Given the common goal of closing the care gap, home-based primary care providers should be natural allies of home care providers. Some organizations do, others don’t.
Emily Cook, CEO of Wellcome Health, SCAN Group’s home primary care medical group, believes the fragmented nature of the healthcare sector makes it more difficult for healthcare providers to build rewarding relationships. increase.
“We all work in our own little silos and don’t really understand each other’s incentives and challenges,” she told Home Healthcare News.
Welcome Health provides primary care, preventive care, chronic disease management and more in the home. The company infuses its model of primary care with geriatric principles, and some of Wellcome Health’s doctors are geriatricians.
Welcome Health often works with home healthcare providers. At least half of the organization’s patients receive home health care services for some time to help resolve current clinical problems.
Primary care physicians view home health care as an extension of the care they provide, Cook said, but that doesn’t always translate into harmonious working relationships.
“Nurses and therapists who see patients at home don’t necessarily reach out and strategize with primary care physicians,” she says. “If our primary care physicians have a different desire for home health care than we have today, it’s that they see our primary care physicians as quarterbacks, and It just means they know we care about their work and want to interact with them.”
Due to the fragmented home health care market in California, establishing referral relationships with home health care providers can be difficult.
“We’re in Los Angeles and Orange County, but we’re expanding to other parts of California,” Cook said. “With fewer big players in California, I think it will be easier to involve our systems and models of care in those home health organizations.”
Different payment structures are also an obstacle, as Wellcome Health is paid for through value-based arrangements and most home health care is covered by Medicare service fees.
However, that could change soon.
Cook believes there is still room for improvement in the relationships the organization already has with home care providers.
“We really need to spend time designing how we’re going to work together,” she said. “Ultimately, moving away from the referral mindset can lead to stronger relationships and better care in the long run.
“Ask a different question than just wanting to secure a referral,” says Cook. “The question is, how can you become part of your organization’s mission and design?”
Home health care struggles in rural America
As an in-home primary care provider, Homeward has a very specific focus as an organization. Its mission is to restructure healthcare delivery, especially in rural areas across the United States.
“If you’re a rural American, you’re going to experience significantly less outcomes than you’d be in an urban area,” Homeward President Amar Kendale told HHCN. “As an example, we are talking about a 20% increase in mortality rates. There weren’t enough people, there wasn’t enough capacity.”
In addition to this, people living in the United States already have limited access to effective primary care. Rural areas have been hit hardest, Kendale said.
“There are about half as many primary care providers in rural areas as there are in urban areas, and about one-eighth as many specialists,” he says. “In a way, it’s a double whammy.”
Because of Homeward’s focus on addressing rural care shortages, there is often a shortage of home care providers in the communities it serves.
This means that organizations are less able to work with home care providers than they are with the healthcare system, for example.
In general, home health care providers often face difficulties operating in these areas. Retention of the workforce, limited access to the internet, and limited access to long-term support and service providers all contribute to disparities in access to rural home health care.
Kendale believes that such encounters between home health care and Homeward are rare, and that mutual promotion of stronger technology solutions could be a potential bridge.
“We’re thinking about how drugs will be administered, but we don’t have a lot of technology to support the way people deal with it today,” he said. “Given how complex chronic diseases and multiple chronic conditions are managed, there is not much that is helping people today. I believe we are at the dawn of permeation.”