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Home-based care executives described rising expectations from payers and referral partners, including rapid referral responses, timely starts of care, clinical capabilities and detailed performance data. They said providers also need to maintain compliance, choose relationships that fit their expertise and use technology carefully; the discussion took place at Home Health Care News’ FUTURE conference.
Home-based care providers are being pressed by payers and referral partners to respond to referrals faster, begin care sooner and supply more detailed performance data, executives said at Home Health Care News’ FUTURE conference. They also cautioned providers not to pursue partnerships or expansion beyond their clinical capabilities and operational strengths.
Dean Alverson, CEO of LifeCare Home Health Family, said preferred-provider arrangements can come with expectations that providers accept referrals within seven to 10 minutes and start care within 24 hours or on the same day. Partners also want agencies to demonstrate that they have the clinical alignment and expertise to serve the populations being referred. “If you don’t have all the disciplines, you’re going to get left out,” Alverson said.
Alverson said payers and partners increasingly want granular performance data, including information about rehospitalizations linked to medication errors or gaps in care. He warned that providers without meaningful data could lose a place in payer networks. Jamie Davis, owner of Cornerstone Medical Supply, said compliance should be built into routine business operations rather than limited to a designated annual event.
Aaron Marcum, co-founder of Riverside Home Care, said operators should be selective about payer relationships and growth, including acquisitions and new locations. His company focuses on private-pay and Veterans Affairs business, he said, and aims to stay within its areas of expertise. The conference discussion also covered technology: Alverson said AI scribe tools cut LifeCare’s start-of-care documentation time from about two and a half hours to about 45 minutes.
Meeting Expectations Without Overextending
The expectations described by the executives affect how home-based care agencies compete for referrals and maintain payer relationships. Faster intake and starts of care may help providers meet partner needs, while clinical coverage and reliable data can help demonstrate whether an agency is equipped to manage referred patients. The conference comments describe operator experience and expectations, not a universal requirement adopted by every payer or health system.
There is a business trade-off. Expanding into new services or markets may bring referrals, but it can also stretch staffing, clinical oversight and compliance capacity. Marcum’s warning to stay within an organization’s wheelhouse reflects that risk. Providers may have to weigh potential revenue against whether they can deliver care safely and consistently in the populations and services they take on.
Technology may offer added capacity, but the reported time savings do not by themselves establish broader improvements in outcomes or financial performance. Alverson said LifeCare wants clinicians to spend some saved time with patients and described the possibility of completing more starts per day. Those benefits depend on how a provider coordinates referrals, staffing and workflows, not just on adopting software.
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What Providers Said They Need
The comments came from executives at three different types of organizations. Irving, Texas-based LifeCare Home Health & Hospice Family offers skilled home health, private duty and personal care, and hospice services in Arizona, Texas, Florida and Nevada. Fort Collins, Colorado-based Riverside Home Care provides personal care, companionship, respite and specialized care in Colorado and Wyoming. Cornerstone Medical Supply supplies durable medical equipment, braces and patient care products across the Midwest.
That range matters: payer demands and operational considerations may differ between home health agencies, personal-care providers and medical-equipment suppliers. The conference speakers described their own organizations’ experiences and recommendations. The source report does not establish that all providers face identical response-time targets or that every payer applies the same standards.
On technology, Alverson said LifeCare uses AI tools that are not supplied by its electronic medical record vendor and would prefer more integrated options. Marcum advised providers to check what their existing EMR can do, and what its vendor plans to add over the next three to six months, before buying another product. Alverson said LifeCare keeps flexibility in third-party technology contracts so it can move to other solutions as they become available.
““You’re going to have to get granular.””
— Dean Alverson, CEO of LifeCare Home Health Family
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Targets and Technology Still Vary
The conference report does not identify which payers or health systems use the cited seven-to-10-minute referral response target, how widely that expectation applies, or whether the 24-hour or same-day start target is written into contracts. It also does not provide comparative data showing how common those standards are across regions or provider types.
LifeCare’s reported reduction in start-of-care documentation time is an example from one organization. The source does not specify the number of clinicians or visits measured, the period covered, the cost of the software or the effect on patient outcomes. Alverson discussed possible increases in daily starts, but the report does not say that this level of productivity has been reached across the company.
Broader questions also remain open, including how agencies can measure the return on AI tools, how payer data requirements will develop and how providers will manage compliance risks as software changes. Davis said subject-matter experts are needed to understand AI compliance and risk; the report does not describe a specific regulatory change or enforcement action.
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Provider Decisions Ahead
Providers facing these pressures will need to review referral workflows, start-of-care capacity, clinical coverage and the data they can share with partners. The speakers’ comments point to practical areas for that review: whether an agency can meet a partner’s timing expectations, whether it can serve the referred population, and whether its reporting and compliance processes are ready to support that work.
For technology purchasing, Marcum’s advice was to ask current EMR vendors about existing tools and near-term plans before adding separate products. Alverson said LifeCare expects EMRs to become more integrated and AI-friendly, while keeping its third-party contracts flexible. These were expectations and strategies shared by the executives; the report does not name a product rollout or industry-wide deadline.
The next developments will depend on how payers communicate and apply their expectations, and on whether providers can show that new workflows and tools improve capacity without weakening care or oversight. No further policy announcement, payer deadline or conference follow-up was specified in the report.
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Key Questions
What referral response and care-start times did the conference speaker cite?
Dean Alverson said some payers and health systems expect providers to accept referrals within seven to 10 minutes and start care within 24 hours or on the same day. The report does not say that all payers apply these targets.
What data may payer partners want from providers?
Alverson cited detailed information such as the number of patients rehospitalized because of medication errors or gaps in care. The report does not describe a standard data set required by every payer.
How did LifeCare use AI scribe technology?
Alverson said the tool 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 return part of the saved time to patient care. This is a company-reported example, not a sector-wide result.
What should providers consider before adding AI software?
Marcum recommended checking existing EMR features and the vendor’s plans for the next three to six months before buying additional tools. Davis said providers also need subject-matter expertise to understand AI compliance, risk and operational effects.
Why did the speakers caution against pursuing every growth opportunity?
They said providers need to match payer relationships and expansion plans to their clinical expertise, staffing and compliance capacity. Marcum said Riverside aims to stay within its areas of strength rather than expand beyond its wheelhouse.
Source: rss
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