Axxess AGILE 2024: Embracing the Future of Post-acute Care

The Axxess AGILE (Axxess Growth, innovation, and leadership experience) conference was the place to be this week where leaders came from across the country to honor the importance of care provided in the home and boldly embrace the future. 

The Agile conference brought together home health leaders, thought leaders and innovators in our space to discuss the challenges and opportunities that we face. It would have been easy to come together to lament the stagnating revenue, staffing shortages, and challenges created by value-based care requirements. These pains are real. The combination of: 

• growing senior demands to age in place, 
• shifting payor mix to lower reimbursing government providers, 
• crippling staffing shortages, and 
• the lack of HIT adoption incentives enjoyed by acute care systems 

Make it hard for home care agencies to survive and thrive. Instead, these leaders came together to explore innovations, fresh ideas, and creative solutions sharing their collective wisdom and framing this as an opportunity to achieve the Quadruple aim. 

The Quadruple Aim is a framework used in healthcare to enhance the quality of patient care while also focusing on the well-being of healthcare providers.  

          1. Improving the patient experience of care. 

Nick Webb, futurist, author, and tech innovator kicked off the conference challenging leaders to lean into the blur and engage with patients differently. Webb said "People do not want transactions. They want experiences that are authentic and beautiful." How do we look at the whole person, and understand their priorities and social determinant needs? How do we communicate differently using technology? Most markets have multiple home care competitors; patients have choices. To survive and grow, organizations need a proactive strategy to adapt and prepare. ‍

          2. Improving the health of populations. 

Starting in 2024, home health organizations will receive either a 5% penalty or up to a 5% bonus depending on their performance against value-based care metrics. In addition to the OASIS process and patient satisfaction measures, organizations are now accountable for reducing hospitalizations and ED visits. 51.6% of ED visits are potentially avoidable. This requires organizations to rethink how they engage with patients outside of scheduled visits and after-hours. It is critical to adopt telehealth and home health monitoring technologies. It is equally critical to engage differently with patients and families both screening and coaching prevention and coaching caregivers on how to reach out early to the home health organization for (non-emergent) guidance. Successfully supporting this may require staffing and scheduling changes, new technology, and more robust ways to support patient-initiated contact. 

          3. Reducing the per capita cost of healthcare. 

Medicare margins average 22%; Medicare Advantage margins average -7% so the care costs more to deliver than the payment. We must find cheaper ways to provide care. How can organizations streamline care so that organizations can do more with less. QliqSOFT had many conversations with conference attendees about ways to: 

• Streamline onboarding 
• Streamlining communication to staff in the field 
• Reducing phone tag 
• Communicating with patients about upcoming visits so patients feel safe opening the door 
• Adopting telehealth to evaluate and address issues that would have previously required an unscheduled visit 
• Adopting secure communication with patients to confirm that needed people would be at the home during the visit, capture signatures without needing to drive to the patient, and more. 

Fifty-five percent of a caregiver's day is spent on documentation, driving, and interacting with the physician. The important theme here is that technology is not eliminating the need for your care team. You are removing busywork to enable them to do what they went to nursing school to do – take care of patients. Care in the home is overly manual. Margins may be slim, but judicious adoption of technologies with proven ROI can reduce organizational costs, increase revenue, and reduce manager and staff burden.

          4. Improving the well-being of healthcare providers. 

The repeating key theme was, "You must take care of your clinicians so they can take care of your patients." Topics spanned a value-based care leader explaining how she used nursing aids to support nurses and enable them to work at the top of their license. There were many conversations on collaborative care teams. One session, facilitated by Sonnie Linebarger stands out in my mind. The session focused on the importance of culture and leadership. This was no fluff session. Sonnie showed data on factors that influence retention and turnover. She interviewed one Axxess client who had zero open positions and lost one person last year because she went back to college. What followed was an engaging conversation on how she cultivated mission, purpose and worked in the field with her staff to understand and address their challenges, proving that staff shortages were not inevitable. 

The conference stressed the importance of including the four elements of the quadruple aim and that they be in balance in your strategy, including technology, people and process interventions. I can't wait until Axxess AGILE 25 to see what these leaders have accomplished.