Understanding the Tötal Value™ of wound care standardization
Wound care has become increasingly important among home health providers due to its quality-of-life implications, as well as the high cost associated with care of chronic wounds. On a national level, there is an uptick in the need for long-term wound care. About eight million Medicare beneficiaries have wound-related conditions. In 2019, the national volume of home health wound care claims checked in at six million.1 This growing need underscores the importance of standardizing wound care to achieve the most effective and efficient care. To reduce costs and avoid redundancy, home-based care providers can implement consistent wound care processes and products to achieve the most cost-effective care.
For its wound care needs, CommonSpirit Health at Home, a postacute care service provider, works with Mölnlycke, a world-leading medical products company whose solutions are designed to help providers minimize true patient care costs by managing the whole value equation, known as “Tötal Value™.” CommonSpirit operates more than 1,000 care sites and 142 hospitals across 21 states with home-based care arm CommonSpirit Health at Home offering specialized home care, hospice and home infusion services nationwide.
The organization’s partnership with Mölnlycke means lowering total cost — not just product cost — as well as improving outcomes.
As part of its newly approved home health proposed payment rule, the U.S. Centers for Medicare & Medicaid Services (CMS) has issued a nationwide expansion of the Home Health Value-Based Purchasing model (HHVBP). When the rule takes effect in 2023, providers will go up against industry peers on a number of performance measures that could result in a maximum bonus or penalty of 5%.2
For providers, HHVBP means potential upsides, but it also means potential cost pressures. Fortunately, agencies have experience with these pressures, having now operated under the Patient-Driven Groupings Model (PDGM) since January 1, 2020. This was a complete overhaul to the payment system, geared toward prioritizing value over volume.
Andrea Callahan notes four key reasons that CommonSpirit Health at Home sought a wound care standardization partner.
• Standardization of wound care protocols
• Clinician education and support
• Quality evidence-based products on formulary
• A redundant formula that led to high-cost, low-utilization items