As hospital-to-home health referrals continue to climb, provider acceptance rates remain low, a new report from WellSky found.
WellSky’s latest report pulls data from the company’s network of more than 2,500 hospitals, accountable care organizations (ACOs) and physician practices, as well as 130,000 providers across the country. WellSky is an international software and professional services company.
Overall, the report shows that securing timely post-acute care options for patients is a pain point for hospitals. Even though home health referrals increased by 6%, acceptance rates were only 34.5%.
Tim Ashe, chief clinical officer at WellSky, believes that this is the biggest challenge the health care system is currently facing.
“Demand is increasing, patient acuity continues to expand, and then you layer in the workforce challenges and the supply side constraints that those shortages present, and you have a capacity problem in the post-acute markets, including home health,” he told Home Health Care News. “The 34.5% acceptance rate is really indicative of home health organizations wanting to take those referrals, but in many instances they are constrained either by supply, availability, capacity in general, or the ability to take on particular payers.”
Ashe noted that this is a “troubling dynamic” creating a bottleneck across the system.
“Patients need the level of care that home health provides, yet the capacity to care for all of those patients is constrained,” he said.
The report also found that patients discharged to home health care saw a 7% increase in average hospital length of stay.
“While home health agencies want to accept these referrals, they can’t, and so these patients are sitting longer in the hospital,” Ashe said.
Ashe pointed out that these challenges were an opportunity for providers to continue to seek out technology solutions that improve care planning and deployment.
Along these lines, the report also came to the conclusion that generative AI and predictive analytics could be a gamechanger.
“We see the implementation and integration of AI capabilities being a good fit inside of the provider’s workflow,” Ashe said. “It has to be intuitive. And it has to be done in a way that is part and parcel to the clinician, or the provider agency, being effective and efficient in how they’re scheduling, how they’re planning and how they’re deploying care. Ultimately, that leads to them being more enabled to provide higher quality care, and a higher volume of services to more patients.”
Ashe emphasized the importance of using these solutions to automate and eliminate administrative burdens, in order to improve access to care.
The report also highlighted some of the regulatory shifts taking place in the health care market, including the Transforming Episode Accountability Model (TEAM), ACO Primary Care Flex (ACO PC Flex) and the Making Care Primary (MCP).
“All of these regulatory changes and models are shifts and require us to educate ourselves, to prepare and make sure that we’re able to meet the requirements that CMS introduces,” Ashe said. “I see it as a positive and continued movement towards value-based care. At the end of the day, that improves quality. If done right, it reduces cost, which is a critical aspect to making sure that we have a sustainable health care market going forward. Ultimately, it’s the right thing to do for patients.”
Companies featured in this article:
