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.
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