August 2, 2024

Welcome to the Moving Health Home newsletter!

In this monthly newsletter, you will find policy developments, research, and updates on how health care organizations are striving to shift more health care delivery into the home – meeting patient needs where they are and expanding access to quality health care.

Please send any news or events to rcheung@movinghealthhome.org for future inclusion in this newsletter.

Moving Health Home Updates

Modern Healthcare: Push for Hospital-at-Home Waiver Extension Increases (7/31) - The Bipartisan Policy Center, a bipartisan think tank in Washington, DC, released a report recommending Congress to extend the hospital-at-home waiver, noting the need for additional research about the program. Moving Health Home, a trade group representing hospitals and hospital-at-home vendors, said the center's recommendations were reasonable and that standardized quality measures are appropriate and essential to scaling the care model.

Modern Healthcare: Skilled Nursing Facility at Home (7/16) - Hospital-at-home technology and a small number of health systems offer home-based skilled nursing programs as a way to move patients more quickly into post-acute care, cut costs and reduce hospital readmissions. Traditional fee-for-service Medicare won’t reimburse for SNF-at-Home services and only a handful of Medicare Advantage plans and commercial plans will cover it through negotiated value-based contracts. 

Moving Health Home is pushing for legislation that would cover the service under traditional Medicare.

Administration

Food and Drug Administration (FDA): Home as a Health Care Hub – Stakeholder Listening Session (7/25) - FDA held a virtual public meeting on its Home as a Health Care Hub initiative. Participants discussed the home environment as an integral part of the health care system and shared ideas on aspects to consider in developing the initiative. FDA is seeking comments regarding the workshop by August 23, 2024. Additional coverage can be found on MedTech Dive. 

Centers for Medicare and Medicaid Services (CMS): Calendar Year (CY) 2025 Physician Fee Schedule (PFS) (7/10) - CMS issued the CY 2025 Medicare PFS proposed rule, which proposes payment rates and policy changes effective January 1, 2025. Overall, the proposed CY 2025 PFS conversion factor is $32.36, a decrease of $0.93 (or 2.80%) from the current CY 2024 conversion factor of $33.29). Notable home-based proposals:

• CMS is proposing to add caregiver training to the Medicare Telehealth Services List.
• CMS is proposing to establish new coding and payment for caregiver training for direct care services and supports. 
• CMS seeks feedback on its Advanced Primary Care Management Services (APCM) codes, which include home visits. 

Comments are due September 9, 2024. 

CMS: Participants Announced for the Guiding an Improved Dementia Experience (GUIDE) Model (7/8) - The Centers for Medicare & Medicaid Services’ (CMS) Guiding an Improved Dementia Experience (GUIDE) Model is live. Among its participants are a wide range of home-based care providers. The model represents yet another way for providers to engage with alternative payment sources. That’s particularly true for non-medical home care providers, who often deal with dementia patients, but don’t always work with Medicare as a payer. Additional coverage can be found in Home Health Care News. 

Congress

House of Representatives: Introduction of Improving Access to Emergency Medical Services for Seniors Act (H.R. 8977) (7/17) - Rep. Carey (R-OH) and six bipartisan cosponsors introduced the Improving Access to Emergency Medical Services for Seniors Act (H.R. 8977), which would require the Center for Medicare and Medicaid Innovation to test an emergency medical services treatment-in-place model under the Medicare program. Specifically, the bill would allow seniors on Medicare to receive at-home emergency medical services to treat minor medical incidents. 

Research and Polling

HealthSnap: HealthSnap Announces National Remote Patient Monitoring and Chronic Care Management 2024 Clinical Outcomes Report (7/31) - HealthSnap announced its 2024 Clinical Outcomes Report, which highlights the impact of integrated Remote Patient Monitoring (RPM) and Chronic Care Management (CCM) on hypertension, obesity, and type II diabetes management. The findings demonstrate significant improvements in clinical outcomes when RPM and CCM is administered as a comprehensive program for chronic condition management.

Journal of Hospital Medicine: Patient and Care Team Perspectives on an App to Support Hospital-at-Home Admission Decision Making (7/29) - Hospital at Home (HaH) programs are used throughout the United States and are beneficial in both providing patients care in environments most comfortable to them and freeing up inpatient beds. Better informing patients about HaH programs, while promoting shared decision-making (SDM), should be prioritized by health systems. This study found that SDM apps may better inform patients' HaH care decisions, allowing patients self-directed access to information and engagement with visual content, which may address challenges related to health literacy and navigating complex, time-sensitive decisions.

Expert Review of Pharmacoeconomics & Outcomes Research: Cost of Long-Term Care and Balancing Caregiver Wellbeing (7/25) - This review highlights the global variability in LTC costs and the significant burden on caregivers, emphasizing the need for policy interventions and comprehensive insurance schemes. Formal LTC includes paid services in facilities or at home, while informal LTC primarily involves unpaid family caregiving. Informal care often leads to high opportunity costs and financial strain. This review emphasizes the need for policy interventions, comprehensive insurance schemes, and standardized assessment tools to support caregivers and ensure sustainable LTC solutions.

American Journal of Geriatric Psychiatry: Caregiver Contributions to Older Veterans’ Mental Health Utilization: New Opportunities for Exploring Caregiving Roles and Impacts (7/24) - Older Veterans who utilize the Veterans Health Administration (VHA) represent the largest group of older adults in the United States receiving care via an integrated healthcare system where mental health providers are embedded into settings including primary care, home-based primary care, and nursing homes. This study aimed to understand the role of caregiver and its association with mental health service utilization. 

Studies in Health Technology and Informatics: The Role of Health Information Technology During Hospital at Home Transitions (7/24) - The use of healthcare information technology (HIT) is vital for storing and exchanging health information during patient transitions, playing a significant role in care coordination for sepsis survivors. Efficient information transfer during HHC referral highlighted the need for improved EHR access. The study underscores HIT's importance and potential while emphasizing the need for collaborative policy and interface development to promote effective transitions in care.

Journal of Pain and Symptom Management: Challenges in Pediatric Home-Based Hospice and Palliative Care (7/5) - Pediatric home-based hospice and palliative care is a growing and important sub-field within the larger pediatric palliative care landscape. Despite research demonstrating the clinical and systemic efficacy of pediatric home-based hospice and palliative care, there remain barriers to its optimal development, implementation, and dissemination as well as best clinical practice knowledge gaps. This case series presents specific examples of ubiquitous challenges in pediatric home-based hospice and palliative care in hopes of guiding future research, education, advocacy, and program development efforts.

News and Market Developments

UMass Chan Medical School: Study to Evaluate Post-Hospital Skilled Nursing Care at Home (8/1) - UMass Chan Medical School announced it will conduct a study on post-acute skilled nursing facility services provided in the patient’s home. The Skilled Nursing Facility or SNF at Home trial is a large, randomized clinical trial, the first of its kind, supported by a $6.5 million grant from the Massachusetts Executive Office of Health and Human Services. Researchers plan to enroll 650 patients who are eligible for inpatient-level skilled nursing care following acute hospitalization across the two sites.

Modern Healthcare: WellBe Senior Medical Proves In-Home Care is Hot Topic (7/31) - Home-based care for chronically ill older adults is a sweet spot for venture capital investment, with WellBe Senior Medical becoming the latest beneficiary of the trend. WellBe Senior Medical is among a growing number of companies, including HarmonyCares and Patina Health, that offer home-based care to chronically ill older adults through value-based care arrangements with Medicare Advantage plans. The goal is to manage patients’ illnesses and keep them at home instead of sending them to the hospital. That makes the companies attractive to both insurers and investors. 

Wall Street Journal: For Decades, Mississippi Locked Up the Mentally Ill. It’s Trying Something Different (7/31) - Mississippi is working to keep people with mental illness from repeated hospital confinement by treating them in their homes or clinics in their communities. The state is treating more patients at home and clinics instead of cycling them through hospitals and jails. Mississippi, which like many other states has limited resources and abundant demand, has long relied on forcing mentally ill residents into state psychiatric institutions as a remedy. 

Home Health Care News: Maxim at Home Rebrands to Villi (7/29) - Maxim at Home rebranded to Villi. The Dallas-based company integrates technology with traditional companion care to keep adults at home, living independently. Recently, in-home companion care models have become more popular, in part due to a shortage of caregivers and increased demand. They use technology to connect older adults with “Papa Pals,” who provide companionship, technology assistance, meal preparation, light housework and similar services.

Home Health Care News: Another Home Care Leader Bets On Primary Care In The Home (7/24) - Seniors who have difficulty leaving their homes or accessing traditional medical facilities have a new option for health care: mobile, medical home care visits from Horizon Care Services. The company will prioritize ongoing primary and specialty care, monitoring conditions, and addressing issues before they escalate. Horizon Care Services bills Medicare, but offers a private-pay option for added flexibility.

HealthTech: Bringing Hospital Care Home: A Revolution in Rural Health Care (7/24) - Hospital at home bridges the access gap by offering high-quality care at the patient’s home or at a senior care location. The hospital-at-home model represents a significant advancement in rural health care that addresses long-standing access issues. By bringing comprehensive care directly to patients’ homes, this model may improve health outcomes, increase patient satisfaction and provide a sustainable approach for rural health care providers.

Luna: Luna Celebrates One Million In-Home Physical Therapy Visits (7/24) - Luna celebrates its one-millionth in-home physical therapy visit, underscoring the success of the innovative care model. Luna, a provider of in-home, in-person physical therapy (PT), is proud to celebrate its one-millionth visit since the service was launched in 2019. Luna collaborates with more than 25 leading healthcare providers such as Emory Healthcare, Providence, Intermountain Health, Adventist Health, MedStar Health and Baylor Medicine while also serving as the exclusive provider of physical therapy for AARP members. These partnerships are pivotal in Luna's mission to revolutionize access to physical therapy and provide essential relief to those experiencing musculoskeletal (MSK) conditions.

Becker's Hospital Review: Why CommonSpirit Health is Investing in the Home (7/18) - Chicago-based CommonSpirit Health has grown into the country's largest Catholic provider of care at home. The care model has evolved dramatically in that time, as more patients grew to demand — and expect — medical treatment in the comfort of their homes, with technological advancements enabling that shift.

Upcoming Events

August 7, NIHCM Foundation, "Meeting the Health Care Needs of an Aging Population." 

August 21-23, Home Health Care News, “Future Conference”

October 20-23, HLTH, "HLTH 2024." 

October 21, Moving Health Home, "Reception at HLTH."

October 28-29, Home Care Association of America, "National Home Care Conference." 

December 11, Home Health Care News, "Continuum Conference." 

Previous Events, Videos, and Podcasts

Pear Healthcare Playbook, "Lessons from Kevin Riddleberger, Co-Founder of DispatchHealth, on Crafting a Trusted and Comprehensive Home Healthcare Experience." In this episode, Kevin Riddleberger, Co-Founder of DispatchHealth explore the founding and scaling of DispatchHealth, the challenges of reimbursement and scaling, strategies for securing payer contracts, the provider model they use, their success stories, and legal and fundraising advice for founders.

MarketScale, "Best Buy Health: Scaling Health Care at Home". Dr. Ben Zaniello of Besy Buy Health and Verizon's Robin Goldsmith explore the use cases, social issues, funding, logistics, data considerations, and future vision for care at home. 

KevinMD, "Innovative Solutions to the Clinician Shortage Crisis." KevinMD and Jamie Babcock, a health care executive dive explore the growing demand for skilled providers and the critical clinician shortage. Jamie shares insights on innovative strategies that health care leaders can employ to address these challenges, emphasizing the importance of interdisciplinary care teams. Discover how home-based care, supported by field responders, advanced practice practitioners, and telehealth technology, can optimize patient outcomes and ensure high-quality care.

John A. Hartford Foundation, "Geriatric Emergency Medicine Podcast Series 2024: Why Hospital at Home May be the Best Option for Your Next Patient". The podcast series, Geriatric Emergency Medicine's GEMCast, has released a new episode on, "Why Hospital at Home May be the Best Option for Your Next Patient." Dr. Christina Shenvi and Dr. Mike Craig discuss the "Home Hospital" model and its potential to transform the way we care for older adults, by bringing hospital-level care to patients' homes.

Healthcare Finance, "Hybrid Models Integrate Virtual Care into Hospital at Home." LG Electronics went into digital health through partnerships and its own build strategies, leaning into health systems for clinical feedback. By partnering with health systems to support hybrid care models, long-term care facilities can mitigate staff shortages of staff and better manage available beds. 

MedPage Today, "Do People Buy Into Hospital-at-Home Care?" Elizabeth Tracey, director of electronic media for Johns Hopkins Medicine in Baltimore, and Rick Lange, MD, president of the Texas Tech University Health Sciences Center in El Paso, discussed acceptability of hospital at home, among other topics. 

Please subscribe to this newsletter and send any news or events to rcheung@movinghealthhome.org for inclusion in this newsletter.