Below is a transcript of an interview with Michael Neuman, Trella’s VP of Data Science and Engineering. To see the original post and additional commentary, please visit Home Health Care News. For questions related to Mike Neuman’s answers or to learn more about Trella Health’s data and insights, please email firstname.lastname@example.org
What career experiences do you most draw from in your role today?
My experience comes from 15 years in the health care industry, including my time at Trella. I spent 12 years in academic medical centers building teams that bridged the gap between operations and technology. Those teams managed the functionality for analytics so we could push organizations to become data-driven. I have experience in the full gamut of health care data and analytics, from the raw data ingestion and warehousing, all the way to operationalizing and implementing processes that improve outcomes and efficiency. Data is one of the most valuable non-labor assets in any organization today, including the health care industry.
Trella Health was founded in January 2015. What was its mission then, and how has that mission evolved?
I joined Trella Health in 2017, and the real focus has always been leveraging data to provide market insights. Our mission statement back in 2015 was, “Bringing transparency to health care.” Presently, our mission is “Empowering meaningful change in health care.” The foundation is the same: making sure we have data and analytics that can support more impactful decision-making in the health care industry.
Part of that is bringing transparency, which then ultimately leads to process improvement and change. Additionally, we have expanded our reach within the industry. We originally focused on post-acute care, but as we’ve built out our capabilities and gained in-depth real-world experience within the health care sector, we’ve expanded beyond post-acute. Now, we’re working with ACOs, health systems, providers and payers. We really cover the entire spectrum of the health care delivery system in our country.
What sets Trella’s offering apart from its competitors?
Many organizations have access to some claims data because it is readily available from various sources. It can be acquired with the right amount of money, so it’s not a question of access, but what you do with it.
We are always looking for new data sets and ways to enhance what we do. Trella Health was recently certified as a Qualified Entity through the Centers for Medicare & Medicaid Services (CMS). This seal not only enables us to make technological advances in our capabilities but shows CMS’s level of trust in our ability to create meaningful analytics. We are one of only 11 companies to have this certification at a national level from CMS.
Trella Health’s experienced team, comprehensive data sets, and technology are able to deliver unprecedented data solutions to the markets we serve. These attributes really set us apart.
Trella notes that post-acute providers need market data to succeed in 2021. How does Trella define “market data,” and how can post-acute care organizations use that data to be successful?
Market data is essential in any industry, and health care is not excluded from that. Trella Health allows customers to look at “market data” through several lenses. We believe that organizations need to analyze referral data and quality of care metrics. Providers need to be able to ask and answer questions, such as:
We look at all of those aspects of market data in order to help our clients succeed. We know who the competition is in a given market because we have access to 100% of the fee-for-service data in the country and we use our proprietary algorithms to determine referral sources and destinations. We’re able to look at the full continuum of care within our suite of solutions and believe all of those pieces lead to a better understanding of any given market. Trella Health’s solutions empower our users through data.
What role do you see market data playing in 2022 that doesn’t exist today?
We’re at a turning point in the health care industry, related to the pandemic. I don’t think we could have this conversation without talking about what the pandemic is doing within the health care delivery system. In 2020 and 2021, we’ve seen a shift in where and how patients are receiving care.
We’ve seen patients directed out of congregate care facilities and skilled nursing facilities and put directly into home health when leaving the hospital. We’ve seen shorter lengths of stay in the hospital to free up capacity. There are a lot of shifts happening.
Patients are going into settings they’ve never dealt with before and health care organizations need to understand how that market is shifting. Are there certain geographies where those shifts are happening more readily? Are other areas lagging behind? As I said, providers need to understand where those patients are coming from and where they’re receiving optimal care, or on the converse, where care is suboptimal.
For example, while we’re shifting away from skilled nursing as the destination of choice for low-acuity patients, are we seeing that readmissions and hospitalizations are increasing, going down, or staying the same? Are patients in home health receiving the same quality of care as they would in another setting? All of those components of market data are absolutely necessary for helping PAC organizations be successful into 2022 and beyond.
What impact have you seen on PAC organizations from the increase in Medicare Advantage enrollment?
Medicare advantage now makes up approximately 40% of total Medicare enrollment. Medicare Advantage is expanding the services it covers and offers, so it’s not going away any time soon. Historically, there were some questions about whether Medicare Advantage was here to stay. I think we can now say with confidence that it’s going to continue to grow and expand.
The Biden administration has said they want to invest in and expand Medicare Advantage, and that it’s a successful model. What we’ve seen is that organizations, specifically in the PAC market segment, don’t fully understand the implications of Medicare Advantage.
These organizations need to look at how to segment their referral sources by payer. How much of their referral sources are coming from fee-for-service versus Medicare Advantage? Are they partnering with organizations that are predominantly fee-for-service today? If they are and they’re not seeing growth in the Medicare Advantage volume, then there could be a time when they may struggle to receive patients.
If they are not developing partnerships, building out networks, and becoming in-network with specific Medicare Advantage plans, they’re at risk of losing their population space, and that could drastically impact their operations. I think Medicare Advantage is a permanent trend and organizations need to start paying attention to it. Medicare Advantage is a process of shifting risk. Post-acute care organizations need to be acutely aware of how quality is measured and how risk is assessed in order to get in-network and partner with the appropriate MA plans.
What is the biggest challenge you and Trella faced in 2021, and how did you respond to it?
As a company serving the health care segment, you can look and see how everything with regards to COVID-19 is changing and shifting the way we live, work and even receive care. We wanted to make sure that we were staying relevant in a world where things were quickly changing.
The changes initiated in 2020 around rerouting patients to different locations in terms of post-acute care have remained permanent, and we expect them to grow. We’ve had to respond to all of these changes in the marketplace while also responding to questions from our clients and prospects who need more data and transparency than ever before.
We’ve had to go out and obtain additional data sources to give us more visibility into Medicare Advantage. We’ve spent a lot of time developing our Mosaic solution that lets folks build better networks and optimally analyze costs associated with ACOs and DCEs (direct contracting entities).
There have been a lot of changes in a short period of time, and they all directly impacted the market segments we serve. For us, the biggest challenge has been responding to those changes quickly enough for our customers to maintain and adjust their business operations as they learn more using the insights we generate.
Entering this year, no one knew fully what to expect in the home health industry. What has been the biggest surprise in the industry this year, and what impact do you think that surprise will have on the industry next year?
I think we’ve seen it play out: home health can offer the same services patients would get in other settings, but in the home, and can offer high-quality care while maintaining costs. Why are we still questioning if home health is the appropriate destination or if these services should be covered? From everything we know as industry experts, it’s absolutely a segment that needs to be invested in.
That’s the biggest surprise to me, because all of the indicators point to home health being a high-quality care setting.
Editor’s note: This interview has been edited for length and clarity.