Home Health | Hospice | Industry | HEALTHCAREfirst

Home Health

What is Home Health Care?
Home Health, in its simplest definition, is care provided to individuals at home rather than in a hospital, inpatient unit or physician's office. The care provided typically consists of part time or intermittent skilled care which may include nursing, physical therapy, occupational therapy and speech therapy. Additional services such as those of a Medical Social Worker or Home Health Aide may be provided. Oftentimes patients who receive Home Health services are homebound. The goal of Home Health Care is to treat an illness or injury such that the patient is able to regain their independence as best as possible. Some examples of skilled Home Health services might include:
  • Speech Therapy
  • Physical and Occupational Therapy
  • Wound care
  • Injections
  • Monitoring and on-going treatment regime associated with a serious illness or unstable health status
  • Patient & caregiver education
What services do Home Health Care agencies provide?
Home Health agencies provide an array of services. The most frequent disciplines of care include:
  • Skilled Nursing
  • Physical Therapy
  • Speech Therapy
  • Occupational Therapy
  • Medical Social Services
  • Home Health Aide Care

Some examples of skilled Home Health services might include:
  • Speech Therapy
  • Physical and Occupational Therapy
  • Wound care
  • Injections
  • Monitoring and on-going treatment regime associated with a serious illness or unstable health status
  • Patient & caregiver education
Who pays for Home Health Care?
The primary sources of payment for Home Health Care are Medicare and Medicaid plans, however most private insurance plans also provide accommodation for some form of Home Health Care.
What is HHCAHPS?
The US Department of Health and Human Services (HHS) has a branch for Healthcare Research and Quality (AHRQ). The AHRQ branch funds and administers a program called Consumer Assessment of Healthcare Providers & Systems (CAHPS).

This program consists of a group of standardized surveys that ask recipients to evaluate their healthcare experience. One of the surveys in the group is the Home Health Consumer Assessment of Healthcare Provider Systems Survey (HHCAHPS). The survey consists of 32-34 questions that ask the recipient to rate their experience with a particular Home Health agency.

Participation in the HHCAHPS program is a requirement of Medicare certification for Home Health agencies.

Does my Home Health agency need to obtain certification?
Most Home Health agencies operating in the United States today have obtained, or are working to obtain, their Medicare Certification. This enables agencies to provide care to Medicare recipients and receive reimbursement for services through that program. Agencies that are not certified to do so are not able to receive monies from the Medicare program for services they have rendered.

In addition, many agencies will seek the certification of the State Medicaid program, for reasons similar to why they'd seek Medicare certification.

If an agency only seeks to provide care to private insurance patients and/or patients who are able to pay out of pocket certification is not a requirement.
Does my Home Health agency need to be accredited?
Accreditation is a choice, it is not required. Many agencies choose to become accredited to provide consumers (future patients and families) with an additional measure of peace of mind that the services and processes that the agency is following are of the highest standards.
How many Medicare certified Home Health agencies are in the United States?
There are more than 10,000 Medicare certified Home Health agencies in the United States. The majority of those agencies being proprietary (free-standing), for-profit organizations.


What is Hospice Care?
Hospice Care provides medical services, emotional care and spiritual support for individuals that have been given a terminal diagnosis in which the physician has identified that the anticipated life-expectancy is less than six months. However, the duration in which a Hospice patient receives Hospice Care varies greatly depending on their choices and the treatment regime they are undergoing.

Hospice Care provides assistance with managing the symptoms associated with the terminal diagnosis. Patients who elect hospice care have made the decision to forgo treatment options that are meant to cure or prevent the illness from worsening.

Hospice Care also provides the family members care and assistance as they cope with the illness and after-effects of the loss of their loved one.
What is Palliative Care?
Palliative Care is targeted to assist recipients with relief of suffering associated with pain or other symptoms associated with a serious illness.

Palliative Care may be coupled with treatment regimens geared towards curative measures for the disease/diagnosis.
What is Bereavement?
The period in which the loved ones of a deceased family member (or friend) grieve over the loss is referred to as bereavement.

Agencies that are Medicare certified are required to offer bereavement options to loved ones and friends for a period of 13 months following the death. Many Hospices however will extend the offering if the loved ones continue to need their support.

Bereavement care can be offered in various forms including, but not limited to support groups, individual counseling, social gatherings, camps and memorial services.
Who pays for Hospice Care?
The primary source of payment for Hospice Care services is Medicare however most State Medicaid and private insurance plans provide a measure of care similar to or including Hospice Care.
Who is included in the Hospice team?
The Hospice care team is also referred to as the Interdisciplinary Team (IDT). The IDT team typically includes physicians, nurses, social workers and chaplains. In addition to this core group of individuals there may be others in the IDT including:
  • Volunteer Coordinators
  • Bereavement Coordinators
  • Psychologist
  • Pharmacists
  • Physical or Occupational Therapists
  • Art, Music, Play Therapists
  • Child Life Therapists
  • Case Managers
Does a Hospice agency need to become certified?
Most Hospice agencies in the United States do obtain, or are working on obtaining, their Medicare certification. Medicare is the primary source of reimbursement for the program and without the certification agencies are not eligible to bill Medicare for services provided to Medicare recipients.

Many agencies also seek State Medicaid certifications for similar reasons.

If an agency does not wish to have the ability to bill Medicare or Medicaid for services rendered certification is not a requirement. In those situations agencies are typically funded through grants, community support and donations.
Does my Hospice need to be accredited?
Accreditation is a choice, it is not required. Many agencies choose to become accredited to provide consumers (future patients and families) with an additional measure of peace of mind that the services and processes that the agency is following are of the highest standards.

Home Care Industry

What is a MAC?
Medicare Administrative Contractors (MACs) are under contract with the federal government and handle the administration of both the Medicare Part A and Part B programs in designated geographic regions. MACs serve as the primary point of contact for the receipt, processing and payment of claims. View a list of MACs.
What is the difference between Home Health Care and Hospice Care?
While both Home Health and Hospice Care provide comprehensive care for the needs of a patient within his/her home, the difference is the care focus.

Home Health Care focuses on patient rehabilitation and medical management in order to improve a patient's medical condition. Hospice Care focuses on supporting patients who are terminally ill, providing comfort measures to assure the patient's comfort and quality of life.

Home Health and Hospice services are sometimes referred to as "Homecare."
What are the accrediting agencies for Home Health and Hospice agencies?
Accrediting agencies, through "deeming authority" by CMS, have the regulatory authority to survey agencies providing Home Health, Hospice and home medical equipment services to determine if they meet Medicare Conditions of Participation and CMS Quality Standards.

The two main accrediting agencies are Joint Commission and Community Health Accreditation Program (CHAP). The Joint Commission accredits more than 5,600 organizations and services are provided directly or through a contracted individual or program. CHAP is an accrediting body for community-based health care organizations. It has accredited more than 5,000 agencies nationwide and is not-for-profit.
What kind of education is offered for Home Health and Hospice agencies?
There are many opportunities for Home Health and Hospice education. Most national and state homecare associations offer Home Health and Hospice education through conferences, trainings and online learning. Additionally, there are several private programs that offer continuing education courses as well as e-learning opportunities.
Are there any industry associations my agency can join?
Many agencies choose to become members of Home Health and Hospice associations in order to participate in conferences, networking events and other learning opportunities. Most states have associations dedicated to Home Health, Hospice or both. In addition, agencies might consider joining the National Association for Home Care and Hospice or the National Hospice and Palliative Care Organization. Both of these associations offer a wealth of information regarding professional development, regulatory changes and advocacy.


What types of products & services do you offer Home Health & Hospice agencies?
HEALTHCAREfirst is the industry's leading provider of Web-based Home Health and Hospice management software. In addition, we offer outsourced billing and coding services, physician's portal, business analytics and consulting services. We work together with agencies every day to understand your needs and deliver innovative, easy-to-use and affordable solutions to allow you to put patients before paperwork.
What is the difference between Web-based and Server-based software?
Web-based software is less expensive to purchase and maintain. It also enables a very efficient and seamless update process since changes are accessed whenever a user signs into the software. With Web-based software, there are no large upfront costs, paying a monthly fee instead. There are no servers to buy, backups or hardware maintenance required. Server-based software typically has 2-3 releases per year requiring manual installation by your IT staff.

Server-based software is software that is installed onto individual computers, with the data deployed, managed and executed on a server within your office. A large upfront investment is typically required, and once the software is purchased, is yours to keep.
Your software is Web-based. What if we can't get Internet connectivity in the field?
We understand that Internet access isn't always possible. Because of this, our software is designed to allow you to enter data remotely and then easily sync up when you return to the office.
How long does it take to get up & running on your software?
We know that a fast and easy implementation is important to your agency. That's why HEALTHCAREfirst follows a proven implementation process to get your agency started with a quick, seamless experience. Most agencies can launch within 30-60 days, with data conversion managed at no cost to you.
What upfront costs are involved in purchasing your home health agency software or hospice agency software?
Unlike with most Server-based software, there are no up-front costs involved in purchasing your software. We provide comprehensive, hands-on training of the software at either your location or at one of our training facilities for a minimal cost.
How much does your home health agency software or hospice agency software cost?
The cost of our software varies based on several factors including agency size, product and needs.
I don't have my Medicare certification yet. Can I still use your software?
Absolutely! In fact, we offer a special pricing plan just for start-up agencies. Contact us today to learn more!
What kind of training do you offer users?
Upon implementation, we will provide training to your staff on-site or at one of our training facilities. In addition, HEALTHCAREfirst Implementation Representatives will provide regular check-ins and on-call availability to help answer any questions, large or small.
What kind of support do you offer users?
We offer a variety of ways our customers can access support including telephone support, online support question submissions and chat. Our telephone support line is available 24 hours in case of an emergency.
What kind of education do you offer users?
HEALTHCAREfirst offers our customers free online learning tools we call Online Learning Modules or OLMs. These are available for viewing at your convenience and include online coursework, lectures and discussions about your software. This is a perfect way to educate new staff or just as a refresher!
I want to learn more about your products and services. How do I contact you?
We would be happy to give you a demonstration of how we can help you put patients before paperwork. Schedule a free demo today or call us at 800.841.6095

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