Bon Secours Hampton Roads Health System has long been an advocate for those without a voice, this time the local health system is speaking out for patients who need home care. Obtaining high quality care in the home may become more challenging for patients with decreasing Medicare payments, escalating technology costs and government budget cuts.
Bon Secours Home Health Manager, Terry Tranbarger recently invited Congressman Scott Rigell, Second District of Virginia, to see firsthand the challenges facing home health care in Hampton Roads. Meeting at the Virginia Beach home of patient John Nederostek, Ms. Tranbarger, Congressman Rigell and Sharon Slawta, RN, discussed how the budget reductions could have an impact on care.
Ms. Tranbarger says, “Congressman Rigell was very receptive. He really got it. He asked me to put together a report summarizing the budgeting challenges we are facing in home health care.” She says the primary issues threatening the home health care industry are Medicare regulations and reimbursement reductions, while keeping up with life-saving technology.
Bon Secours Home Care uses two essential technological systems to provide
the highest quality care to homebound patients. These are telehealth, a high-tech monitoring system placed in the patient’s home to alert the medical staff of any variation in the patient’s vital signs, and ConnectCare, an electronic medical records system linking all patient information into one record. Ms. Tranbarger says, “Telehealth is worth its weight in gold because it tells us if there is a change in the patient’s condition even if a nurse isn’t present.” Bon Secours has been using telehealth for five years, longer than any other hospital system in Hampton Roads. The system relies on computers, software and the people to maintain them, all of which are expensive.
Medicare regulations also contribute to the challenges of providing great care, along with declining reimbursement, and the additional paperwork and regulations designed to thwart Medicare fraud. According to Ms. Tranbarger, nurses now have to spend half of a patient visit completing paperwork, leaving less time for patient care.
Another challenging Medicare regulation is scheduled to take effect April 1, 2011. The new law requires the homebound patient to be seen by a doctor face-to-face within a specified time or the home health care provider will not be compensated for the services. This new regulation places an additional burden on homebound patients to find a way to get to their doctor’s office or find a new doctor willing to make house calls. If visiting doctor is found, that doctor then becomes the patient’s primary physician, meaning any long-standing physician-patient relationships will have to comply with the regulation.
Ms. Tranbarger says, “Home health care is an extremely vital service, saving the health industry millions of dollars each year. If it were not available, people would have to stay in the hospital longer or go to long-term care facilities. Losing it to budget cuts would be tragic.”