Home Health & Home DME

We never lose sight of the fact that patients never lose sight of home.

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.

man playing boardgames
  • 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
nurse with elderly patient

Benefits

  • 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

Need expertise to manage Home Health or Home DME?

Sources:

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