Good article from Advance for Nurses. Something we should all be aware of: ADVANCE for Nurses | Editorial

Being aware of the limited funding available forhome care treatments, nurses will need to have a clear and concise plan of care for all patients, especially those with wounds. These patients tend to present with the highest costs due to frequent care and medical supplies.

Increasing the knowledge base of each agency nurse about wound causes, treatments and prevention will allow the agency to increase income and improve patient outcomes.

Further, having properly trained wound care nurses can cut costs and may potentially create a profit by working with physicians to promote newer, advanced dressing modalities that require less frequent nursing visits.1


There needs to be proper measurement of both the value and cost-effectiveness of various wound care products in home care as prospective payment system (PPS) and pay for performance (P4P) stands on the horizon.

According to the Centers for Medicare and Medicaid Services, a predetermined payment is made to home health agencies based on health condition and care needs of a patient.2

This PPS provides the agency with a set sum, determined by data collected upon initial evaluation by a skilled provider, which will need to cover all expenses from clinical staff and medical supplies in addition to clerical services and office needs. P4P ties a portion of the reimbursements to the delivery of care and achievement of certain quality measurements.3
Dollars & Sense

Developing a wound care program that includes a product formulary can decrease nursing visits noticeably.4 Additionally, a certified wound care nurse will be able to provide in-services to colleagues toincrease their knowledge and ability to properly care for these clients.

Part of the teaching to fellow nurses would include causes of various types of wounds, preferred treatment modalities, and the need for an evaluation by a certified wound nurse (WCC) for any daily wound care patients. By having the WCC evaluate those patients who have daily dressing orders, a possible alternative treatment requiring less frequent visits could be suggested to the physician.

Even though an advanced dressing may cost more per piece, by having less intermittent visits, the agency can save money. Proper use of trained wound care nurses can decrease visits per patient by approximately 20-30 percent saving more than $100 per visit.5

In the U.S., 2.5 million people are affected by venous ulcers; 1.3-3 million people are affected with pressure ulcers; and up to 20 million people with diabetes are at risk for developing a diabetic ulcer within 3 years.6 The total direct annual cost incurred in the treatment of these wounds is estimated to be in the tens of billions of dollars.6

Effective Care

Improving all nursing staff understanding and ability to care for patients with wounds will increase the profitability of a home care agency.

As more and more patients come home from hospitals with either acute surgical wounds or with chronic wounds, it will be critical for agencies to have staff that can effectively provide care.

How does your home health agency stand in the fight against wounds?