I am a PT who desires to re-enter the workforce. I need the flexibility that home health on a part-time basis offers. Since I am just now entertaining the thought of returning to work, what resources do you recommend to brush up on the home health industries?  Do you know of any continuing education courses that would be helpful? 

As physical therapists, we are fortunate to have many opportunities and can literally “re-invent” our career paths to fit our lives and lifestyles. On the other hand, as you so astutely represent by the very asking of your questions, we must keep up with not only professional clinical advancements but also industry changes that occur when we change practice environments.

The practice of physical therapy in homecare is highly unique compared to the other settings. The vast majority of patients seen in this setting are elderly or otherwise qualifying Medicare beneficiaries. Medicare regulations have undergone drastic changes since the Balanced Budget Act of 1998 with the onset of a Prospective Payment System (PPS) in 2000. This changed the way agencies are reimbursed from a fee for service structure to payment based on a series of clinical, functional, and service indicators taken from an assessment tool (OASIS) performed at the initial home care visit. At the time that this major transformation occurred, agencies had to not only internalize the fiscal realities of how this change affected them, but also how they would educate their staff about the changes. Most agencies took on that challenge internally with mass instruction sessions, in-services, education fairs, etc. They taught the specifics of how to fill out the OASIS form and document what they saw as the patient needs for programming. What agencies missed, in retrospect, was to enlighten the clinicians about the big picture – how the clinical and fiscal outcomes were being merged. Many therapists and nurses practicing today do not truly understand the key role they play in the composition and direction of the average Medicare home health program. Specifically, they drive not only the patient’s clinical results, but also play the primary role in the agency’s financial success or failure.

That said, now Medicare has put before the home care industry a New Rule that will take effect on January 1, 2008. This reform further links the clinical and fiscal realities for agencies and spotlights the need for clinical staff to be as knowledgeable as ever in their roles. Agencies will once again be providing clinicians with education internally as Medicare reforms are enacted. Where will agencies be getting their information? Many industry resources exist and hopefully those are being shared with treating clinical staff members already. We encourage you as a clinician, to seek out educational venues such as conferences or publications rather than rely on the agency for direction.

HHSM has had excellent experiences with all the DecisionHealth products. Specific publications such as Home Health Line, Home Care Outcomes and Success In Homecare are a few of their offerings which outline timely commentary about contemporary home health trends and topics. In addition, their continuing education conferences provided nationally offer meaningful direction in multiple homecare areas. Topics including financial health, clinical best practices, reforms and coding are regularly presented. In addition, HHSM provides these bi-monthly articles in ADVANCE FOR PT/PTAs in both print and online versions (these are all archived at www.homehealthstrategicmanagement.com post publication). Lastly, the National Association for Home Care (NAHC), your state home health association and your state professional review organization (PRO) are worthy resources that regularly provide educational opportunities for the homecare clinician.

Teri N. Thompson and Arnie Cisneros are physical therapists with more than 35 years of combined home care experience. They are co-owners of Home Health Strategic Management of East Lansing, MI; providing clinical service management and home care consulting expertise. They also lecture and provide OASIS, HHRG, OBQI and P4P training at seminars nationally.