MHE video chats with Joanne Cunningham, executive director of the Partnership for Quality Home Healthcare, on the latest with COVID-19 and how healthcare workers and patients are being affected.
MHE: Can you tell us about the Partnership and who you represent?
Cunningham: The Partnership for Quality Home Healthcare is a coalition of many of the national home health companies with large footprints across the nation. They care for tens of thousands of patients and are in many, many of the 50 states. Their focus is on ensuring the highest quality home health program and pursuing policy to promote patient care, ensure program integrity, and enhance quality.
MHE: The Partnership released a report today that said America’s home healthcare workers are an untapped resource in the time of COVID-19. Can you tell us the major findings of the report?
Cunningham: It was a report that we along with the National Association for Home Care and Hospice released, and its focus was essentially the role that the home health community can play in helping to combat and mitigate the COVID-19 crisis, essentially by tapping and unleashing the home health sector to be sort of a safety valve for the hospital and institutional sector, and helping to manage more patients who can appropriately be cared for in the home.
MHE: What are the major advantages of keeping more patients in the home setting during the pandemic?
Cunningham: Well, for patients who don't need to be in hospital beds, the safest place for them to be is in their own home. And many patients who are symptomatic with COVID-19, still need clinical monitoring. They need someone to make sure that they're being cared for and that their clinical needs are being met, especially if they have any kind of underlying health condition or any kind of comorbidities or immune compromised health indicators, any of that. The best place for them to be is in the home if they don't need to be in a hospital right now. Home healthcare is a very experienced modality of healthcare delivery, in that these are clinicians whose practice area is the home so they are very used to serving the clinical needs of patients in the home. So, we think it's a perfect delivery system to help serve as a safety valve for the hospital sector.
MHE: What are the major barriers to home health workers participating more fully in the effort to care for the chronically ill right now?
Cunningham: Well, I think one of the things that's difficult is there are regulatory rules and and requirements for the Medicare Home Health Program, which is what my members focus on, and are providing care for the Medicare population. We are working closely with the Centers for Medicare and Medicaid, to look at the regulations that right now could be modified or waived or suspended for the time of this public health emergency to allow for more flexibility and enabling more patients to be cared for at home. I think if you do that, then what you're going to do is free up this sector to be able to work much more closely with hospitals and nursing homes and other facilities to care for patients.
MHE: Your report outlines a plan of action for relying on American’s home healthworkers for care of the chronically ill at home. Can you walk us through the steps?
Cunningham: Sure. I mean, one of the first steps is to ensure easy access to your home health provider. Right now, we have a couple of challenges. One is for our existing patients, many home health patients reside in assisted living or even nursing homes or other facilities, and one of the things that we've noticed in this sort of lockdown environment is that home health providers who are the caregivers for these patients are being restricted from accessing them. So, that's an area that we need to make sure that we're not preventing patients that are in assisted living or other from being able to see their home health. Care Nurse during this time.
The other area is, you know, for patients who are right now in the home healthcare system. So, they are currently patients in the Medicare Home Health Program. Many patients in their homes, elderly folks are especially nervous about providers coming in their home, even if it's their home health nurse that comes in once a week to help address their underlying condition. So, one of the things that is a difficulty is trying to make sure we manage those patients at home. So, that's one, I think another step that we've identified is making sure that home healthcare providers have appropriate PPE to protect them, to protect their patient population. We're in the line of providers that have identified a need for PPE, hospitals are obviously struggling with that and need it as well, but if we want to make sure that people are safely cared for in the home, we also need PPE to do that.
MHE: About how many home health workers could be added to the available staff nationwide if your ideas were put into action?
Cunningham: Well, the Medicare Home Health Program is a very robust program right now. I would say that I can't give you an exact number, but what we're trying to do with this report is say to our hospital partners, our health system partners, we have the capacities to be your partner to be your safety valve and helping to move patients out of the hospital who don't need to be there that are ill with COVID-19 that don't need to be in a hospital bed, but can be cared for under the direction of a Home Health clinician, a registered nurse, another clinician, a therapist who will be able to monitor their condition, make sure that that they're not accelerating to a point where they should be hospitalized, but really keeping an eye on their health status during a very vulnerable and very tricky time.
So, we think that role can be very important. I know there's patients in hospitals right now that I'm sure are very ill, but under the circumstances of being able to be cared for by a clinical team of home health clinicians, they would be able to safely be cared for in their homes. That's the patient population we're talking about, and it's only going to grow as the COVID-19 numbers continue to go up. Our hospitals are being very strained and very taxed in their capacity right now.
MHE: Any other thoughts on ways that home healthcare workers and the Partnership could do more to help relieve hospital staff?
Cunningham: I think personally that one of the ways that we can manage this public health emergency is by stronger partnerships together. Right now, home health works very well with hospitals. Many of the patients that are in hospitals who need some sort of post acute care come into the home healthcare sector. We have strong relationships with physician partners, with health plans, and I think one of the the lessons that we need to learn through this whole process is that the more integrated we are in our approach to caring for people, and the more that we use all of the facets of the American healthcare system, which includes home healthcare. I think the more we can stretch our capacity and safely and appropriately [provide] care for the numbers of COVID patients that are just increasing by the day.
To read the full report, visit the Partnership for Quality Home Healthcare at http://pqhh.org/