In this episode of Home Care Hindsight, host David Knack is joined by Steven Gonzales, CEO of HealthView Home Health & Hospice, to demystify the world of home health.
Steven breaks down the core function of home health, its role in the care continuum post-hospital discharge, and the critical financial challenges driven by payer mix and Medicare Advantage. He shares invaluable insights on how home care agencies can become essential partners by understanding clinical needs, tracking client payer data, and focusing on true care coordination.
Steven also looks to the future, discussing the exciting potential of AI and personalized medicine to transform patient outcomes and free up caregivers to focus on human connection.
Lesson Takeaways:
1. Home Health's Core Role: The primary goal is to help patients recover after a hospital discharge through skilled nursing and therapy, with success measured by preventing rehospitalizations.
2. Payer Mix is Everything: The biggest challenge isn't getting referrals—it's profitability. Declining reimbursement rates, especially from Medicare Advantage plans, force agencies to be highly selective about which patients they can accept without losing money.
3. Become a Data-Driven Partner: Home care agencies can stand out by tracking their clients' insurance (payer mix) and proactively presenting this data to potential home health partners to see if a business relationship is even feasible.
4. You Are the Eyes and Ears: Non-medical home care is a powerful tool for preventing hospitalizations. The key is to be "woven into the care plan" and act as an early warning system for changes in condition, communicating effectively with clinical partners.
5. The Future is Personalized: Advancements in AI and technology will lead to more personalized medicine and customized software solutions, freeing up professionals to focus on the human elements of care and coordination.
Timestamps:
00:00 - Introduction to the "Home Health 101" series and Steven Gonzales
02:30 - Steven’s journey from non-medical home care to leading a post-acute continuum company
05:00 - How HealthView differentiates itself through culture in a competitive nursing market
09:15 - The day-to-day of home health: Who gets referred, from where, and why
12:45 - The real challenge: It’s a payer mix problem, not a referral problem
18:20 - Why Medicare Advantage plans are squeezing home health margins
22:30 - The metrics that matter: Hospitalization, rehospitalization, and proving value to health systems
28:50 - The critical gap home care can fill in the care continuum
33:40 - How home care providers should approach partnerships with data in hand
38:00 - The exciting future of personalized medicine and AI in home-based care
Quotes:
Steven Gonzales: "There's such a demand for home health... but it's not a referral problem, it's really a payer mix problem."
Steven Gonzales: "Home care [is] such a pivotal part of preventing hospitalizations as long as... they're weaved into the care plan. They're the eyes and ears."
David Knack: "Something to give is something that... takes very little extra work. Just make it part of the intake process."
Steven Gonzales: "The reason computers were built was for us to go do life... Freeing up people's time so they can... do the human stuff really well is what I think is pretty cool."
Resources:
1. HealthView Home Health & Hospice: https://healthviewhomehealth.com/
2. Connect with Steven Gonzales on LinkedIn: https://www.linkedin.com/in/stevegonzalez/
3. Connect with David Knack on LinkedIn: https://www.linkedin.com/in/david-knack/
4. Powered by Zingage: https://zingage.com
5. Watch Episode on Zingage’s YouTube: https://www.youtube.com/@Zingage
