An interesting whitepaper from NavCare shed some light on the importance to the bottom line and patient outcomes of virtual visits and associated technology. In 2020, the perfect storm hit home care: the phasing in of the Patient-Driven Groupings Model (PDGM) and the COVID-19 pandemic. Declining patient visits and census due mostly to patients’ fear of exposure to COVID, scarcity of personal protective equipment (PPE), staff reluctance to conduct in-home visits and just the general effects on patient care (hospitals, physician practices, etc.) have profoundly threatened the very survival of home care agencies.
Although virtual visits cannot replace face-to-face (F2F) visits, a few changes due to COVID can be leveraged into positives for the industry.
Virtual visits for PCP F2F Encounters
In the past, home health agencies have had difficulty obtaining the required F2F visit from the patient’s primary physician. Without the documented visit, agencies could not bill Medicare. Virtual visits have lowered this burden. The article uses an example of a nurse setting up the patient’s virtual F2F visit and then attending the visit so as to dialogue with the clinician and receive his or her specific orders for home care. This delivers a win-win for everyone: the patient doesn’t need to leave his/her home; the nurse can dialogue directly with the clinician while expediting the agency’s billing; and the clinician can see the patient’s living environment, address any issues with the nurse in “real time,” and know that he or she has truly partnered with the agency on behalf of the patient.
Relaxed Homebound Requirement
Because of the pandemic, CMS has added to the homebound definition: patient feels at risk for contracting the virus that causes COVID. As the author states, “This essentially opens the door for any patient to be considered homebound.” For patients who may be postponing needed care, or whose families live far away and cannot travel during the pandemic, this development is a true game-changer: a professional can more readily evaluate mom or dad and coordinate needed care in the home.
Efficient Augmented Care
Virtual visits from certain home health agency professionals can supplement F2F visits in important ways that also happen to be cost-effective for the agency. Virtual technology can be employed to monitor a patient’s vital signs and virtual patient “check-ins” can allow a nurse, for example, to more frequently follow-up with the patient about his or her care. Therapists can also assess, for example, whether the patient is properly performing in-home exercises, which would normally require more frequent visits to the home. Virtual-ness, according to the author, makes the visit more efficient in staff travel costs and time, and also cuts down some of the chit-chat that occurs during a F2F visit, thereby expediting the encounter.
Improved Patient Satisfaction
Sometimes patients don’t want multiple home visits from all the professionals involved in their care, as is the case with my parents. COVID has exacerbated those feelings as primarily the elderly also fear exposure. Being able to touch base virtually to check on the patient’s progress toward his or her goals can still be accomplished with less hassle to the patient.
The article concluded that virtual visits represent a valuable tool in the home health bag and the author expects they will remain a key component in home health’s future.