Optimizing Home Health Care and Home DME

The Challenge

Post-acute care is interconnected. Reducing costs in one area, without careful planning, can have unanticipated impact in another area. Reducing over-utilization of Skilled Nursing Facilities (SNFs), for example, must be augmented by carefully managed home care to result in lower readmissions.

An approach that integrates Home Health & Home DME is important to connect care across the post-acute care continuum – but many health plans do not have the resources to connect the silos that exist on a patient’s post-acute care journey.

Home Health expenditures are expected to grow to $157B by 2022¹

Demand for Home DME is estimated to reach $43B by 2019²

Waste and abuse is growing in these categories as well – estimated at $1.5B – $5B each year³

The CareCentrix Approach

CareCentrix provides scalable solutions for cost-effective, patient-centered Home Health & Home DME through a national provider network of over 8,000 locations. Our program helps connect the silos that currently exist on a patient’s post-acute care journey and allows them to heal where they want to be: at home.

The CareCentrix Home Health & Home DME approach:

Uses a “home first” methodology when possible, supports patients with the services they need to heal, and reduces risks attributed to institutional settings
Contracts and credentials with over 8,000 provider locations, including for durable medical equipment, home health services, home infusion nursing, and orthotics/prosthetics/supplies
Provides URAC-accredited utilization management and support through highly trained nurses and clinical teams
Reduces the risks and costs of fraud, waste, and abuse
Validates that patients receive the care they need to – by calling them 24 hours after care was expected to start

Provides expertise and experience
- Coordinated more than 1 million home health visits in 2016, and more than 4 million orders for home medical equipment
Delivers care on time
- CareCentrix meets the start-of-care date over 99% of the time

Coordinates services and eliminates silos
- The average patient leaving the hospital may need between 3 and 4 services delivered in the home, usually provided by different agencies
Reduces fraud, waste, and abuse
- CareCentrix estimates up to 10% of current spend may be detected as fraud, waste, or abuse

Leading Home: Using Big Data to Improve Care at Home

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Sources:

Centers for Medicare and Medicaid Services, Office of the Actuary.
http://www.harriswilliams.com/sites/default/files/industry_reports/DME%20Industry%20Update.pdf
http://www.bio-medicine.org/medicine-technology-1/NICB-Report-On-Durable-Medical-Equipment-Fraud-30000-2/

If you have difficulty understanding English, we offer language assistance and interpretation services at no cost to you. For help, please call 1-844-359-5381. If you have hearing or speech loss and use Telecommunications Relay Services (TRS) or a Text Telephone (TTY), dial 711 to connect with a TRS operator.

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CareCentrix maintains a drug-free workplace.

Home Health & Home DME

The Challenge

The CareCentrix Approach

Benefits

Provides expertise and experience

Delivers care on time

Coordinates services and eliminates silos

Reduces fraud, waste, and abuse

Featured Resources

Leading Home: Using Big Data to Improve Care at Home

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