In this twice-monthly newsletter, you will find 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.
This newsletter recaps current events and research. Please send any news or events to firstname.lastname@example.org for future inclusion in this newsletter.
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Home Health Care News:Strength in Numbers: Home Care Executives Reveal 2021’s Most Important Partnerships (6/1) – The old adage “there is strength in numbers” has stood the test of time because it’s largely true. Advocacy and government relations partnerships with organizations like the Home Care Association of America (HCAOA), International Franchise Association (IFA) and Moving Health Home are essential to influence federal policy, as well as advocate at the state level to address workforce development and access to care issues.
Home Health Care News:‘They Face What We All Face’: Amazon’s Entrance into Home-Based Care Doesn’t Faze Providers (5/27) – Amazon takes another step toward health care almost monthly. Lately, one of its biggest focuses has been the shift of health care into the home. On the other side of the coin, if Amazon wants to get into home-based care, it’ll face the same problems everyone else does, Kerin Zuger, the chief of strategic growth at Right at Home, told HHCN. Right at Home is another member of Moving Health Home, having joined earlier this week.
This Week In Health IT:Showcasing Healthcare Transformation with Advanced Technologies with World Wide Technology and Intel (5/26) – In this podcast, Bill Russell discusses Microsoft and Intel's engagement with World Wide Technology to develop a hybrid cloud solution to demonstrate the power of Azure Stack Edge Pro's edge compute and AI technology. The locus of care is shifting to remote venues and really into the home. As part of the discussion, the podcast touches on the Moving Health Home initiative, and says it "is really driving and lobbying to make permanent changes to the home care health reimbursement policies."
McKnight's Senior Living:New healthcare coalition makes a splash in Washington, lobbies for hospital-at-home extension beyond pandemic (5/25) – Just two weeks shy of its three-month anniversary, Moving Health Home, a coalition pushing for more clinical care done at home, has already tripled its membership and sharpened its policy focus in Washington. “The extension would give us time to convince Congress that we need a hospital-at-home program in the statute,” Drobac explained. “We don’t want to build programs based on waivers. We need more time to work on what worked and what didn’t work during the pandemic. Then, when we go back to normal times, what does a hospital-at-home program look like during normal times?”
Home Health Care News:Right at Home joins Moving Health Home (5/25) – The in-home care franchise Right at Home has joined the Moving Health Home (MHH) coalition, which was formed in March to advocate for home-based care in the U.S. Specifically, the Washington, D.C.-based MHH was built to vie for more favorable legislation from lawmakers. The coalition currently includes other home care franchise systems such as Chicago-based BrightStar Care and the Nebraska-based Home Instead Senior Care. In addition, it includes Amazon Care (Nasdaq: AMZN), Landmark Health, Signify Health (NYSE: SGFY), DispatchHealth, Elara Caring, Intermountain Healthcare, Ascension and Amwell (NYSE: AMWL). Based in Omaha, Nebraska, Right at Home has 650 collective franchise locations in the U.S. and seven other countries.
Healio:Outset Medical allies with home-based care coalition (5/21) – Outset Medical Inc. has joined the health care coalition Moving Health Home, according to a company press release. Moving Health Home unites health care companies in improving federal and state policies that will let patients receive clinical care from home, according to the release. “Through collaboration with forward-thinking leaders in the health care space, we aim to encourage policymakers to reimagine the home as a site of care for clinical treatment, such as for chronic disease management,” Krista Drobac, founder of Moving Health Home, said in the release. Outset Medical joins stakeholders like Amazon Care, Landmark Health and Signify Health in the coalition.
New Blog Post: Moving Health Home and Signify Health
May 24, 2021
For older Americans, the home must become a choice for patients
By Krista Drobac and Damien Doyle, MD
May is Older Americans Month, and this year we should use it as a time to think big about changes we can make for how seniors receive their health care. Coming out of the pandemic, we have an opportunity to embrace the lessons we learned about what is possible. Millions experienced their first home visit, their first doctor’s appointment by telemedicine, their first sharing of biometric data remotely to improve care management or even their first admission to the “hospital” at home.
Receiving care at home became the norm during the pandemic, and we should keep it that way.
In late 2020, Signify Health conducted a Harris poll of some 1,100 U.S. seniors and found that 61 percent of seniors would like to receive healthcare services in their home; and nearly half (45%) expressed interest in receiving social services at home.
Right at Home, a leading global in-home care franchise system with over 650 provider locations in seven countries, announced that it has joined Moving Health Home, a coalition of innovative companies in their fields that is exploring ways to move more health care into the home setting. “Moving Health Home members believe home-based care affords an opportunity to deliver significantly more clinical care in the setting most people prefer, and to approach care in a more holistic way,” said Krista Drobac, Founder of Moving Health Home. “Right at Home will be helpful in advocacy efforts to integrate the home as a site of clinical care, utilizing and sharing their firsthand knowledge and lessons learned from providing care in the home.”
Reps. Axne, Schakowsky, and McKinley Unveiled the Americans Giving Care to Elders (AGE) Act (6/3) – On June 3, Rep. Cindy Axne (IA-03), Rep. Jan Schakowsky (IL-09), and Rep. David McKinley (WV-01) unveiled bipartisan legislation that supports Americans who are caring for their older family members by offering tax credits to cover costs of elder care. Approximately one-third of caregivers leave the workforce entirely to provide care for someone in their life. The legislation could help offset expenses related to facilitating care in the home.
Senate Confirmed Chiquita Brooks-LaSure to Led CMS (5/25) – The Senate confirmed Chiquita Brooks-LaSure to serve as the next CMS Administrator. Brooks-LaSure’s nomination was approved by a 55-44 vote, with four Republicans voting alongside Democrats to confirm her nomination.
Home Health Emergency Access to Telehealth (HEAT) Act Reintroduced in Congress(5/20) – Reps. Jodey Arrington (R-TX), Terri Sewell (D-AL), Mike Kelly (R-PA), and Mike Thompson (D-CA) reintroduced the HEAT Act, a bipartisan bill to provide Medicare reimbursement for audio and video telehealth services furnished by home health agencies during the COVID-19 emergency and future public health emergencies. U.S. Senators Susan Collins (R-ME), Ben Cardin (D-MD), Roger Marshall (R-KS), and Jeanne Shaheen (D-NH) introduced companion legislation in the Senate.
President Biden Released the Fiscal Year (FY) 2022 Budget (5/28) – President Biden released the FY 2022 Budget, which proposes $131.8 billion in discretionary budget authority and $1.5 trillion in mandatory funding to the Department of Health and Human Services (HHS). The budget invests in enhancing the health of Americans by tackling major challenges including the COVID-19 pandemic, increasing numbers of Unaccompanied Migrant Children, climate change, the opioid and substance use crisis, ensuring that all HHS programs equitably address all of the country’s diverse populations, and more.
CMS Posted Fourth Annual Report for the Home Health Value-Based Purchasing (HHVBP) Model(5/24) – CMS posted the fourth annual report and associated materials for the Home Health Value-Based Purchasing (HHVBP) Model. The first four years of implementation of the HHVBP model have resulted in cumulative Medicare savings of $604.8 million, a 1.3 percent decline relative to the 41 non-HHVBP states, as well as improvements in quality. These impacts were observed during 2019, the second year for quality based payment adjustments, as well as the initial three years of the model.
Research and Polling
Journal of Clinical Oncology: Hospital at Home May Reduce Hospitalization, Costs for Cancer Patients (5/26) – Study demonstrated efficacy, cost-effectiveness of providing hospital-level services at home. A hospital-at-home model for cancer care led to significantly fewer unplanned hospitalizations and almost a 50% reduction in cost as compared with usual care for patients recently discharged from hospital, a comparative-cohort study showed. Unplanned hospitalizations occurred 55% less often and healthcare costs were 47% lower among patients who received hospital-level care at home. Total hospital days and emergency department (ED) visits also were lower in the hospital-at-home group. Frequency of ICU admissions did not differ between the two cohorts.
News and Market Developments
HealthAffairs Blog: Family Caregivers: The Unrecognized Strength Behind Hospital At Home (6/3) – Hospital at Home (HaH) programs are a case in point. These programs have existed since the 1970s in the United Kingdom, Canada, France, Australia, Israel, and other countries with government-run health systems. Begun in the US in 1995, at Johns Hopkins under the direction of geriatrician Bruce Leff, the model was designed to help older adults avoid potential hazards commonly experienced in the traditional hospital, such as functional decline, inappropriate medications, overuse of tests, and delirium. The solution was to provide hospital-level care in a more comfortable and safer setting—at home. HaH programs can enhance their patient-centered services by recognizing and responding to the needs of family caregivers. Several program developers have already begun to add family caregivers to their agendas, and there are actions program leaders should take to enhance the process.
Landmark Health Expands Home-based Medical Care for Seniors in New York (6/3) – Landmark Health and its affiliated medical groups announced today an expansion of services into Central New York. With this growth, Landmark’s house calls will reach senior patients across the state – covering the Capital District, Western New York, New York City and surrounding boroughs, and now Central New York. Landmark started seeing patients in New York state in 2014, and now with services available locally through eight health plans, nearly 50,000 eligible patients with complex, chronic conditions in the state have access to in-home medical care and care coordination.
Home Health Care News: Home-Based Care Providers Fear They’re Being Squeezed Out of Medicaid (6/1) – New York state’s 2020 final budget includes a Medicaid policy provision that has caused serious concern among home-based care providers and advocates. Those groups are now asking lawmakers to overturn the provision. Broadly, the original Medicaid policy issue was that the state authorized the New York Department of Health to essentially decide which home-based care providers could participate in the state’s Medicaid program.
McKnight's Senior Living:What will home care look like post-COVID-19? Brooks-LaSure will help guide us (5/27) – It is not a coincidence that two symbolic healthcare policy events took place this week. I’m talking about the Senate’s confirmation of Chiquita Brooks-LaSure as administrator of the Centers for Medicare & Medicaid Services and the introduction of H.R. 3447, the Permanency for Audio-Only Telehealth Act. The latter would allow for Medicare coverage of audio-only telehealth services after the COVID-19 public health emergency. Brooks-LaSure is stepping into CMS at a time when Congress and regulators are making key decisions about healthcare in the post-pandemic world. She will help lead home care and other providers through this major period of transition.
Forbes:Will Senate Moderates Sink Biden’s Medicaid Home-Based Long-Term Care Plan? (5/27) – President Biden’s proposed massive expansion of Medicaid home-based long-term care is running into trouble in the Senate. And it may be done in, not by hard-core conservatives, but by a small group of self-styled Senate moderates. In his American Jobs Plan, Biden proposed increasing the federal share of Medicaid’s home and community-based services (HCBS) program by $400 billion—the largest increase n the program’s history. Following more than 150,000 covid-19 related deaths in long-term care facilities, Biden moved aggressively to encourage states to create alternatives for older adults and younger people with disabilities who are able to live at home, rather than in nursing facilities.
The National Law Review: A New Era for Home-Based Patient Care (5/26) – Among the numerous consequences of the Covid-19 Pandemic is a well-documented emphasis on the home. Work at home. Exercise at home. See your doctor or other health provider at home. Home-based health care beyond the traditional nursing care is yet another change wrought by the pandemic that will not likely be eliminated as we come to define the new normal. Home health agencies have long operated in the health care ecosystem. These providers, however, are heavily focused on providing skilled nursing services to seniors, predominantly Medicaid beneficiaries. More recently, industry participants have started furnishing an expanding and robust set of services in the patient’s home, including telemedicine-enabled primary physician care.
Modern Healthcare:'Better than the hospital’: Pandemic boosts care for serious illnesses at home (5/26) – Late last year, Janet Yetenekian was one of the thousands of people in Southern California whose case of COVID-19 was serious enough to send her to the hospital. But Yetenekian’s recovery was not typical: She received hospital-level care in her own home in Glendale. “It was even better than the hospital,” Yetenekian said, laughing. “They were constantly reaching out — it’s time for you to do your vitals, or it’s time for you to take your medications.” Yetenekian contracted the virus that causes COVID in December, after friends invited her family to an afternoon barbecue. It seemed like a safe antidote to the isolation caused by the pandemic. But the day after the gathering, the host came down with a fever. A test confirmed it was COVID.
Home Health Care News:DispatchHealth Announces New Health System Partnerships (5/25) – The in-home medical care provider DispatchHealth on Tuesday announced partnerships with Eastern Connecticut Health Network (ECHN) and Waterbury Health. The partnerships revolve around bringing patients same-day, at-home medical care. Denver-based DispatchHealth partners with health systems and payers to offer an array of services within the home. The company’s care teams are available every day of the week and help address the needs of patients in order to reduce hospital readmissions and other adverse health events.
The Hospitalist:Hospital at Home: Delivering hospital-level care without the hospital (5/25) – The United States spends one-third of the nation’s health dollars on hospital care, amounting to $1.2 trillion in 2018. U.S. hospital beds are prevalent, and expensive to build and operate, with most hospital services costs related to buildings, equipment, salaried labor, and overhead. Despite their mission to heal, hospitals can be harmful, especially for frail and elderly patients. A study completed by the Office of the Inspector General (OIG) found that 13.5% of hospitalized Medicare patients experienced an adverse event that resulted in a prolonged hospital stay, permanent harm, a life-sustaining intervention or death. In addition, there is growing concern about acquired post-hospitalization syndrome caused by the physiological stress that patients experience in the hospital, leaving them vulnerable to clinical adverse events such as falls and infections.
Kaiser Health News: Is Your Living Room the Future of Hospital Care? (5/24) – Major hospital systems are betting big money that the future of hospital care looks a lot like the inside of patients’ homes. Hospital-level care at home — some of it provided over the internet — is poised to grow after more than a decade as a niche offering, boosted both by hospitals eager to ease overcrowding during the pandemic and growing interest by insurers who want to slow health care spending. But a host of challenges remain, from deciding how much to pay for such services to which kinds of patients can safely benefit. Under the model, patients with certain medical conditions, such as pneumonia or heart failure — even moderate covid — are offered high-acuity care in their homes, with 24/7 remote monitoring and daily visits by medical providers.