ACTON NURSING SERVICES

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1 Five Year Trend Analysis ACTON NURSING SERVICES Donna Galluzzo, PhD, RD Cheryl Leslie, RN, MPH

2 Trend Analysis Report Contents Purpose of the Report Background Acton Nursing Services Operations Trends Financial Trends Future Options Conclusions Final Recommendations 2

3 Purpose of the Report Acton Nursing Service is at a Crossroads Strategic Charge from the Board of Selectmen Explore Partnerships with Other Certified Agencies Perform a 5 Year Operations and Financial Trend Analysis Guide the Board s Decisions Regarding the Future of ANS and Potential Service Options 3

4 Background Health Systems, ACO s and Hospital Trends Future Trends and Concerns Reimbursement Population Management Technology Investments The Value Equation-Integrated Networks Massachusetts Health Care System Competition for Patients Home Health Opportunities and Threats CMS HH Mandates New CMS HH Mandates for CY

5 Operations Trends Acton Operations: Selected Home Health Data Acton Nursing Service Public Health Data Acton Nursing Service Daily Operational Activities 5

6 Financial Trends Operating Expenses Reduced as Patient Revenues Declined 2014-Sharp Decline in Revenue 35% decline in referrals Decline in Medicare referrals 2010-Operating Deficits Required Enterprise Funds Days Sales Outstanding Impacted by Billing Vendor Performance Net Collection Rate Decreased to 88% Well Managed Bad Debt Write-off Increasing Need for Charity Care (grant funded) 6

7 Future Options Status Quo Close ANS and: Outsource Services Transition to Parmenter for Nursing and Public Health Services Transition Nursing to Parmenter but Acton Maintains Public Health Services Transition Nursing Services to Parmenter but Maintain Public Health Services and Develops a Navigator Program Refer Nursing Services to Several Agencies but Maintain Public Health and Develop a Navigator Program 7

8 Navigator Program A Navigator Program could provide assistance to Acton residents by coordinating services from all types of providers, promoting education and outreach, obtaining information about insurance resources, and facilitating the integration of town services. Advocate for Residents and Families Facilitate and Coordinate Community and School-based Services Act as an Information Clearinghouse/Create a Resource Database Provide Crisis Intervention for Mental or Physical Health Needs Participate in Town Committees Educate the Community Regarding Healthy Behaviors to Improve Wellness and Chronic Disease Management 8

9 Conclusions Increasing Competition Eroding Marketplace Critical Unknowns Baby Boomer Demands for Home Care Services Impact of Health Care Reform Investment in a Navigator Program Creates an Innovative Population Management Model for Acton and Surrounding Communities 9

10 Final Recommendations Acton Should Move from a Provider of Home Health Services to a Coordinator of Care in Order to Maximize Resources for Residents of All Ages Closing the Home Health Certified-Only Portion of ANS Partnering with A Strong Agency That Can Survive the Challenges of the Next Critical Years Maintain Public Health Services under Acton Control Adding a Navigator Program 10

11 Questions? HMS wishes to thank the Town leaders and Acton Nursing Services staff for helping complete this analysis. We consider it a privilege to have worked with such a dedicated team and to be part of creating a vision for future health care services for Acton residents. 11

12 Leadership Donna Galluzzo, PhD., R.D., President and CEO (203) Robbin Boyatt, M.P.H., Director of Operations (203) Cheryl Leslie, R.N., M.P.H., Director of Homecare & Hospice (860) Pamela Meliso, J.D., M.P.H., Director of Consulting & Regulatory Affairs (203) Joanne Erickson, R.N., M.S.N., Director of Advisory & Continuum Services (203) HMS Healthcare Management Solutions, Inc. 8 Research Parkway Wallingford, CT

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