The Future of Health Care: Technology, Home Care Management, and the 21st Century Cures Act

Stephen Vaccaro, president, HHAeXchange, discusses how the Care Insights for Payers platform is improving health outcomes in home care and technology’s role in the future of health and home care.

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My name is Steve Vaccaro. I'm the president of HHAeXchange. I've been with HHAeXchange now about 6 and a half years. And I focus primarily on the market side of our company. HHAeXchange is a SaaS software company. We do work in really 4 different verticals. We do work with state Medicaid programs, Medicaid managed care plans, provider agencies, and in the self-direction space with fiscal intermediaries. And our technology is used by all four of those constituents or stakeholders in addition to the caregivers in the home supplying home care. And we primarily focus on the Medicaid personal care services. Although we also do work on home health and private pay.

Can you discuss the launch of the Care Insights for Payers platform and how it is helping home care management teams improve health outcomes?

Our Care Insights for Payer program is pretty innovative in the industry. And what really has driven this is as healthcare is moving more toward a value based care approach, and we're seeing this in many different sectors right now, but payers and providers have the need for, increasingly have the need for timely cost effective ways to monitor member trends, capture critical change condition information, track various quality metrics that correlate to improved outcomes. And at the end of day, it's all about improved outcomes, right? And then we also see on the reimbursement side, a move toward value based payments. So that was what really, I say, brought about the need for this innovation, right, in this space. And what we really did is we integrate with the care management programs at the payers, so different Medicaid managed care plans we'll integrate with their care intervention programs.

And we basically have tools that are used in the home that are utilized by the caregiver, in essence, making the caregiver part of the care team for that individual receiving the services. And they're able to in a structured manner collect observations about the member in the home and those observations, they can be clinical observations. So it can be things such as dehydration or is the individual having trouble breathing to non-clinical observations or social determinants of health. It could be things like is the individual facing food insecurity or is there snow outside the home during winter, right? That could be a slip and fall hazard, right? So that information could make its way back to the payer so that the payer can intervene to try and avoid an adverse outcome, adverse outcome being something where an individual, the recipient gets injured for some reason, somehow, or they need to go to the emergency room or to a hospital. And that's what we're trying to avoid. And we want our technology to help improve really the outcomes, right, for those individuals.

How does the platform help payers and providers address the need for increased visibility?

One of the key things that have happened over the past few years in the Medicaid program is the 21st Century Cures Act was passed. And that's now the law of the land and Medicaid programs have rolled out their different structures for how they're going to comply with those programs. The Cures Act was really designed to address fraud, waste, and abuse, but an outcome of that has been to really bring innovation into the Medicaid space. And we liken it in many ways to becoming like the infrastructure, like a cable company that has the infrastructure now that they come into your home, but now you're getting Netflix and you're getting phone calls on that same cable.

And so it's that same concept now. Now that the infrastructure is being rolled out via electronic visit verification as a result of the 21st Century Cures Act, we see the ability now to leverage additional information from the caregiver in the home, which in the past was very difficult to do. So now leveraging technology, we're able to have the caregiver in the home, provide increased visibility, communication with the payer and their providers that they're working with and better compliance toward the plan of care.

So we can really see what's happening in the home during those visits, so the duration of the visits, what services are being done. And really that's been I think, a game changer in terms of capturing timely member changes, right, to help reduce the risk for any type of escalation or adverse outcome. So that's really been, I think what's really changed the whole industry at this point. And that's really, what's driving change in the industry going forward.

Is there anything else you would like to add regarding how technology can be leveraged to further ensure ongoing effectiveness and a consistent quality of home care? 

That's an area that we're very focused, as a company at HHAeXchange, because as more care becomes home based and that's the direction care is going. Right. Everyone wants to be out of the facility. They want to be in their home and their community. So as more care is becoming home based communication methods, data collection tools have to evolve to really give consistent quality of care in the home. And leveraging technology, I think is a key piece of that. And we're seeing this today with home care providers where they're able to leverage additional efficiencies in terms of servicing those members in the home as they're receiving care. So, because they could do better training for their caregivers in the home via, let's say mobile technology, they could have communications or they could see photos of things that are happening in the home to assess if they need to intervene, they're able to do different types of clinical visits via technology in the home right now, where they need to.

So, it really has helped improve the overall I'd say quality of care that an individual could receive in the home. In addition, we see a lot of more integration happening between the payers and the providers in this space, in this home and community based space, where the payers are doing a better job in terms of, I'd say, delivering authorizations in an electronic manner to the providers, providers then have those electronic manner. And they able to work more quickly to train their caregivers. They're able to ask questions back to the payers and they could sort out about different care items that come up more real time than it had ever been in the past. And it's all a result of technology. So technology's really transforming the whole industry now.

Is there anything else you would like to add to the conversation today?

At HHAeXchange we're really very focused on what the future brings and how do we bring innovation into the marketplace, right? And we have a lot of passion around this. We're really focused on how do we deliver technology for all the various stakeholders in a manner to eliminate or alleviate administrative burden where possible to give everyone more time to focus on the individual recipient receiving the care and to improve their outcomes. So we see that continue to be a trend in the future. And we're very excited about where the future's heading with home based care.