Wheels Beginning to Roll on THR, Methodist Home Health Care Partnership

The home health care partnership between Texas Health Resources and Methodist Health System has been nudged into motion by its Louisiana-based partner.

The two systems announced July 1 that they contracted with LHC Group of Lafayette, La., to deliver home health care to their patients.

Texas Health Dallas has ended its hospital-based home health unit, and will be the first hospital to begin using the partnership, with Harris Methodist not far behind. The partnership plans to integrate home health into 12 hospitals over the next 16 months.

Karen Wyble

Karen Wyble, LHC regional vice president of operations, said the partners have several initiatives they hope to implement in the coming months. Among them:

Care Transition Coordinators. When patients are referred to home health care, the coordinators meet with the patient and caregivers to reconcile medications and review the care plan before they leave the hospital.

Call Us First. Patients are asked to call field clinicians instead of going to the hospital emergency department. Wyble said they would assess patients in their homes and often take care of the problem there.

Lifeline Button. Patients are given the device free of charge to press, directly connecting them to a provider who can contact a visiting nurse or can call 911.

The Three T’s. This stands for triage, transition and training of chronic-disease patients. Home care personnel will create individualized care plans and train those patients to monitor themselves remotely.

Post Acute-Care Mapping. Wyble said providers typically create care plans for hospital patients for the anticipated inpatient stay. She said she will encourage those plans to extend past the hospital discharge to give physicians greater control over the continuum of care and enhance prevention.

Wyble said the home health care venture has received “overwhelming support” within THR and Methodist facilities.

“It’s a change in culture, and it has created excitement. Physicians want to bring back the momentum of control toward them, and that helps drive this (change),” she said.

Hospitals increasing are targeting readmission rates because of penalties authorized by the Affordable Care Act against those with excessive cases. Twenty-six local hospitals will be penalized beginning in October because of readmission rates. Research consistently shows that about one out of five Medicare patients return to the hospital within 30 days. That translates to about 2 million Medicare beneficiaries, and costs the insurance program for the elderly more than $17 billion in additional hospital bills.

Home health care is a critical component to decreasing readmissions. However, the sector is fragmented and under scrutiny for its billing practices. The Office of the Inspector General (OIG) has recommended a Medicare moratorium on new home health care agencies in Texas. It said about 40 percent of suspicious billings for home health care originated in Texas. Forty-five percent of the state’s home health agencies—or 1,000 out of 2,212—had questionable billing. The Texas rate was five times greater than the national average, the OIG reported. There are about 1,500 licensed home-health agencies in North Texas.

Steve Jacob is editor of D Healthcare Daily and author of the new book Health Care in 2020: Where Uncertain Reform, Bad Habits, Too Few Doctors and Skyrocketing Costs Are Taking Us. He can be reached at steve.jacob@dmagazine.com.