Driving volumes is a primary consideration for a post-acute provider’s financial viability.However, as the health care market transitions away from fee-for-service and toward value-basedreimbursement, post-acute providers must ensure their selected specialties are attractive to referrerstaking on risk.

In the context of value-based care, one of the main drivers of value is care quality. While care protocols set a foundation for high-quality care delivery, they are not a substitute for clinical experience and expertise.

Continue reading to learn how one home health provider paired their generalist staff with specialty experts to improve care efficiency. For more tactics to build and support specialty lines, download our research report excerpt: 10 Tactics to Ensure Specialty Return on Investment, Part 2.

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Specialty expertise can be especially challenging for home health providers, who are typicallygeneralists out of necessity. Home health nurses typically manage geographic areas and must beprepared to care for all patient types nearby. This type of assignment improves efficiency byminimizing nurse travel time, but it reduces nurses’ ability to deliver specialty care once a patientreturns home.

MedStar Visiting Nurse Association, a home health provider associated with the MedStar Health, has solved this challenge by assigning each nurse manager to a clinical specialty area.At MedStar, home health nurses are assigned to patients geographically, but they arematched with a different manager based on each patient’s clinical presentation. This gives thenurses easy access to a specialist in the patient’s primary condition, delivering specialty carewithout being specialists themselves.

Case study: How one SNF unlocked $472K in Medicaid reimbursement

Two components ensure MedStar’s manager assignment structure results in excellentspecialty care:

1. Managers must be true specialty experts. They are assigned to specialties based on previous experience, certifications, and skills, making certain they can coach home health nurses through the complex challenges unique to the patient type.
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   Market update: Trends in readmission rates

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3. Nurses must have real-time access to their assigned managers. At MedStar, the correct manager is assigned by the system’s EHR based on each patient’s most acute or circumstantially relevant condition. The assigned manager’s contact information is auto-populated, and the manager can view the nurse’s documentation in real time. All nurses carry work-issued secure cell phones to create a direct link to the manager, enabling the nurse to call the manager with any questions and even send photos as needed.

These connections ensure specialty care is delivered seamlessly across the entirety of the healthsystem, strengthening the relationship between the hospital system and VNA.

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