In October 2017, Colorado Visiting Nurse Association’s (VNA) partnered with innovative telehealth company, Health Recovery Solutions (HRS), to launch a pilot intervention program for adults living with heart failure.
Individuals with heart disease have a national average 30-day readmission rate of 24%. Colorado VNA is hoping to significantly reduce this rate for their home health heart failure clients with the use of remote monitoring technology through HRS’ telehealth software.
At the behest of House Bill 15-1033, which passed in 2015, a “multidisciplinary private and public sector stakeholders’’ group to develop a comprehensive strategic action plan on aging through the year 2030” was convened. In short, the Strategic Action Planning Group on Aging (SAPGA) was created to figure out how to respond to the challenge of a dramatically expanding 65+ population.
The 2016 CVNA Annual Report is out and it includes an Infographic detailing the services CVNA provided. In reviewing the report, I am delighted and awed – and hope you are, too – by all that our dedicated and compassionate employees have accomplished, as well as all the changes the organization has weathered. In May 2016 we merged with our sister agency, RVNA, and now serve a combined total of 17 counties along the Front Range. We created an Innovation Lab, an internal research and development program through which we explore promising practices, foster creative collaborations with both health systems and community-based organizations, and creatively design or redesign systems, processes, and/or programs to ultimately achieve positive health impacts that are both sustainable and scalable. (And in 2017 we were able to pilot two Innovation Lab initiatives, CAPABLE and Telemedicine!) And we achieved a 4.5-star rating by Medicare for quality of patient care (out of 5 stars).
As Colorado VNA’s CEO, I think about aging and the perception of aging a lot given that over 75% of patients we serve are 65 and older. In fact, in partnership with our Board of Directors, our organization has begun to update its strategic plan beginning with our mission, vision, and values. This was encouraged largely by the realization that our patient demographics are changing and that the over-65 population will grow dramatically in Colorado over the next several decades (it is estimated that one in four Coloradans will be 60+ by 2040).
Home health is one of the most beleaguered medical services used and supported by Centers for Medicare and Medicaid (CMS). Every year there are increasing regulations and seemingly decreasing reimbursement. Because of these pressures, agencies must look for ways to cut costs while also increasing capabilities. Health systems and hospitals have a motivation to decrease readmissions because of CMS’s Readmission Reduction Program mandated by the ACA. A growing technology that is helping to provide additional services to patients while improving efficiency and decreasing costs is telehealth.
Over the last two decades, we’ve come to understand that oral health means much more than healthy teeth. As the American Dental Association states “Your mouth is a window into the health of your body” and regular visits to a dentist allow for a view into general health and wellness. Similarly, foot care is about so much more than simply clipping toe nails, especially for older adults and those with diabetes. Our feet often reveal signs of disease such as nerve disorders, gout, arthritis, melanoma, and heart disease. Feet can tell us about the state of our circulation and the condition of our thyroid. Our feet falter when our shoes are too tight, our toenails too long, we don’t moisturize our skin, and problems such as ulcerations and infections go unnoticed and untreated.
As I described in this post there is massive growth in the elderly population in Colorado with projections of more than 1.4 million people over the age of 65 in Colorado by 2030. This surge is taxing our health care system and there is no one solution to this challenge. In fact, clinicians, community health workers, and senior advocates alike all agree that it is best serve older adults with a constellation of health and wellness services that address both acute and long-term needs. I strongly believe that, too. I also believe that by creating more and better partnerships within the nonprofit health sector, where organizations focused on different aspects of care and services collaborate together, we can better respond to the diverse and growing needs of older adults. This post details several of Colorado VNA’s burgeoning partnerships as well as information on other community-based nonprofit organizations that are delivering low-cost, high-quality service solutions through partnerships.
The population in Colorado is aging quickly, more quickly than most other states. Related to our aging population, is the rising cost in healthcare, much of it fueled by chronic disease management which affects about 80% of older adults in our country.
And yet, despite the additional medical oversight required when living with chronic disease, the vast majority of older adults want to remain in their homes. According to a study by AARP (Page 2, Housing Preferences) “73 percent [of older adults] strongly agreed that they would like to stay in their current residences as long as possible, while 67 percent strongly agreed that they would like to remain in their communities as long as possible”.
Colorado VNA (CVNA) in Northern Colorado has been providing Medicaid Home and Community-Based Services (HCBS) services for over thirty years. Like many organizations that care for HCBS patients, our organization is struggling to care for these patients because the reimbursement is too low, well below our costs. In recent years, with the increase in home health care regulations; the cost to provide homemaking and personal care services has risen significantly. It is because of the gap between reimbursement and costs that CVNA is working to find other agencies to take on some of our patients. Additionally, CVNA will be kicking off a fundraising campaign to seek support from caring donors passionate about helping Colorado residents remain in their homes. The following is an overview of how CVNA came to this decision to decrease our HCBS census as well as a description of what other states are doing with HCBS.
Interested in working for VNA?
We are always looking for top notch care givers to support our mission of providing the best at home care in the industry.
Visit our careers page for more information.
6750 West 52nd Avenue
Arvada, CO 80002