1. Highlights from the IOM-NRC Workshop Teresa Lee, JD, MPH Alliance for Home Health Quality & Innovation ©AAHCM

2.  None ©AAHCM

3.  501(c)(3) non-profit research and education foundation  Mission: To lead and support research and education on the value home health care can offer to patients and the U.S. health care system. Working with researchers, key experts and thought leaders, and providers across the spectrum of care, we strive to foster solutions that will improve health care in America.  www.ahhqi.org www.ahhqi.org

4. Membership

5.  Demographic & human imperative to serve older Americans and those with disabilities  Government investment in home health, but persistent policy questions: ◦ Program integrity ◦ Cost in general ($20b per year) ◦ RESULT: payment cuts and regulatory barriers  New models of care: what is home health’s role & relevance? ©AAHCM

7.  Current role/value of home health care  Role/relevance of home health in new models  Key needs to appropriately optimize home health in the future ◦ Infrastructure ◦ Workforce ◦ Technology ◦ Research and Measurement ◦ Policy reform and communication strategies ©AAHCM

8.  Hosted by IOM-NRC Forum on Aging, Disability and Independence  Diverse sponsors: AAHCM, ANA, APTA, Axxess, CHAP, Home Instead, National Alliance for Caregiving, UnityPoint at Home  Convened stakeholders from government, academia, industry, philanthropy, consumer groups and thought leaders ©AAHCM

9.  A shift towards community-based care  New models are achieving the Triple Aim  Policy/Payment reform needed for models  Home health workforce will be key  Technology as critical enabler  Appropriate quality/outcomes measurement

10.  Accountable Care Organizations  Bundled Payment Arrangements  Independence at Home/Home-based primary care  Advanced illness management  Hospital-at-home

11.  Focus on sickest, costliest (multiple chronic conditions, ADL limitations) ◦ Data analytics/HIT for risk stratification  Home health partnerships with primary care, palliative & end-of-life care  Most focus on post-acute care and all focus on preventive maintenance/stabilization  Nursing, therapy play critical roles & HH aide’s role strengthened

12.  Telehealth and remote monitoring (even low-tech) to engage patients and increase efficiency  Person-centered, not just patient-centered (including caregiver)  Many new models showing reduced hospitalizations & rehospitalization, ED visits, days in ICUs, total cost of care

13.  What policy reforms are needed? Payment for stabilization of function, waiver of homebound requirement  How important is vertical integration? Enables alignment of incentives and consensus on financial bottom line  How important is scale? ◦ Start with focus on evidence-based “best” practices, protocols to track quality & cost metrics geared toward priority measures

14.  IOM-NRC Workshop Summary released  Symposia: DC, South, Northeast, Midwest, West  Development of strategic framework for Future of Home Health Care, with identification of key needs to address  Welcome input, ideas, & perspective: FutureofHH@ahhqi.org FutureofHH@ahhqi.org  Twitter: #FutureofHH