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By Bill Grana
For many individuals, the COVID-19 pandemic resulted in a dramatic shift to more time at home – everything from working, connecting with loved ones, interviewing for jobs, and taking classes all from home. Healthcare was no exception. The rise of virtual care enabled people to interact with healthcare providers in ways they never had before, creating meaningful benefits for patients and clinicians.
The new focus on receiving care from the comfort of ones’ home brought an influx of new technology and an increase in adoption of telehealth. Patients and providers alike can monitor concerning symptoms in real-time through health-tracking wearable devices, monitors, and apps while eliminating a trip to their doctor’s office.
Telehealth has now become an integral part of the health at home system and recently the Centers for Medicare and Medicaid Services (CMS), announced an extended timeline for Medicare reimbursement for current telehealth services, and relaxed the criteria for diagnosing, evaluating, and treating mental health disorders via telehealth. While healthcare at home holds massive potential for higher-quality care and value-based care, there are a range of factors that organizations should consider when adopting health at home strategies.
Harnessing Growing Support for Greater Access
At present, two pieces of legislation are key in driving adoption of healthcare at home. The “Hospital Inpatient Services Modernization Act[BG1] [VB2] ” (S.3792) is bipartisan legislation introduced in March by Sens. Tom Carper, D-Del. and Tim Scott, R-S.C. If passed, the legislation would extend the Centers for Medicare & Medicaid Service’s (CMS) Acute Hospital Care at Home program for an additional two years after the COVID-19 public health emergency expires. The extension impacts healthcare providers and patients by paving the way for continued health at home, enabling improved care and outcomes at lower costs. Supporters of this legislation, including the American Hospital Association (AHA), also cite that the program relieves strain from the healthcare system while also allowing vulnerable Americans, who prefer health at home, the ability to continue receiving care at home. Similarly, the “Choose Home Care Act 2021”, (S. 2562/H.R. 5514) was introduced in Oct. 2021 by Rep. Henry Cuellar, (D-TX-28), to provide coverage of home-based extended care services under Medicare. The bill provides coverage of services that are furnished to Medicare beneficiaries in their homes by home health agencies. This includes nursing care, meals and nutritional support, home medical supplies, nonemergency medical transportation, and care coordination.
Research commissioned by Partnership for Quality Home Healthcare and the National Association for Home Care & Hospice found a majority of adults support expanding care options for older Americans. In addition, the research confirmed 85% of Americans were in favor of greater access to healthcare services in the comfort and safety of their homes. The healthcare industry is receptive and responsive to market demand. Providing a projected $265 billion of care and services, Medicare FFS and MA beneficiaries could transition traditional healthcare settings to health at home by 2025. According to a recent KLAS Research report, there are several factors contributing to this sudden shift.
Evolving Payment Models
First, we’re seeing changes to payment models that incentivize healthcare facilities and physician groups to adopt telehealth or value-based payment arrangements. Second, patients are rapidly moving towards healthcare consumerism, and rightfully so. Hours-long wait times, sky-high medical bills, and impossible to book appointments are common parts of the American healthcare experience. Patients are demanding more – and market pressures are needed to guide healthcare organizations to better serve patients. Third, technological advancements, such as remote patient monitoring (RPM), are improving patient supervision and enabling more people to receive reliable care while at home. A recent study by Mayo Clinic used RPM for COVID-19 patients and found a 78.9% engagement rate, proving remote management of acute illness is safe and reliable. Lastly, staffing shortages, limited capacity, and higher risks of infection make hospitals a less than ideal and unnecessary environment for patients who could receive care at home.
According to the National Association for Home Care & Hospice, home health providers expect increased demand from patients and hospital partners so much so that the Choose Home Care Act could result in $925 million a year savings for Medicare. Further, this legislation could generate about $4,623 of savings under Choose Home per patient.
A KLAS whitepaper stresses four critical areas that healthcare provides must address in implementing healthcare at home: technology, supplies, professional services, and staffing. The essential nature of these four areas cannot be understated as more organizations expand healthcare at home services.
Technology that Enables Interoperability: Critical to an organization’s success is ensuring technology stacks and platforms work together, not against each other. Data from remote patient monitoring, as well as electronic health records, are essential to coordinate care. According to the KLAS report, an increased focus on patient education and communication, and ensuring telehealth platforms are optimized will position organizations for success. To ensure patients and providers can get the most out of virtual appointments, virtual care competency among care providers must be prioritized.
Managing Supplies. Managing supplementary home care supplies is a critical aspect of an efficient and effective health at home program. Unique to home healthcare, supplies can be sourced by either the provider or the patient, requiring systems to monitor not only clinical provided supplies and devices but also patient-acquired devices and medications.
Advisory and Managed Services. Technology continues to play a vital role in the transformation of healthcare – from expanding access and reducing barriers to connecting with providers – and requires people and expertise. Delegating the daily management and associated support tasks to outsourced service providers can enable healthcare systems to become more efficient and flexible. Providers implementing healthcare at home stand to benefit from comprehensive and encompassing operational support for networks, servers, desktops, mobile devices, email, and security that help ensure seamless service delivery.
Seamless Staffing. Prioritizing the support of health at home programs by a robust team of physicians, nurse practitioners, and personal care professionals is paramount in ensuring patients receive high quality care.
Ultimately, this is an arena ripe for optimization and continuous improvement. Planning with these critical elements in mind, healthcare organizations can expect increased positive patient outcomes such as increased patient safety, improved outcomes and satisfaction, and lower costs. Additionally, providers will be able to provide higher quality care at a lower cost, while reducing hospital stays, and hospital readmissions. As health at home grows, the model will continue to evolve to meet the needs of its stakeholders, from the patient to the provider to the healthcare system. Meeting challenges head on by implementing necessary support systems requires agility, adaptability, and a commitment to better health outcomes. For hospitals, post-acute and long-term care providers that make this commitment, the results are well worth the investment.
Bill Grana is a seasoned entrepreneur and technology professional with a diverse background in mergers and acquisitions, finance, law, and other business functions. As CEO of award-winning healthcare IT services firm HCTec, Bill draws on extensive leadership experience at early-stage high-growth technology companies.
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