2023 home care predictions, part II: Technology and regulations

Part one of this series?focused on the people-centric approach the home care industry is taking in 2023 — a nod to personal elements, ranging from the continued shift to person-centered care to the calls for better compensation and empowerment of caregivers. This second and final installment will cover the reasons why home care in 2023 is expected to assume a new shape, largely influenced by industry developments centered on technology and new legislation. Armed with the right innovative tools and regulatory support, the home care community is poised to rise to the next level. Here are our technological and regulatory-based predictions for home care in 2023:

Prediction No. 1 – Effective home care hinges on the evolution and acceptance of technology.

As the healthcare community becomes more comfortable with technology — including AI and predictive analytics — it will be increasingly integrated into home care and hospital-at-home programs, supporting enhanced communication among providers to allow close coordination around the delivery of higher acuity services in the home. These technologies offer great potential to support proactive care by monitoring individuals and capturing real-time data that can be used to spot trends and improve outcomes, all in the comfort of members’ homes. Connecting home care data to electronic health records (EHRs) and health systems with social services will also help to ensure continuity of care.

Additionally, home care agencies and payers will look to use data insights delivered by simplified reporting to gain greater visibility into industry best practices in order to compete and grow. Benchmarking tools that allow for metric comparisons will enable agencies to see how their peers within the industry are performing so they can establish whether they are behind or in-line with the targets. Using metrics, agencies will look to gauge their progress on a variety of facets, including electronic visit verification (EVV) compliance and caregiver timeliness, authorizations, missed visits, short visits, billing trends, HR and caregiver compliance, and payroll processes.

Prediction No. 2 – New rules and legislation will change the landscapes of integrated care as well as payment and service delivery.

After eight long years, March 17, 2023, marks the deadline for the?Home and Community-Based Services (HCBS) Final Rule. It addresses how states may use federal Medicaid funds to pay for these services and reflects Centers for Medicare and Medicaid Services’ (CMS) goal to ensure that individuals receiving support and care through Medicaid’s HCBS programs are able to receive services in the most integrated settings. In order for states to continue receiving federal reimbursement of HCBS beyond the rule’s transition period, they must comply with all criteria regarding settings, as long as the criteria is not directly impacted by COVID-19 pandemic disruptions.

Still in flux, too, is the use of GPS as part of EVV processes. The 21st Century Cures Act established a Jan. 1, 2023, deadline for states to use EVV for all Medicaid-funded home health care services (HHCS), or their full federal matching funds may be withheld. Many EVV solutions being implemented to meet the deadline include GPS features. The proposed Cures Act 2.0 includes a provision prohibiting “the use of geographic tracking features and biometrics within EVV systems” for privacy reasons, despite support from CMS to include GPS capabilities in EVV so that providers can track data, time, location, and types of services being provided.

Caregivers, payers, providers, IT professionals, administrators, researchers, manufacturers and members alike are impacted by this legislation, and all stakeholders must do their part to stay on track with EVV compliance deadlines. Encouraging accountability from everyone involved ensures that members can ultimately receive the care aligned with their assessments, authorizations, and care plans. The best way to do this is by making the proper tools and resources available, thus improving transparency and efficiency while facilitating reliable communication with payers, providers, and caregivers.

Prediction No. 3 – Self-direction will play a larger role in the delivery of HCBS.

Even before the COVID-19 pandemic, states had been working for decades to shift away from facility-based care options and now, there is an even greater urgency to encourage HCB alternatives. Additionally, the rise of consumer empowerment has inspired individuals to become active participants in their own health care. Self-directed programs provide options that give program participants more choice and control over their care. As the population continues to age and individuals become more involved with the management of their own care, interest in self-direction will grow steadily. In addition, the advance of self-directed care could reduce some of the burden on overworked homecare agency staffers. It’s a mutually beneficial approach, so it behooves homecare agencies to equip themselves and their clients with the proper tools and information needed to achieve success.

Increasing technological advancements and regulatory support are proving effective against common challenges in the home care industry, but much work remains to be done. While these encouraging developments are making inroads, the industry requires continued collaboration with policymakers and a constant eye on the future to stay ahead of additional obstacles. Proactive engagement, advocacy and an innovative approach toward the evolution of quality home care will drive improvements the industry has already begun registering.