Case Study: How Advanced RehabTrust Improved Quality of Care with KinnserMarch 26, 2013 by Victoria Garment
Providing quality patient care amidst decreased Medicare reimbursements and ever-growing operating costs has proven challenging for Medicare-certified home health agencies in recent years. According to American Medical Association President Jeremy A. Lazarus, “Over the last 12 years, Medicare payments to physicians have increased by only four percent, while the cost of providing care has jumped 20 percent.”
Inflation has also driven up the price of things like gasoline for clinicians, who log many miles driving to and from patient homes. Together, these factors created a difficult financial situation for Advanced RehabTrust Home Health, which employs 40 staff members and serves 400 patients per year.
In addition to the financial pressure they were under, the Denton, TX-based agency was having trouble with the software they were using to manage their accounting and point-of-care needs. At the time, they employed two systems, which interacted poorly with one another. These systems detracted from productivity, were costly to maintain and made it challenging to maintain regulatory compliance. The agency found itself struggling to mitigate this situation without sacrificing their level of patient care.
Looking to resolve these issues, Advanced RehabTrust sought a cost-effective, Web-based solution that would fulfill their needs, provide extensive customer support and enable a seamless transition. In August 2010, the agency made the switch to Kinnser’s Agency Manager software. The result: significant improvements to agency operations across the board.
A Host of Challenges
Advanced RehabTrust previously relied on one type of software for back-office billing needs and another as the point-of-care solution for clinical documentation. These systems were unable to automatically exchange information between one another, meaning data had to be transferred manually — a time-consuming and inefficient process. Paying for both inflated overall costs, and a lack of online data storage required space-consuming paper copies of documents to be kept in the office. The systems were also not up-to-date on regulatory and compliance concerns, making it difficult for the agency to meet certain requirements.
Overwhelmed by the mountain of data they had to record, monitor and track, Advanced RehabTrust looked for a solution that would help streamline operations for both back-office staff and clinicians in the field. The agency wanted to focus on their number one priority: providing the highest possible level of patient care.
“We wanted a system that would be comprehensive and complete so work would flow from the initial contact with the referring physician, to admitting the patient to care, to complete billing, scheduling and reporting, to discharge of the patient,” explains Kristina Brown, Director of Nursing and Alternate Administrator for Advanced RehabTrust. “We didn’t want clinicians to be distracted from patient care.”
Another essential feature the agency desired was excellent training and customer service. “With our previous software system, we still had significant issues after six months,” recalls Brown. “We were constantly retraining staff and calling customer support to find out how to do things.”
A Seamless Transition to Kinnser’s Easy-to-Use Solution
Advanced RehabTrust considered many other software systems before making a decision. Kinnser, however, which is the fastest growing software vendor in the home health industry and is used by over 1,300 agencies, was the clear front-runner.
“Other systems we looked at were too complex and difficult to use or had a higher upfront cost,” says Brown. “Many of the larger [home health software] companies make it extremely difficult for field staff to navigate and make changes and there are many hoops to jump through to get to the next step.”
When it came time to make the switch, Kinnser’s intensive customer support and training enabled a seamless transition to the new software. Kinnser staff arrived on-premise and trained agency employees to use the system in just two days. All personnel were comfortably using the software within two weeks.
Efficient Processes and Accurate Billing Save Thousands of Dollars
Since the implementation of Agency Manager, Advanced RehabTrust has seen significant advances in nearly every area. Data entered into the Web-based system is available immediately so clinicians and physicians can view patient information as soon as it has been recorded. Staff no longer have to wait several days for charts to be manually updated.
One of the biggest improvements has been in the time it takes the agency to admit and process new patients. The admitting clinician or nurse can complete the required 22-page OASIS assessment on an iPad while in a patient’s home, which means the supervising nurse can code it within 24 hours.
Prior to implementing Agency Manager, creating the CMS 485, which outlines the plan of care for the patient, was a separate and time-consuming process. Agency Manager generates the 485 form as the clinician enters information into the OASIS, so both documents are completed together. The agency office is then alerted that the RAP, the bill the agency sends to Medicare, is ready to go.
With Advanced RehabTrust’s previous system, this entire process took anywhere from 14 to 20-plus days to complete. Agency Manager has shortened it to less than a week, which enables the agency to better utilize staff and increase overall productivity.
According to Brown, Agency Manager’s Home Health Resource Group (HHRG) worksheet and Dashboard are two of the most useful features when it comes to managing daily operations. The former helps identify profit and loss at the beginning of each episode. The latter allows staff to easily look at past due visits, outstanding OASIS, unprocessed claims and orders, agency census, top diagnosis and any other important information to ensure nothing falls through the cracks.
Agency Manager has also eliminated billing errors. In Advanced RehabHealth's final two years with their previous software, more than $94,000 in errors were found by a billing recovery service. In the agency's two years with Agency Manager, zero dollars have been lost to billing errors. “With Kinnser, an outstanding or rejected claim cannot be overlooked,” observes Brown. “It’s very simple to use and access to correct errors and rebill.”
Better Communication and Patient Care
Less time spent commuting to and from the office permits clinicians to spend more time with patients during each visit. Kinnser’s scheduling application ensures compliance with the required frequency of patient visits and reminds staff at the start of each if labs are due, a patient’s weight needs monitoring or their wounds require measuring, etc.
Agency Manager’s HIPAA-compliant K-mail feature has greatly improved communication between disciplines. This email system informs all staff of new orders or changes in patient status and helps ensure all patients receive the proper care.
Additionally, greater overall efficiency enabled Advanced RehabTrust to grow their census by 50 percent, allowing them to address the needs of significantly more patients.
Faster Payroll Processing and Lower Overhead Costs
With Agency Manager’s accounting functionality, the agency reduced their payroll processing time from four days to just four hours, allowing them to eliminate one full-time staff position. This, together with going paperless, enabled the agency to downsize their office space and save $1,000 per month.
The ability to enter and track data via iPad from anywhere with Internet access has drastically reduced staff commute time and improved collaboration. In the past, employees were required to participate in weekly hour-long case conferences at the office, but found they were often unable to attend due to scheduling conflicts. Agency Manager provides a specific case conference form that enables all clinicians involved with a patient to discuss ongoing needs and address issues online, resulting in 100 percent case conference participation and saving the agency $4,000 per month.
In fact, Agency Manager has been so cost-effective for Advanced RehabTrust that they’ve been able to launch a new telehealth system. This system helps provide better patient care by enabling staff to track blood pressure, weight, heart rate and oxygen statistics in patients’ homes and monitor this information around the clock.
The Future for Home Health Agencies
With the implementation of Kinnser’s Agency Manager software, Advanced RehabTrust has seen numerous marked improvements. They’ve significantly decreased costs, increased productivity, improved the quality of patient care and the overall visit rate for clinicians, and can even offer staff more competitive pay and benefits. As more home health agencies feel the pressure of decreased Medicare reimbursements and higher operating costs, it’s likely that more and more will seek cost-effective Web-based management systems like Kinnser to help streamline operations and facilitate a higher level of patient care.
To learn more about Kinnser, visit http://www.kinnser.com/