TL;DR
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Home-based care leaders described rising expectations from payers and referral partners for rapid referral responses, timely care starts and detailed performance data. They said providers need to weigh those demands against their clinical strengths, compliance systems and ability to use technology effectively.
Home-based care providers face higher expectations from payers and referral partners for fast responses, timely starts of care and detailed performance data, executives said at Home Health Care News’ FUTURE conference. They also cautioned that providers need to choose partnerships and growth opportunities that fit their clinical expertise, compliance capacity and business model.
Dean Alverson, CEO of LifeCare Home Health Family, said payers and health systems selecting preferred providers increasingly expect agencies to accept referrals within seven to 10 minutes and begin care within 24 hours or on the same day. Partners also want providers with the clinical disciplines and expertise to serve their patient populations. “If you don’t have all the disciplines, you’re going to get left out,” Alverson said.
Alverson said partners are also seeking meaningful, granular information, including data on rehospitalizations linked to medication errors or gaps in care. Providers that cannot supply requested information risk losing access to payer relationships, he said. Jamie Davis, owner of durable medical equipment supplier Cornerstone Medical Supply, said compliance needs to be part of routine operations rather than limited to designated compliance days or weeks.
Executives also described technology as a way to improve capacity and patient service. Alverson said scribe technology reduced LifeCare’s start-of-care documentation time from about two and a half hours to about 45 minutes. He said the company wants to use some of the time saved for patient interaction and could enable clinicians to complete four or five starts of care a day rather than three. Those are company-reported results and potential capacity, not an independently measured industry-wide finding.
Payer Access Depends on Operational Fit
The expectations discussed at the conference can affect which providers receive referrals and are considered preferred partners. Fast response times, timely care starts and usable data may help agencies demonstrate that they can serve a payer’s population, while gaps in staffing, clinical disciplines or reporting can limit their ability to compete for that work.
Meeting those expectations can also require investment and coordination across an organization. Technology that shortens documentation may create additional clinical capacity, but that capacity has value only if the provider can coordinate referrals, staffing and patient care. Alverson said LifeCare has asked its sales teams to generate referrals to use the added capacity and said the company shares time savings with staff, who are paid per visit.
The advice to remain selective highlights a potential trade-off: pursuing more payer relationships or expanding into new services may increase opportunity, but can stretch an organization beyond its expertise or compliance infrastructure. The executives’ comments describe their operating priorities; they do not establish that every payer uses the same standards or that every provider will see the same results.
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Service Mix Shapes Growth Decisions
The speakers represent organizations with different service models. LifeCare Home Health & Hospice Family, based in Irving, Texas, provides skilled home health, private duty and personal care services, and hospice care. It operates in Arizona, Texas, Florida and Nevada, under several brands. Cornerstone Medical Supply supplies durable medical equipment, orthotic braces and patient care products across the Midwest.
Aaron Marcum, co-founder of Riverside Home Care, said providers should avoid pursuing every payer source or expanding into services that do not fit their strengths. Riverside, based in Fort Collins, Colorado, provides personal home care, companionship, respite and specialized care in Colorado and Wyoming. Marcum said the company’s emphasis on private-pay and Veterans Affairs work informs its decisions about acquisitions and new locations.
The discussion also addressed how providers choose technology. Marcum advised agencies to review what their existing electronic medical record (EMR) systems already offer, as well as vendors’ plans for the next three to six months, before buying separate AI products. Alverson said LifeCare uses AI technology outside its EMR and would prefer integrated tools, while keeping flexibility in third-party contracts to change solutions.
“If you don’t have all the disciplines, you’re going to get left out.”
— Dean Alverson, CEO of LifeCare Home Health Family
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Standards and Results Vary by Provider
The conference comments do not specify how widespread the cited seven-to-10-minute response expectation is, which payers apply it, or how consistently referral partners enforce it. The speakers described demands they encounter, but the discussion did not establish a uniform industry standard.
LifeCare’s reported documentation time reduction and potential increase in daily starts were not accompanied by independent validation or details about how results vary by clinician, patient or care setting. The discussion also did not quantify the costs of adopting AI tools, measure their effect on reimbursement, or establish that technology alone improves outcomes.
It remains unclear how quickly EMR vendors will add the integrated AI functions Alverson expects, and whether those tools will meet providers’ clinical, privacy and compliance needs. Davis stressed the importance of subject matter expertise in evaluating AI-related compliance and risk, but the conference account did not detail specific safeguards or regulatory changes.
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Providers Review Tools and Partnerships
The immediate steps described by the executives are operational: providers can examine their referral response and start-of-care processes, assess whether they have the clinical disciplines partners request, and review whether their data systems can produce meaningful performance information. They can also examine existing EMR functions and vendors’ near-term product plans before committing to separate technology contracts.
Agencies considering new payer relationships, acquisitions or geographic expansion will need to compare those opportunities with their staffing, compliance capacity and established services. No new payer rule, deadline or policy change was announced in the conference discussion. Further developments will depend on payer requirements, provider performance and how clinical software vendors develop and integrate AI tools.
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Key Questions
What are payers and referral partners asking home-based care providers to do?
According to LifeCare CEO Dean Alverson, some expect referral responses within seven to 10 minutes, care to start within 24 hours or the same day, suitable clinical capabilities, and detailed information about performance such as rehospitalizations linked to medication errors or care gaps.
Does the conference report establish a universal payer standard?
No. The speakers described expectations they encounter, but the report did not say that all payers apply the same timelines or requirements.
How did LifeCare say AI affected its start-of-care process?
Alverson said scribe technology reduced the company’s start-of-care documentation time from about two and a half hours to about 45 minutes. The figures were reported by the company and were not presented as an independently verified industry result.
Why did executives caution against pursuing every payer or growth opportunity?
They said providers should avoid expanding beyond their clinical expertise, service strengths and ability to maintain compliance. Marcum said Riverside uses its existing private-pay and Veterans Affairs focus to guide growth decisions.
What should providers check before buying new AI software?
Marcum advised providers to review the AI functions already available through their EMR and ask vendors about near-term plans. Davis also emphasized involving subject matter experts to evaluate AI-related compliance, risk and operational effects.
Source: rss
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