The relationship between Home Health Agencies (HHAs) and referrals from the acute sector is symbiotic – it affects both sides.
Expectations are increasing for both providers as health care trades the fee for service model for a quality model.
HHA’s must prove their value by submitting claims compliant with Medicare guidelines, keeping quality high while cost and LOS are low. Failure in any of these areas will result in decreased referrals, and ultimately losing market share and solvency in the industry.
Because physician’s compliance is also under review, physicians are paying more attention to the HHA orders they are signing. ZPIC investigators are including physician’s in audits where “medical necessity and homebound status” are questioned.
A growing number of physicians insist that HHAs use OperaCare to ensure patient acuity and service utilization are correct, protecting the physician from auditors while improving outcomes their outcome metrics as well.