The phrase "caregiver" has many definitions these days, from the primary care doctor to the great-great grandchild or neighbor who looks in on a homebound senior to make sure the medications have been taken and the heat is on.
Regardless of the definition, the impact of healthcare reform is clear: As care moves beyond the hospital setting and into the home or assisted living facility, whoever is providing it needs to make sure it's being done right. And they're feeling the pinch from insurers who, pressured by the Accountable Care Act, won't reimburse for home health care unless those standards of care are met.
That's the goal of Caremerge, a Chicago-based company that debuted in late 2012 and is now providing a Care Coordination Platform to some 100 senior and assisted living networks in the United States. The company recently announced a deal with BMA Management, the 16th largest provider of assisted living services in the country, to roll out the platform to its 38 facilities in and around Illinois.
Just as important to company founder and CEO Asif Khan, though, is the recent addition of a family engagement app to the platform, enabling caregivers of all definitions to be included in the health management conversation.
"People are not communicating what's going on." Khan said during a recent interview with mHealth News. "You might be at work, thinking 'Is my Mom being taken care of or is she just sitting in her room looking at the walls?' And you wouldn't have any way of knowing."
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"This gives family members and other caregivers proof that their loved ones are being cared for properly," he said, adding it took Caremerge officials several months of studying caregiver workloads and needs to fill out the app.
Khan says the Care Coordination Platform "kills three birds with one stone." First and foremost, it gives assisted living facilities an online checklist to create and fill out documents to meet Affordable Care Act (ACA) managed care organization guidelines, providing an audit trail for reimbursement. Second, it cuts down on the paperwork – and time spent filling that out – so that nurses and home health aides can spend more time actually helping a patient. And third, it provides an immediate link back to family members and other caregivers, so that they know what's been done.
At Chicago-based BMA Management, the Caremerge platform helps reduce an already-heavy workload for its employees. And with Medicare and Medicaid dropping traditional lump sum payments and reimbursing under the ACA's new managed care organization (MCO) guidelines, it's important to get that workflow right.
“Like other providers, we have always been trying to find an EHR to fit into the assisted living workflows," said BMA Management spokesperson Ruta Prasauskas in a press release. "Traditional skilled nursing EHRs are too complicated (due to code-based reimbursements) and do not fit into our model easily."
Prasauskas added that the data Caremerge enables BMA Management to capture and show to MCOs will, in turn, elevate its standards of care, demonstrate better outcomes, and highlight how it providers services less expensively than a skilled nursing facility.
"Most importantly,' Prasauskas continued, "this will allow us to provide a higher quality of life for our residents, and also allow us to scale our operations.”
Khan says the Caremerge platform will continue to be improved as it works to include more of the caregiver team in the communication network. That might mean adding more social features, like a patient profile that home health aides and nurses can use to tailor their care routine for each individual patient.
In addition, the platform is drawing attention from other sections of the healthcare chain, including transitional care facilities.
Claiming that it makes things simpler, Khan added that "this is real-time healthcare."
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