When it comes to home health care, one might say Florida has a bit of a spotty record. Florida usually is on CMS “watch list” for home health care services. In 2015 CMS even imposed a moratorium on new Home Health Agencies in four States including Florida and since that time extends it every 6 months.
Florida Home Health business is often associated with fraudulent activities, improper billing, high cost and poor quality outcomes.
Readmission rates, avoidable use of Emergency Departments, utilization of physical therapy services, cost of service in Florida are higher than same on the national level.
Being that I own a home health care company (Quality Home Care Providers), this is a problem I take very seriously. So I am overjoyed when I find a company that is doing home health care right — one that my own company can learn from — like Faith Health Care in Miami.
The turning point for them was in 2010 when the company changed ownership and built a new management team led by Dr. Alex Sino. Since then, Faith Health Care has made the Top 500 US agency list with impressive daily census and quality outcomes. Dr. Sino has successfully moved Faith Health Care from traditional “pop and mom” home health agency to a sophisticated multi-disease management company.
I must admit, while I am impressed, I am not completely surprised. I have known Dr. Sino for years and he has always had incredible expertise in acute, post acute services and managed care.
As a Vice President of New York Health and Hospitals and Beth Israel Medical Center or as Chief Operating Officer of New York Doctors MSO, he always kept his professional focus on patient centered services models and compliance, which I always admired.
Today, Dr Sino has brought that mentality to Faith Health Care and it shows, as they are among 5% of national agencies receiving “5 Star” CMS Ratings. Hospital readmission rates at Faith Health have gone down to of 11.1% compared to averages of 15.4% in Florida and 12.9% nationally.
Faith also demonstrates lower rate (7.4%) of unplanned ED visits than Florida (11.2%) and National (12.9%). Faith Health Care achieved 98.4% Overall rating Quality Assurance Report and HHVBP Total Performance Score of 2.084% (3% maximum for Florida) that Represents 90 percentile ranking within Cohort CMS.
In 2012–2016 Faith Health Care was selected among only 5 other companies in South Florida to participate in CMS Community Care Transition Program CCTP).
So what are the keys to Faith’s success? I spoke to Dr Sino, and here is what he told me:
“Think global but focus local”. Faith is very well familiar with local ethnic communities — Cuban, Haitian, Eastern European, Jewish and successfully provides cross cultural training for its clinical and clerical staff. 95% of over 500 employees working at Faith Health Care are bi-lingual. Faith is cooperating with local nursing schools and provides professional training for graduates. Dr. Sino says “Faith office and clinical staff looks and speaks exactly like our patients do”.
“Invest to build experienced quality team”. Faith employs a great team of QA specialists — RNs, LPNs, and Case Managers. Majority of them are foreign trained medical doctors with clinical degrees in US.
“Train your team to understand not only home health but also the whole scope of health care delivery system”. Faith prefers to hire office and clinical employees extensive hospital, rehab and managed care experience. As the result several local hospitals, accountable care organizations (ACOs) and HMOs named Faith Health Care a preferred provider.
“Coordinate care and provide concierge type of services to patients, hospitals, and insurance companies”. Faith implements Care Transition protocol for all discharged patients. Care coordinators constantly communicate with patients and care givers. Faith does not rely on answering services and have intake coordinators picking up the phone off hours.
“Invest in compliance program”. Faith Health Care runs quarterly self-assessment studies, uses sophisticated electronic verification of visits, GPS empowered systems, keeps billing and coding in-house, benchmarks utilization to indicate and substantiate proper treatment plans.
“Diversify business portfolio”. Payer mix is important factor of business success. Faith keeps Medicare only as a minor source of income within almost 100 different payers and contracts.
“Network with other providers”. Develop a strategy to work with other acute and post-acute providers and offer capitations and bundled payments for home health services.
Florida may be known as a state where fraud and abuse run rampant, but Dr Sino has showed over the last few years. Hopefully, other home care providers will learn from the terrific job he and his staff have done in creating a first rate operation at Faith.
I know I have.
Munr Kasmir, MD.
NEW JERSEY HEALTH CARE FACILITIES FINANCING AUTHORITY