitoring, as well as the ability for your employees to work from home (this will not go away – it is the most fundamental change for employees moving forward).  

How do we think about a world in a more technologically savvy environment in the future? Panelists urged all providers to accept, embrace, create, and expand our use of technology. To alleviate administrative costs in the system, the cost structure must change from throwing more people to investing in technology and utilizing people where patients need them most: care.  

When it comes to patient adoption of technology, one panelist exclaimed, “We need to stop lying to ourselves; these patients want this! We need to deliver and not fall back on what is easy. The expectation is that patients want technology.” The pandemic has shown how important anything online has become. Most patients want digital interaction and offerings. While some may need some hand-holding, others do not. One of the most important things a provider can do is educate their teams to get patients over the initial hesitancy or fears. “The burden is on us as the provider to get them over the fence at the beginning.” 

Legislative/Regulatory Landscape: We Have Power in Numbers 

I thought it would be most impactful to quote the parting comments from the panel. Here are some of the thoughts that the panelists had regarding the changes we all want for the HME industry and how collectively we can influence these changes.

Everyone in the industry must decide to allocate some of their own personal time to get involved. This can come in multiple ways, with local health systems, state Medicaid, get involved with state (at minimum) and national associations. The HME message can't come from just a few people, we can't just rely on everyone else. Two to three hours per month will make a big difference if all those voices are out there being heard.

I urge everyone to e-prescribe more. If we work together as an industry, we can drive change. Talk to referrals about leaving the fax machine behind. There needs to be reduction of administrative costs in the system. If we can show CMS these administrative costs, we may be able to keep some of the margins for ourselves.

Competitive bidding driven by the pandemic and blended rate in rural areas are the two biggest issues we've been tackling. This is the worst point in time to proceed with competitive bidding as it was designed. The ask is to delay, not for forever, but this is not the right point of time, as we cannot limit capacity now. There is no rule yet on what is going to happen. Keep buckled up to see what is going to come. [Industry groups] have done all that is possible to talk to every side/address stakeholders and now we can just hope they understood the concerns we all have.

The way to sustain this industry through price pressure is reducing the administrative burden.  Everybody has way too many people involved in paper processing and billing and collections, rather than helping patients. Whenever we get competitive bidding news, as an industry how do we work to change that level of administrative burden? And I'm hoping that what comes out of the pandemic is that CMS also realizes that it doesn't have to be the way it used to be.

Never waste a good crisis. Most of the people we work with or receive business from have a short memory about good things and a long memory about bad things. What was done in the places with huge surges but no hospital distress because of home care companies – those stories need to be told. The work everyone did to step into the breach really bailed out the system and we should all feel good about talking about that moving forward – don't let this be forgotten!

What is your pandemic story? We’d love to hear it and help you share it. Contact VGM to share. 

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