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 email@example.com for future inclusion in this newsletter.
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Mark Your Calendars: Moving Health Home Members to Speak at 5th Converge2Xcelerate Annual Symposium in November
Hospital at Home Model Featured on NBC's Today Show
Dr. Pippa Shulman, who helped design the Mayo Clinic's Hospital at Home program, explains how consumers could pay less for care with this type of program and demonstrates the model at work in a patient's home.
From the MHH perspective, extending the Centers for Medicare and Medicaid Services (CMS) Hospitals Without Walls and Acute Hospital Care at Home flexibilities would help keep these patients in their homes, reduce the risk of readmissions, and improve outcomes while decreasing costs and freeing up beds.
Dr. Ellen Montz as Deputy Administrator and Director of CCIIO;
Dr. Natalia Chalmers as Chief Dental Officer in the Office of the Administrator; and
Dara Corrigan as Deputy Administrator and Director of CPI.
CMS Expanded Medicare Payments for At-Home COVID-19 Vaccinations (8/24) - To ensure Medicare beneficiaries who have difficulty leaving their homes or are otherwise hard-to-reach can receive the vaccination, healthcare providers can now receive additional payments for administering vaccines to multiple residents in one home setting or communal setting of a home. Medicare previously increased the total payment amount for at-home vaccination from approximately $40 to approximately $75 per vaccine dose, in certain circumstances.
Medicare Trustees Report Released (8/31) - Each year the Trustees of the Social Security and Medicare trust funds report on the current and projected financial status of the two programs. Among other highlights, it was reported that the Hospital Insurance (HI) Trust Fund, or Medicare Part A, will be able to pay scheduled benefits until 2026, the same year as reported last year. At that time, the fund’s reserves will become depleted and continuing total program income will be sufficient to pay 91 percent of total scheduled benefits. The fact sheet can be found here. While a grim outlook, MHH believes programs that bring care into the home demonstrate promise to save Medicare money and help improve the solvency outlook.
Budget Resolution Passed the House and Senate With Inclusion of Home and Community-Based Services (8/24) - The House (H. Res. 601) and Senate (S. Con. Res. 5) have both passed the Resolution on the Budget for the Fiscal Year (FY) 2022. This concurrent resolution establishes the congressional budget for the federal government for FY 2022, sets forth budgetary levels for FY2023 to FY2031, and provides reconciliation instructions for legislation that increases the deficit. The budget resolution framework includes “long-term care for seniors and persons with disabilities,” suggesting that reconciliation legislative text may be based on Sen. Casey (D-PA) and Rep. Dingell’s (D-MI) proposal to enhance and strengthen home and community-based services.
New Legislation on Home Infusion Therapies Introduced in the House (8/23) - Reps. Sewell (D-AL), Upton (R-MI), Dingell (D-MI), and Buchanan (R-FL) introduced the Preserving Patient Access to Home Infusion Act (H.R. 5067), which would clarify congressional intent and preserve patient access to home infusion therapy under the Medicare program. Specifically, the bill would remove the requirement that a provider has to be physically present when a patient receives their infusion. This legislation is the companion bill to Sen. Warner's (D-VA) bill in the Senate. Press coverage can be found here.
Research and Polling
Infection Control & Hospital Epidemiology: Healthcare-Associated Infection Rates Rose in 2020 Amid Pandemic (9/2) - Pre-pandemic methods used to decrease infections were not followed as rigorously last year due to a shortage of personal protective equipment and a shift in priorities leaving patients receiving care in a hospital vulnerable to infections. Blood infections associated with central line catheters increased the most: Rates were 46 percent to 47 percent higher in the third and fourth quarters of 2020 compared to 2019.
International Journal of Environmental Research and Public Health: Home Health Care Services Reduce Rehospitalizations for Medicare Patients with Diabetes (8/30) - Rutgers University researchers studied the importance of quick transitions from the hospital to home health care in connection to risks of re-hospitalizations. They found that patients who had a short delay in beginning home health care were 1.28 times more at risk of re-hospitalization compared to patients who began within the recommended timeframe. Patients with delays beyond 2 days were 4.12 times more at risk of re-hospitalizations. The researchers emphasized the importance of discharge planning that includes ensuring patients and their families understand the purpose and value of home health care and assistance navigating structural and systemic barriers.
Journal of the American Geriatrics Society Commentary: The Underappreciated Success of Home-Based Primary Care: Next steps for CMS' Independence at Home (8/25) - Independence at Home has produced 10-times the per-beneficiary per year savings of Accountable Care Organizations. The core of the intervention rests with the mobile, interdisciplinary teams providing primary care across settings to frail Medicare beneficiaries. The program should be replicated and scaled to support an aging society that increasingly prefers to remain in the community.
NEJM Catalyst Commentary: No Place Like Home: Hospital at Home as a Post-Pandemic Frontier for Care Delivery Innovation (8/23) - Although approximately 150 hospitals implemented Hospital at Home (HaH) programs during COVID-19, it remains to be seen whether HaH is at a true inflection point. America’s rapidly aging population is poised to increase demand for acute care. However, lower hospital margins for Medicare relative to commercial payers incentivize systems to shift service delivery for this population to ambulatory settings, rendering programs like HaH increasingly attractive from a business case perspective. HaH can provide a new vehicle for integrating non-medical services (e.g., broadband access, food security) into acute care at a time point when patients may require increased support due to the complexity of their illness.
JAMA Internal Medicine: Number of Homebound Adults More Than Doubled During Pandemic (8/23) - Mount Sinai researchers found that the share of the population that rarely or never leaves their homes rose held steady at about 5 percent from 2011 to 2019 but leaped to 13 percent last year, likely driven by isolation during the COVID-19 pandemic. The study also found that 65 percent of Hispanic people, 44 percent of black people, and 35 percent of white people reported fair or poor health. Additionally, seventy-seven percent of Hispanic respondents do not own computers compared to 57 percent of Blacks and 42 percent of whites.
News and Market Developments
Forbes: Introducing Post-Acute 2.0: New Services Needed to Deliver Care At Home (9/1) - In this op-ed by Ashish Shaw and the Forbes Technology Council, they emphasize the need to promote and create ways to bring more care into the home via hospital-at-home programs and increased use of telehealth and similar technologies. They argue that the next 10 years will be a critical time of growth as the government has a growing interest in these programs and more beneficiaries age into Medicare.
healthleaders: Hospital At Home Takes Patient Experience to New Levels (9/1) - The hospital-at-home model is one way health systems meet consumer and cultural demands for better access, equity, and experience in healthcare. At Vituity, they call this new patient-centric paradigm Health in Place, and believe that it will quickly become a crucial differentiator for their hospital partners. The model also aligns with the quadruple aim of patient experience, population health, reduced costs, and provider wellness.
INTEGRIS Health: INTEGRIS Launches Health @ Home Program (9/1): INTEGRIS Health @ Home and will offer at-home services to patients who would otherwise require inpatient hospitalization. The command center that receives all the data is monitored 24/7 by a team of INTEGRIS Health physicians and nurses who will respond immediately to a patient’s medical needs via video or telephone. Daily in-home visits by a nurse practitioner and other health care professionals are also part of the treatment plan. IV therapies, oxygen treatments, lab tests, mobile imaging like x-rays and ultrasound are all performed in the home. Other services include skilled nursing, medications, infusions, behavioral health and rehabilitation.
Managed Healthcare Executive: Doing More and Saving More with Primary in Home Care (9/1) - During this podcast episode of Tuning Into the C-Suite, MHE Associate Editor Briana Contreras interviewed VillageMD’s Senior Medical Director of Village Medical at Home, Dr. Tom Cornwell. Dr. Cornwell discussed the main benefits of primary care at home, which includes the benefit of cost savings for patients, maintaining control of hospital readmissions and others. Dr. Cornwell also noted what has changed in the industry of at-home care and if there has been interest from payers like insurance companies and Medicare in the service.
The Capitolist: Lee Health Partners with DispatchHealth to Offer In-Person Medical Care (8/31) - The new in-home healthcare option that will give community members in Lee County more flexibility when it comes to receiving high-quality medical care. Under the new partnership, patients will be able to request care via phone or by visiting DispatchHealth’s mobile app or website, no referral needed. Once requested, DispatchHealth will deploy an expertly trained medical team to the patient’s home within a few hours, equipped with the necessary tools and treatments, including on-site diagnostics and a CLIA-certified lab.
Home Health Care News: Right at Home Helps Franchisees Launch Vaccination Clinics as Delta Variant Continues to Spread (8/30) - Right at Home has teamed up with the National Minority Health Association (NMHA) and its COVID-19 vaccination reward program, Flex for Checks. Flex for Checks is a community-based program that the NMHA developed as part of an $11.1 million grant from HRSA. Through the program, unvaccinated caregivers are able to receive monetary rewards for getting vaccinated. Specifically, caregivers are eligible to receive $75 per shot and $25 after.
The Record: Home Care, Hospital Associations Further Collaborative to Synchronize Care (8/30) -Home Care Association of New York State Education & Research, Healthcare Association of New York State, and Iroquois Healthcare Association are working together to further enhance collaboration across their respective settings through a Statewide Hospital-Home Care Collaborative. The goal is to provide a blueprint that can be adapted to develop similar collaborative models across the state.
Vox: The Staggering, Exhausting, Invisible Costs of Caring for America's Elderly (8/26) - According to the most recent data from the AARP, an estimated 41.8 million people, or 16.8 percent of the population, currently provides care for an adult over 50. What’s required of them is more complex and time-consuming than just 10 years ago, as caregivers deal with overlapping diagnoses related to physical as the elderly live longer. Since the difficulty of this care remains largely imperceptible there have been few attempts, governmental or otherwise, to make it better, easier, or less of a life-swallowing burden. However, the tech industry has recently realized that the family caregiver market is massive and hugely underserved, and various startups are trying to make certain aspects of caregiving less unnecessarily burdensome.
Home Health Care News: The SCAN Group Invests in MedArrive, Expects 'Explosive Growth' in Home-Based Care (8/24) - SCAN declined to disclose financial specifics of the investment, but Binoy Bhansali, the corporate VP of corporate development, told Home Health Care News that it’ll likely be “just the start” of its relations with MedArrive. He also added that SCAN would “absolutely” be looking for more investments to make in the home-based care space in the near term.