How Alacare Home Health Reduces Re-Hospitalizations: A Webinar Recap on Building a Culture of Engagement for Complex Populations

Webinar Recap

As the healthcare industry continues its transition to value-based care, patient engagement is becoming increasingly important. Patient engagement describes any activity that encourages patients to participate in their own care. This can include educational content, proactive outreach, answering surveys, and a number of other activities that promote better care and experience for patients.

While patient engagement is becoming a key element in providing quality patient care, not all populations are easy to engage or make active participants in their care. In a recent webinar, CipherHealth’s VP of Post-Acute Strategies, John Banks Powell, was joined by Alabama-based home health agency, Alacare Home Health and Hospice’s VP of Strategic Network Partnerships, Samika Williams, to discuss engaging with one of their complex populations- Medicare beneficiaries.

Powell opened the webinar explaining that while everyone knows the obvious impact patient engagement has clinical outcomes and patient experience, its impact is broader than some may acknowledge.

“A well implemented patient engagement program can have an impact on an agency’s regulatory compliance with things such as the CoPs, staff workflow efficiencies, and also the agency’s bottom line in the end”, stated Powell. “Value-based purchasing programs have both penalties and incentives tied to re-hospitalizations rates on home health CAHP scores and patient engagement can drive and impact both of these things.”

Patients with complex needs, functional limitations, and behavioral health conditions count for both the highest share of health dollars spent and the highest amount of agency resources and time they take to manage. The question that may agencies is how can the organization more cost-effectively meet the needs of this diverse and oftentimes complex patient population.

Alacare Home Health & Hospice’s Samika Williams answered this question by offering a first-hand account of what it takes to develop a successful patient engagement program to Medicare beneficiaries. With 75% of Alacare’s patient census being Medicare patients, Alacare hoped that by engaging this population, they would be able to achieve their goals of reduced avoidable re-hospitalizations, optimized home health visits, and improved patient satisfaction.

Leveraging CipherHealth’s automated technology, CipherOutreach, Alacare implemented a five-call engagement program that begins 48-hours after start of care. Patients that indicate an issue, such as worsening symptoms or questions regarding care instructions, are triaged to the appropriate staff member for timely resolution.

“Sometimes patients will return to the hospital with issues that are unrelated and unreported. But what we’ve found in our experience is that the overwhelming majority of the time, patients gave us the opportunity to intervene by responding to the telephone survey,” said Williams.

In fact, patients that engaged with three or more calls throughout the program were 50% less likely to be rehospitalized compared to those that did not, helping Alacare not only reduce avoidable rehospitalizations but develop targeted strategies to help further improve outcomes for their patient census.

“Everything from the language in the call scripts that go to the patients, to the subsequent alerts that go to our clinical staff, down to call frequency, enrollment requirements, and really a slew of other specifics, we were able to design a workflow that helped us achieve and maintain buy-in from all of our key stakeholder groups”, proclaimed Williams. “Our patients, our field staff, the in-office clinical staff that serves as the front line of defense when a call is triaged, our QI team, business development, and our executive leadership and that is no small feat to keep that many people happy with just one tool.”

To learn more about how Alacare and CipherHealth are building a culture of engagement for complex populations, access the webinar today.


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