In this twice-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.
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Moving Health Home Updates
Alison Armstrong Joins the Moving Health Home Staff (11/8) - During her 14 years at Anthem, Alison worked on a broad range of health care policy issues, focusing on increasing access to care and promoting care delivery innovation. She served as a subject matter expert on numerous policy issues including telehealth, quality measurement and reporting, price transparency, surprise billing, and prior authorization. She also represented Anthem on several external policy committees and workgroups to successfully promote health care policy strategies aimed at increasing consumer access and protections. Alison earned her Master of Public Policy with an emphasis on American Politics from Pepperdine University and her Bachelor of Arts in Political Science from San Diego State University.
Moving Health Home Continues to Grow- We continue to welcome new innovators who want to integrate the home as a site of clinical care. MHH represents the full continuum of home-based care, including health systems, medical groups, health plans, primary care providers, personal care, durable medical equipment, infusion, dialysis, home health, hospice, tech-enabled care, and more. To see the latest, you can view all of our current members here.
Moving Health Home Mentions
The Gainesville Sun: Amazon Plans to Deliver Health Care to Your Door (11/17) - Amazon Care Director, Dr. Kristen Lloyd Helton, confirmed plans to bring Amazon Care to Dallas, Chicago, Philadelphia, Boston, and Los Angeles with the hopes of being in 20 major cities by sometime in 2022. In March 2021, Amazon launched “Moving Health Home” in partnership with seven large national companies focused on providing care in the home. Together, these organizations want to "fundamentally change the way policymakers think about the home as a site of clinical service," says the founding companies. The groups want to change the reimbursement models used by Medicare and Medicaid and expand services for home care and the newer initiative, “hospital without walls.”
Leonard Davis Institute of Health Economics: Moving Health Care into an At-Home Model (11/18) - A recent panel of four top experts in the field of home care, including Dr. Meena Seshamani, the Center for Medicare and Medicaid Services (CMS) Deputy Administrator and Director of Medicare, discussed the benefits and challenges of shifting care to the home. “We need to double down on the opportunities for partnership and alignment under more holistic models of care. It’s marrying the payment reforms with the transformation of care, because payment is just one side of the coin. It needs investment in these holistic models of care, home-based care being an important part of that, while also creating investment in the communities and supporting change in the way care is actually delivered there on the ground," Dr. Seshamani said.
National Association of Medicaid Directors: Department of Health and Human Services (HHS) Secretary Becerra Issues Opening Remarks, Mentions In-Home Care (11/16) - During his opening remarks, Secretary Becerra reflected on the impacts of the pandemic, the activities of HHS, and potential impacts of the Build Back Better Act. He also emphasized the transformation that Build Back Better would be making to in-home care services for seniors and people with disabilities.
CMS: Leadership Outlines Strategic Vision for Medicaid, Including Investments in Home-Based Care (11/16) - In a new Health Affairs blog, Chiquita Brooks-LaSure and Daniel Tsai outline CMS' vision for Medicaid and the Children's Health Insurance Program. Among other activities, they highlight the importance of broadening access to home- and community-based services to give older adults and people with disabilities the choice to stay in their homes and communities while receiving critical health, functional and social supports, rather than moving to an institutional setting.
House of Representatives: Build Back Better Act Passed the House, Includes Permanent Extension of the Independence at Home Demonstration and Investments in Home- and Community-Based Services (11/19) - Today, the House passed their version of Build Back Better, which includes a permanent extension of the CMS Innovation Center Independence at Home model, as well as funding to administer the program. The Independence at Home model, originally authorized in the Affordable Care Act, tests the effectiveness of delivering comprehensive primary care services at home and if doing so improves care for Medicare beneficiaries with multiple chronic conditions. The version also includes an investment in home- and community-based services, although total spending was reduced from $190 billion to $150 billion.
House Ways and Means Committee: Ranking Member Requests Hearing to Ensure Stability of Medicare Providers (11/10) - Committee Ranking Member Kevin Brady (R-TX) sent a letter to House Ways and Means Committee Chair Richard Neal (D-MA) urging the Committee to hold a hearing on issues related to the Medicare Physician Fee Schedule and how the COVID-19 public health emergency is continuing to impact health care providers. The Medicare Physician Fee Schedule impacts reimbursement rates for many types of providers, including home-based care clinicians.
Research and Polling
ATI Advisory: Delivering on the Promise of the Chronic Care Act: Progress in Implementing Non-Medical Supplemental Benefits (11/17) - Passed in the Bipartisan Budget Act of 2018, the Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act marked a turning point in Medicare allowing Medicare Advantage (MA) plans to offer supplemental benefits that are not primarily health-related. In this report, researchers found that through interviews with 30 plans, providers, and beneficiary advocates that plans have made significant progress. This progress includes significant strides in home-based care. Since Plan Year 2020, in-home support services grew over 200% from 223 plans offering them to 729 plans offering them in Plan Year 2022. However, plans are struggling with:
Educating Medicare beneficiaries, plan staff, providers, and enrollment counselors about benefits
Measuring and sharing results to build an evidence base on what works to meet individual needs in Medicare.
Proceedings of the National Academy of Sciences of the United States of America: In the Wake of COVID-19, Decentralized Clinical Trials Move to Center Stage (November Issue) - The initial design for the clinical trial called for on-site visits, but during COVID, that has begun to pivot for some upon realizing that prospective participants preferred to recuperate and remain at home. For example, the virtual model has enabled New York’s Northwell Health hospital system to recruit a more diverse set of participants than in its other trials, perhaps because on-site visits were not a barrier. Drugs were mailed to participants and all laboratory draws were done at their home. While not a traditional application of home care, this expansion in thinking about where the location of medical research can occur can help support the case for other home models.
News and Market Developments
Healthcare Finance News: Another Home Health Initiative in Joint Venture Between Jefferson Health and Bayada (11/17) - Preliminarily referred to as "Jefferson Health at Home," the joint venture will leverage the employees of both organizations for healthcare services delivered at home. There will be an emphasis on care transitions and access to in-home and virtual care. The agreement, which is expected to be finalized in spring 2022, also includes an academic affiliation which will create new training opportunities for Jefferson students, particularly those at the Jefferson College of Nursing.
Home Health Care News: MedArrive Raises $25 Million, Hopes to Make 'Tends of Thousands' of At-Home Care Visits Next Year - (11/17) The funding round was led by the venture capital fund Section 32, which invests in businesses on the frontier of health care and technology. Section 32 also previously invested in Current Health, a home-focused remote patient monitoring platform that was recently acquired by Best Buy. Other investors such as 7wireVentures and Leaps by Bayer also participated in the round, as did MedArrive’s initial investors: Define Ventures, Kleiner Perkins and Redesign Health.
Home Health Care News: SCAN Group Launches Home-Based Primary Care Arm 'Welcome Health' (11/16) - SCAN Group has entered into the in-home senior primary care space with the launch of Welcome Health. Dr. Scott Weingarten will serve as CEO of the independent primary care medical group moving forward. SCAN Group is a nonprofit organization focused on helping older adults age in place.
InsideNOVA: Inova Partners with DispatchHealth to Provide In-Home Urgent Care (11/16) - Inova has partnered with DispatchHealth to bring on-demand medical care to patients in their homes for urgent illnesses and injuries that do not require an emergency room visit. Inova will be leveraging DispatchHealth’s platform which delivers, provides, and coordinates medical care to patients for a wide range of injuries and illnesses.
NewsOn6: Home Healthcare Industry in Need of More Workers - (11/16) - During the pandemic, health care leaders say the demand for home healthcare workers has gone up while the number of people willing to work has gone down. Home Instead Senior Care is a home health care service provider for people who need non-medical or personal care services such as help bathing or getting dressed. Owner Andrew Garrean says before the pandemic began they had 100 employees, but now they are down to 76. He says the medical field as a whole is struggling right now and home health care has not been immune.
Home Health Care News: Resilient Healthcare, Medical City Healthcare Partner for Hospital-at-Home Venture (11/15) - Through the partnership, eligible patients are connected to a live remote patient monitoring (RPM) device that continuously tracks blood pressure, before they leave the hospital and transition to their home. Resilient has a traditional home health arm, as well as a hospital-at-home model and their care team includes PTs, OTs, speech therapists, dietary specialists and more.
New Jersey 101.5: NJ Hospital Admitting Patients to Their Own Home (11/14) - Holy Name Medical Center is currently handling the 30th admission into its Hospital at Home program — a program tested and approved by the Centers for Medicare and Medicaid Services — which gives patients as much attention and treatment as they'd receive during a hospital stay, but from the comfort of their own home. Among the tools provided to at-home patients is a call button that can dispatch a nurse to a patient's home at any time of day or night.
mHealthIntelligence: Penn State Health, Highmark, Contessa Partner to Launch Home Care Joint Venture (11/12) - Dubbed Penn State Health Home Recovery Care, the joint venture will offer both hospital-level care and skilled nursing care in patients' homes through a combination of in-person and virtual services. The joint venture will leverage Contessa's risk-based model that utilizes a technology platform and provides patients with the devices they need to connect with their care team. Some of the conditions that will be treated via the joint venture include pneumonia, cellulitis, congestive heart failure, urinary tract infections and chronic obstructive pulmonary disease.
9News: Medical Care at Home is Helping to Free Up General Hospital Beds in Colorado (11/10) - The hospital-at-home model is being implemented at numerous sites around the country by VA hospitals, health systems, and home care providers. Earlier this month, 94% of general hospital beds in Colorado were being used by patients. Since January 2020, statewide DispatchHealth said it has prevented more than 38,000 emergency room visits and more than 1,000 hospitalizations by taking care of patients in the home.
Advisory Board: 11 Surprising Ways the Pandemic Changed Health Care (11/10) - In this article, Advisory Board experts share their thoughts on what has changed in health care since the start of the pandemic. Numerous people mention the shift to more home-based care as an opportunity to improve quality of life, accelerate value-based care, and improve health equity.
Healthcare Innovation: Signify Health CMO Stresses the Value of In-Home Evaluations (11/8) - In a recent interview with Healthcare Innovation, Marc Rothman, M.D., chief medical officer at Signify Health, spoke about some of the benefits he has seen as his organization partners with Medicare Advantage plans to provide in-home evaluations to thousands of members. Rothman sees the in-home assessments as part of a larger trend of trying to deliver more care to patients in the home. The in-home visit allows the clinician to better focus on a much more holistic picture, and talk about things like smoking cessation, advanced directives, which take more conversational time than just a routine clinic visit.
Fierce Healthcare: Moving Health Care Home: Insights We've Learned in Kidney Care (11/8) - The pandemic sparked new energy around moving health care into the home. From prescription drugs to hospital services and long-term care, investment is pouring into new companies with promising business models that could make home health care work at scale. While this is a fresh take for many health care companies, it isn’t new in kidney care. Some insights learned that can be helpful to other in-home care include: knowing your patient's environment, committing to the patient experience, and deepening connectivity with smart technology.
The Hill: Lobbying for Choose Home Legislation Amps Up (11/8) - In this opinion piece, the authors make the case for Choose Home. They explain that the time has come for Congress to enable greater patient choice so that American families can choose to safely transition Medicare beneficiaries to the home setting for post-acute recovery. Doing so requires embracing policies that modernize the existing Medicare Home Health Benefit. Under an enhanced home health benefit, many Medicare beneficiaries who live at home and meet Medicare Skilled Nursing Facility eligibility requirements would have the option to receive extended home-based care services.