Even with a bevy of care services in its arsenal, By the Bay Health hasn’t taken its eye off home health.
By the Bay Health CEO Skelly Wingard aims to improve the quality and accessibility of the company’s home health care line by enhancing the company’s clinical informatics and collaborating across service lines and managed care. These initiatives emerge amid regulatory uncertainty, as proposed Medicare home health rate cuts have raised alarms across the industry. Wingard warned that such cuts could force many providers out of business.
By the Bay Health is an affiliate of the University of California San Francisco Health. The organization’s service lines include hospice, palliative, pediatric and skilled home health care. The company serves the entire Bay Area.
Wingard recently caught up with Home Health Care News to expand on her goals for By the Bay Health, as well as the company’s recruitment strategy, the advantages of being a nonprofit and the challenges the company is facing in the space.
Wingard will also be participating in a panel discussion entitled “The Promise of Integration: Inside the payvider model” at Home Health Care News’ FUTURE event in Dallas on September 15 to 17 in Dallas.
The transcript below has been edited for length and clarity.
HHCN: Your company has a broad scope of services. What are your priorities when it comes to the home health segment?
Wingard: We’re really proud that we serve many facets of the continuum of care. Right now, we are supporting hospice, home health, palliative care, both pediatric and adult. We also have a very broad set of bereavement services in the community. As far as home health, I’ve been surprised that there have been so many opportunities to coordinate and collaborate, not only within our other lines of service, but with our outside partners. It feels like we’ve seen tremendous outreach from our health plan, hospital system and overall community partners in being very interested in our home health division, and how we could partner differently.
The goal is, of course, to have the highest quality home health services possible in the Bay Area and where we serve. We’re really focusing on accessibility. That has been such a pain point for so many, so making sure that we’re accessible to as many folks as possible, and increasing our service hours when we can, expanding the complexity of our services, whether that’s wound care, infusion care, other types of complexity.
We’re really looking to expand and enhance our clinical informatics expertise. We have actually hired an informatics specialist, someone who is really well-versed in AI, and how an organization, specifically home-based models of care, uses data to make decisions and the electronic medical record to be able to build efficiencies. We all know that the dollar needs to be stretched as far as it possibly can, especially in home health, and we think that investing in clinical informatics might be a way for us to support the community with home health and also our partners.
What are some of the biggest opportunities By the Bay Health is seeing with this segment?
How do we partner closely with our managed care organizations to support the needs in the home health line of business? Managed care is only growing, and we want to be the leader. Instead of digging our heels in, we want to partner right alongside you to make sure we do whatever is needed to support this patient population. There has been such a resistance, for some reason, to managed care. We have to reduce the waste in the system. By the Bay Health is really a leader in understanding that specifically. We understand efficiencies, we understand scale, we understand how to partner well so that transitions are safe and seamless. We’re decreasing the cost of care as much as possible, so that we’re not having the robust costs that we’ve seen in health care overall.
What unique approaches is your company taking to address recruitment and retention? How have the results been?
We’re trying to build what we call the pathways to care career program. It’s really designed to draw attention to home-based models of care as an incredible opportunity in the health care profession. I’m a nurse by background, and I know many other disciplines can say through their education that the focus is traditionally on hospitals. Professional opportunities in home-based care really get very little attention in the academic curriculum. We’re changing that. We’ve started a program at one of our high schools in Marin County called introduction to the world of health care. We’ve started scholarships at two of the local colleges. We have started paid internship programs for high school students, so they get real experience in health care and an understanding of all of the different career options.
Is there anything that being a nonprofit allows your company to do that you think wouldn’t be possible otherwise?
I feel really lucky that we have a nonprofit corporate structure, because things like the pathways to care career program wouldn’t exist without the philanthropic efforts that we have within our organization to raise money for its development. Any operating margin that we have would need to go back to shareholders. Instead, it goes to these programs that serve the community to hopefully reduce the workforce shortages.
Last year, we invested $4 million in the communities that we serve, and that’s through all sorts of grant programs. Being a nonprofit means that we get to partner in the community very differently than a for-profit does.
What other industry challenges are top of mind? What strategies has the company put in place to combat these challenges?
One of the challenges that we experience, and we’re not unique in the industry, is the compensation that we’re seeing across the industry. It is just getting more and more difficult to compete with hospital wages and even ambulatory care wages and benefits of these larger organizations. We’re constantly monitoring wages, compensation and benefits, and doing our very best to learn what small tweaks we can make to remain competitive in the market.
Are there any regulatory concerns or policy shifts that your company is following? How will this impact your business?
I do have a significant concern about the [home health payment] proposal for a 6.4% decrease in Medicare payments. I think we are all really aware that there’s not a home health agency in the nation that is not having a tough time making a margin. This would potentially put a whole lot of people out of business.
