Is Your Non-Medical Agency Ready to Develop Value-Added Relationships with Home Health Agencies and Hospitals?

02/06/2025

For several years, Guy Tommasi, President & CEO of Corcoran Consulting Group (CCG) has been speaking about the increasing value that non-medical home-based care providers have to offer stakeholders (home health organizations, hospitals, ACOs, physicians, Medicare Advantage) through collaboration. We wanted to probe further into this strategic trend and understand what Guy sees as the future state for these collaborative opportunities.

Question: What is the trend that we should all be watching?

GT: Since 2016, whenever I speak to non-medical home care providers, I tell them that organizations, which seek to elevate their role as a supportive partner within the home and community-based ecosystem, need to embrace CMS’s Value-Based Program. Stakeholders incur financial penalties if their overall patient outcomes do not meet CMS thresholds. Non-medical agencies provide care that has a direct positive impact on these outcomes

Question: What are the categories of metrics that are catching your attention right now?

GT: There are five areas as defined by CMS that directly address Value-Based Care. These are: Rehospitalization, Functional Outcomes, Care team/Client Satisfaction, and the Social Determinants of Health. All stakeholders, especially Home Health Organizations and Hospitals, are impacted by these in varying degrees, but all of them contain elements which non-medical home care can influence in a positive way.

Question: Can you give a specific example of a metric for home health that a non-medical provider could impact?

GT: When you look at PDGM, the Patient-Driven Groupings Model, and how it affects home health reimbursement, you’ll see that having a positive impact on a patient’s Functional Impairment Level is a critical metric. Drilling further into this, you’ll see that the Functional Impairment Level is comprised of several variables, which include grooming, current ability to dress upper body safely, current ability to dress lower body safely, bathing, toilet transferring, transferring, ambulation and locomotion, and risk for hospitalization. When you step back and think about it, these are activities of daily living (ADLs) which non-medical agencies address routinely. We know that we can impact these areas directly.

Question: So, if non-medical agencies currently address these issues, what’s the opportunity?

GT: The opportunity is to stop doing this work in a vacuum. Non-medical agencies that want to differentiate themselves and get a seat at the table with home health providers who need help with these areas have got to track the data and be able to present their performance. Today, home health agencies are accustomed to tracking and reporting on metrics; their livelihood depends upon it. We’ve got to speak their language and show them what we can do! This is the shift we have to make in how we manage our non-medical care businesses. The non-medical agencies that stand out will be the ones that create their own opportunity by demonstrating, with quantifiable data, positive patient outcomes.

Question: Could you tell us about a similar type of metric that would resonate with hospitals?

Guy: The most commonly discussed metric with hospitals would have to be 30-day readmissions. Leading causes for rehospitalization are functional limitations, falls within the first 24-48 hours, high risk patients who do not qualify for home health care under the Medicare benefit, failure to see a primary care physician within 2 weeks of discharge, failure to follow prescribed nutritional and medication adherence. Once again, non-medical providers have always had a positive impact on reducing preventable readmissions, but can we prove it? Keep a dashboard record of how you are addressing the above issues and keeping your clients out of the hospital. Not just at the 30-day interval, but also 7-day. If we can demonstrate an ability to keep patients out of the hospital in the first 7 days, after a hospital discharge, this is a data point that can be a differentiator, as it demonstrates the up-front work you’re doing to ensure a safe transition home.

Question: How would you suggest non-medical providers approach potential home health and hospital partners?

GT: In both cases, knowing what is important to them is the key. I suggest non-medical providers do their homework. Learn about the key metrics for hospitals, home health agencies…anyone with whom you want to partner. Track your areas of performance that impact these metrics for at least three to six months and be prepared to speak to how your agency can help them, if you were to have mutual patients/clients. Propose a meeting with a decision-maker and share your dashboard. Have a goal in mind: more referrals from the home health agency? Perhaps the hospital referring to you for at-risk

patients who are going home with no service because they don’t meet home health criteria? Maybe a contracted rate for the hospital, who may find value in providing post-acute services to at-risk patients who can’t afford it? Start by showing your value to them in terms that are meaningful to them…that’s the differentiator.

Interested in learning more about this topic? Stay tuned to this newsletter to hear about upcoming webinars and future articles. If you feel you’re ready to begin embracing data and pursuing a strategy to differentiate yourself and create value-added collaboratives, CCG is ready to provide support. Whether it’s helping you develop your dashboard, identify differentiating key performance indicators or helping you to address operational areas that you want to improve, we’d be delighted to have an introductory conversation to explain further about how we can help you achieve your goals.