Health plans should be focused on reducing healing time for patients suffering from chronic wounds. Heal rates are a good indicator of the quality of care a patient receives, as well as the value that health plans are getting for their investment. The current numbers don’t paint a pretty picture.
The industry standard heal rate for chronic wounds is 120 days. Over a 90-day period, only 56 percent of wounds are healed. If we look at specific wounds, we see the same trend in CMS data.
On average, diabetic foot ulcers are healed in 3.76 months.
AÂ recent study(1)Â found that only 50 percent of pressure ulcers heal within 12 months.
Only 45.5 percent of venous wounds typically heal by the three-month mark.
This is not a good use of a health plan’s resources.
Lack of Consistency
When we look at the root of poor healing rates, we see several factors. Most notably:
Patients have inconsistent results when it comes to treating and healing chronic wounds because there is little consistency in both the quality of care and timing of care. We’ll address quality in a moment, but the issue with timing is alarming.
We are seeing large gaps in care. For example, most chronic wound patients should be seen weekly. The data shows that many patients go 30-48 days without any wound treatment. Simply put, patients will not see the results they expect if they are not receiving regular treatments. Patients need a care plan that takes into account the social determinants of health by removing barriers to care. This will allow for faster healing rates and will keep patients out of more expensive settings like in-patient.
Inexperienced Clinicians
There are not enough wound-certified clinicians to accommodate patient needs. Outside of the in-patient setting, most patients either receive care in a wound clinic or from a home health provider. Neither of these are an ideal setting. Even in a specialized wound care clinic, few of the clinicians are wound-certified. It’s a much larger issue in home health.
This lack of expertise and access to wound-certified clinicians in the home creates inconsistent care, delivers sub-standard results including missed diagnoses, longer healing times, and high recurrence rates. We need to deliver consistent quality of wound care, regardless of where the patient receives care. By ensuring all clinicians are wound certified, we can deliver better results and faster heal rates.Â
No Evidence-Based Standards of Care
In a sector of healthcare as large and prevalent as wound care, you would expect to see consistent standards of care across the industry. Alarmingly, there are no evidence-based standards of care that unify the clinical response. Wound clinics frequently use dressings and other supplies based on what is on hand. Home health agencies may apply the same treatments to patients regardless of wound type without appropriately changing the treatment plan as the wound condition changes.Â
Without a consistent approach, patients have vastly different experiences and results. That often translates to longer healing times for chronic wounds. If we can create new standards of care that deliver expertise from specialized physicians and nurses, patients will receive better outcomes and health plans can receive consistent results.
Healing times are an important data point when evaluating a wound care strategy. By focusing on reducing the time to heal wounds, we can reduce in-patient admissions and lower costs. At Esperta Health, 74% of wounds we treat heal faster than the industry average. That is creating value for patients and health plans.