National Healthcare At Home Best Practices: What Did The Study Show And Where Do We Go From Here?

June 9, 2023

The results of the National Healthcare at Home Best Practices and Future Insights Study recently released its results. With over 1,000 agency sites, the study results were comprehensive for home health, homecare,  and hospice. This type of research can help our industry solidify itself as a prime mover of care to the aged and infirm communities we serve and help us improve how we do it. Let’s take a look at some of the results from the study.

Home Health and Hospice Results:

This study pulled best practices from over 40,000 data points. It looks at clinical, operational, and financial best practices while addressing the staffing, recruitment and retention issues that continue to hurt our industry’s ability to provide all the care needed. Here are some of the interesting findings from the report:

1: Sales force used to generate referrals: Those considered in this part of the study were agencies in the top 10% for quality and patient satisfaction while also performing well financially in PDGM. The study showed there was no difference in quality scores for those agencies who utilized a clinical versus a non-clinical employee in sales. However, there was a difference small difference in patient satisfaction. The patient satisfaction was improved for those using non-clinical employees.

2. Referral to admission conversion rate: Ultimately, for those agencies converting over 80% of referrals to admission, there was a 4 Star or better rating. Those agencies with 70% conversion rate or less ranked with only 2 ½ to 3 stars.

3. Missed visits metric: Agencies who evaluated missed visits in relationship to LUPA thresholds had a 20% average profit ratio. This is in stark contrast to those who don’t that only show 1% profit ratio.

4. Start of Care Scheduling: In this metric it showed that none of the agencies in the Home Health Centers for Excellence base used the clinical team for scheduling. The majority used a non-clinical scheduler at 65% and non-clinical intake personnel at 35%. These agencies did not sacrifice quality to utilize this approach.

5. Reimbursement: 56% pay RN per diem/per visit while 42% pay salary. Those agencies utilizing this model have an average Star Rating of 4.0. 92% pay rehab staff and social workers salary.

6. Average visits per day: The study showed no correlation between productivity and quality. Over 62% of agencies average 5 visits or more unweighted visits per day. Over 35% average less than 4 unweighted visits per day. Therefore, those doing over 5 visits a day still had the same quality ratings of those at 4 or less.

7. Outsourced ICD 10 Coding And Oasis Review: In the last year, 92.18% of Home Health Centers of Excellence agencies report outsourcing ICD 10 coding.  5.59% of these agencies report outsourcing both Oasis and ICD 19 coding. 0.56% do Oasis, ICD 10 coding and plan of care review through a third party. The primary reason for doing so related to lack of resources. The other reasons listed were for cost and improvement of quality outcomes.

8. Outsourced Billing: Those agencies with outsourced billing showed an average profit ratio of 20% while those who didn’t outsource were at 6% profit .


This blog post lists only a fraction of the findings in this very comprehensive report. It is worthwhile for all agencies to review the results and consider what you could and should do differently to improve clinical financial and operational outcomes. The full report can be found here. If you need help to achieve your goals, call Kenyon Homecare Consulting at 206-721-5091 or contact us online to see how we can help you get there. 


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