CMS requires hospitals to provide patients being discharged with a list of home health providers in the area in addition to information about important metrics, such as quality measures, so patients can make informed decisions. The Office of Inspector General (OIG) is going one step further: requiring hospitals to identify any home health providers in which they have a financial interest and vice versa.
Though patient provider choice has always been sacrosanct, the reality gets a little hazy when the patient is facing imminent discharge. Hospital planners receive the order for home health and often proceed to make those arrangements guided by the patient’s insurer and list of participating providers. They then have been known to present these discharge activities to the patient as a fait accompli because – let’s face it – most patients don’t usually have a preference on home care providers.
This article in Home Healthcare News echoes the anecdotal experiences of many home care clients: hospitals steer patients to those agencies in which they have ownership or receive some sort of financial benefit. This, of course, poses a huge issue to providers who are not affiliated with the hospital and who have long decried the lack of a level playing field for years.
Financial pressures (in revenue, market share, readmissions, etc.) have resulted in hospital systems controlling as much of the service delivery chain by vertically integrating services and owning more pre- and post-acute providers. One can argue that this practice would make for a more seamless transition, for the patient’s benefit and overall health, but the end result can limit competition to the detriment of the system a whole.