Careful Monitoring Ensures Top-Quality HHA Care for CHOICE Members
For the thousands of members enrolled in a VNSNY CHOICE Health Plan, one of the most important CHOICE benefits is often the regular services of a home health aide (HHA). “The assistance these dedicated HHAs provide with meals, bathing and other life activities is key to many of our members’ health and well-being,” says Dr. Hany Abdelaal, President of CHOICE. “For a lot of our members, these services are needed on a daily basis, so we have to make sure all of our aides are qualified and trained appropriately.”
To ensure that every HHA who walks into a member’s home is up to the job, all of the HHA agencies used by CHOICE are subject to the same industry-leading oversight. This includes VNSNY’s own licensed home care services agency, Partners in Care, known for its high standards, which supplies about half the HHAs used by CHOICE members. The other half are drawn from some 130 other HHA agencies in the CHOICE service area.
“Our goal is to ensure we have a high-performing, quality-driven provider network that meets the needs of our entire membership,” says John Caralyus, Director of Network Contracting and Provider Relations for VNSNY CHOICE. “We start by putting each agency through a very rigorous initial credentialing process, to validate that its training and compliance policies and procedures meet our requirements. To hold our agencies accountable, we also produce monthly performance scorecards that measure patient safety, hospital admissions, customer complaints, and other quality metrics. In addition, we routinely monitor all state and federal regulatory sites to ensure that our provider network isn’t subject to any sanctions or exclusions.”
“The 13,000 members of our CHOICE Managed Long-Term Care plan, who account for over 90 percent of our HHA usage, are the frailest of New Yorkers,” adds Sal Bastardi, Vice President for Administrative Services in VNSNY’s Contract Administration Department. “We want to keep them safe and out of the hospital—and that means tightly monitoring our HHA agencies.”
Should an agency be sanctioned by New York State or CMS for any reason, they’re terminated from the CHOICE network that day, notes Sal. Similarly, if one of CHOICE’s regular audits turns up any deficiencies, the agency is immediately put on a corrective action plan. “We also meet regularly with agency leaders to provide training and share best practices,” he says.
All HHAs are individually supervised by nursing staff as well, to make sure that their care plans are adhered to. If an aide is late for a handoff or unable to make a scheduled visit, CHOICE managers will rush a replacement aide to the member’s home. In addition, if an aide turns out to be a less than ideal fit for a member, “our members can request a different HHA at any time,” notes Hany.
“The comprehensive CHOICE oversight process is a great fit with our own rigorous HHA training and supervision protocols,” adds Jennifer Rajewski-Brullo, Senior Vice President of Partners in Care. The recent implementation of a new data system has further streamlined this process, by allowing CHOICE and its contracted HHA agencies to note any problems directly in each CHOICE member’s digital record in real time, alerting CHOICE staff without the need for a phone call or email.
The new data system is one more way that CHOICE is working to ensure a caring and safe home environment for New York’s most vulnerable patients. “When an HHA walks into a plan member’s home, they’re representing CHOICE, no matter what agency they work for,” says Sal. “How that aide performs reflects on us.”