Moving Health Home Update |
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Welcome to the Moving Health Home newsletter!
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 jmccoy@movinghealthhome.org for future inclusion in this newsletter.
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Check out our website and Twitter using the links below |
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The Movement to Advance Care in the Home is Growing |
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On April 9, Moving Health Home announced seven additional members – Compassus, UPMC, U.S. Medical Management, the Visiting Nurse Service of New York (VNSNY), Advocate Aurora Health, Contessa Health, and Vituity. These new organizations will be instrumental in advocacy efforts to integrate the home as a site of clinical care utilizing and sharing their firsthand knowledge and lessons learned providing home-based care during the COVID-19 pandemic, and in the years before that.
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Summary of New MHH Press Mentions
Politico: HOME-BASED CARE COALITION ADDS 7 (4/9) – Moving Health Home, a new coalition of health industry players lobbying to shift health care services into the home, has added seven new members to the group following its launch last month. Hospice and palliative care provider Compassus, the University of Pittsburgh Medical Center, U.S. Medical Management, the Visiting Nurse Service of New York, health care system Advocate Aurora Health, Contessa Health, and Vituity will join the group’s founding members, which include Amazon Care, Landmark Health, Signify Health, Dispatch Health, Elara Caring, Intermountain Healthcare, Home Instead, Ascension and Amwell. The coalition aims at maintaining and building on the progress of shifting health care services out of institutional settings and into homes that the coronavirus only accelerated. The group’s most urgent priority is the extension of authorities granted by the Centers for Medicare and Medicaid Services during the pandemic that allow for hospital-level care at home, according to Sirona Strategies’ Krista Drobac, a lobbyist representing the coalition, though the group will also advocate for changes in reimbursement and payment models to accommodate what they view as an overdue shift.
Becker's Hospital Review: UPMC, Advocate Aurora join hospital-at-home initiative backed by Amazon, Intermountain and Ascension (4/9) – UPMC and Advocate Aurora Health are the two latest health systems to join Moving Health Home, a new healthcare coalition founded by Amazon Care, Intermountain and Ascension. Amazon Care, Salt Lake City-based Intermountain Healthcare and St. Louis-based Ascension partnered in March to launch Moving Health Home, which will support and update healthcare policy changes to designate the home as a site of clinical service. The coalition has attributed tech advancements including telehealth, remote monitoring, digital therapeutics and medical records sharing as driving factors behind its mission to make home care equivalent to healthcare services offered in facilities.
Home Health Care News: VNSNY, Contessa Join Amazon-Backed Home Health Coalition (4/11) – Moving Health Home — the new provider coalition formed in early March dedicated to advancing home-based care in the United States — has landed seven new members. The Washington, D.C.-based industry group announced Friday that Compassus, UPMC, U.S. Medical Management, the Visiting Nurse Service of New York (VNSNY), Advocate Aurora Health, Contessa Health and Vituity have joined its ranks. Founding members already included Amazon Care, Home Instead Senior Care, Elara Caring and several other in-home care titans. The addition of VNSNY gives Moving Health Home support from the largest not-for-profit home- and community-based health care organization in the country, while UPMC brings its $9 billion integrated global health enterprise to the table.
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By Krista Drobac, MHH's Founder |
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I had to share a health equity “aha moment.” In thinking about moving more health care services into patients’ homes, we have focused on a variety of use cases — from seniors who want to age in place to complex patients who need more disease management to working parents who would rather have a nurse visit their home than have their kids miss school for an appointment.
We overlooked something important – how care in the home can contribute to health equity. A brilliant contributor to the health-in-the-home movement just made it crystal clear how more care in the home will contribute to health equity – a change in the power dynamic between patient and provider.
A medical provider is a guest in the home of a patient, which changes the control equation for a patient who, when in an institutional setting, is within the authority of someone else. Communities of color disproportionately lack trust in the health care system, and understandably so. If you have been disenfranchised, why would you expect the health care system to be any fairer?
It’s different if a medical provider visits your home. It’s much easier to build trust with a patient in an environment more comfortable to them. Being in a patient’s home also affords the opportunity to interact with the patient’s caregiver, identify possible food insecurity, fall risks, unsafe social situations, and conduct medication reconciliation. The connection built through an interaction in the patient’s home can also help solidify a longer-term relationship that will contribute to better adherence to care plans, and improved care coordination.
It is realizations like these that reinforce how important it is that we give patients the option to choose their home as a site of care.
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Congressional Activity
President's Discretionary Funding Request Sent to Congress (4/9) – On April 9, the White House Office of Management and Budget sent its discretionary funding request for Fiscal Year (FY) 2022 to congressional leadership. Overall, President Biden is requesting a 23.5 percent discretionary budget increase for the Department of Health and Human Services. The request included $551 million in part for home and community-based services.
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Administrative Activity
HHS Assistant Secretary for Planning and Evaluation (ASPE): Characteristics of Homebound Older Adults: Potential Barriers to Accessing the COVID-19 Vaccine (4/6) – On April 6, ASPE released an issue brief exploring demographic characteristics of homebound older adults and identifying barriers to and opportunities for accessing the COVID-19 vaccine for homebound older adults. Key findings:
- Approximately 1.6 million adults 65 years of age and over living in the United States may have trouble accessing the COVID-19 vaccine because they are homebound; 51 percent of these older adults face at least one additional barrier, such as living alone or lacking technology.
- Nearly 15 percent of Hispanic older adults are homebound, compared to 7 percent of Black older adults, 5 percent of older adults who are American Indian, Asian, or Pacific Islander, and 3 percent of those who are White.
- Just under half of homebound older adults are connected to assistance programs and services such as food stamps, Meals-on-Wheels, and in-home rehabilitative care; vaccinating homebound older adults could be facilitated through partnerships with these programs.
- Almost all homebound older adults–96 percent–report having seen their doctor in the past year; working more closely with primary care providers and health centers may also benefit vaccination efforts.
The Centers for Medicare and Medicaid Services Released FY 2022 Proposed Payment Rulemaking for Inpatient Rehabilitation Facilities, Inpatient Psychiatric Facilities, Hospices, and Skilled Nursing Facilities (4/8) – Each proposed rule increases aggregate payment, including an additional 1.8 percent for inpatient rehabilitation facilities, 2.3 percent for inpatient psychiatric facilities, 2.3 percent for hospices, and 1.3 percent for skilled nursing facilities. The hospice proposed rule also includes a Home Health Quality Reporting Program (HH QRP) proposal to display publicly three-quarters of certain outcome and assessment information set (OASIS) data due to the public health emergency exemptions of the 2020 first and second-quarter data. Additionally, it proposes to rebase and revise the labor shares for continuous home care, routine home care, inpatient respite care, and general inpatient care based on the compensation cost weights for each level of care from the 2018 MCR data for freestanding hospices.
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Research
Journal of the American Geriatrics Society: Hospital at Home services: An inventory of fee‐for‐service payments to inform Medicare reimbursement (4/3) – This study highlights an important barrier to the implementation of the Hospital at Home (HaH) model of care in American health systems—money. The authors describe four scenarios of payment for HaH in the context of 2014–2017 Medicare payment systems.
Frost & Sullivan: Hospital at Home Care Set to Make it Big in the United States with Strong Support from the Government (4/12) – The new report finds that the hospital at home (HaH) care model is gradually gaining momentum in the United States with strong support from the government. This model can extend hospital-grade care to a home setting for acute patients with conditions ranging from asthma and pneumonia to congestive heart failure. The COVID-19 outbreak has further emphasized the need for the HaH care model because it is a safe and effective care alternative for COVID-19 cases, allowing remote treatment of a large population base.
Journal of the American Medical Association: Pandemic Boosts an Old Idea—Bringing Acute Care to the Patient (4/14) – In this perspective piece published in JAMA, the author offers a compelling case for the value of hospital at home programs framed around the COVID-19 pandemic.
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News and Market Developments
Fast Company: Want to make healthcare cheaper? Bring the hospital to you (4/2) – Telemedicine was just the start. The next step? Moving hospital-quality care into your living room. At first blush, the idea of moving most healthcare from hospitals and medical offices to people’s living rooms seems impossible. Of course, once upon a time, so did getting your groceries without leaving your couch. Or voting. Or attending college. Or talking to your doctor. Or virtually any of the activities in our daily lives that used to require going somewhere and doing something. There’s not many silver linings to COVID-19, but the emergence and acceptance of virtual healthcare is certainly one of them. Patients and doctors are now far more comfortable interacting over video or text, discussing intimate healthcare issues, prescribing treatment and conducting the follow up, all without anyone having to go anywhere. No one with a fever prefers climbing into a car or squeezing onto a crowded subway to sit in a germ-infested waiting room only to eventually have a doctor ask the same standardized questions that could have fit into a text.
Modern Healthcare: Home improvement to be provided by ProMedica's new healthy homes initiative (4/7) – ProMedica has launched an initiative addressing the health impact of unsafe housing conditions, one of the first health systems to do so. The Toledo, Ohio-based health system announced Wednesday it was entering into a multi-year, multi-city partnership to reduce the health hazard caused by substandard housing conditions with the Green & Healthy Homes Initiative, a Baltimore-based, not-for-profit organization that provides support services and technical assistance to create healthy housing environments.
Home Health Care News: ‘Better Systems, Better Controls and a Digitized Industry’: Analyzing PE’s Impact on Home-Based Care (4/11) – In late March, members of Congress argued fervently that private equity did not belong in health care, with senior care being a particularly egregious case of trespassing. During a special House hearing, lawmakers addressed the dangers of PE firms digging their heels deeper into the long-term care space and how profit-driven motives can have an adverse impact on patients and the U.S. health care system at large. A general lack of transparency into PE-owned organizations was likewise a major focus.
onehome Partners with Devoted Health to Bring Post-Acute Home-Based Care to Medicare Advantage Members in Arizona, Ohio and San Antonio, TX (4/12) – onehome, a leader in post-acute home-based care (PAHC), is partnering with Devoted Health, one of the fastest-growing Medicare Advantage companies in the United States, to expand care to Devoted Health's members in Arizona, Ohio and San Antonio, TX. The partnership brings enhanced care into members' homes, enabling them to receive healthcare including infusion services, wound therapy and durable medical equipment in the safest environment, avoiding the risks of infection associated with institutional settings.
McKnight's Senior Living: Charting a course toward interoperability in home-based care (4/13) – The pandemic has accelerated the sense of urgency within the home-based care industry to get and stay connected. As the home becomes a healthcare hub in this new decade, post-acute care (PAC) providers need to up their ability to send and accept data electronically to provide better care for their patients and foster long-lasting referral relationships critical to doing business.
Home Health Care News: What Medicare Advantage Plans Want From Home-Based Care Providers (4/14) – Medicare Advantage (MA) has provided tailwinds for home-based care providers, as the overall MA member population has grown substantially over the last decade. In 2020, there were over 24 million MA members in the U.S., over double the amount there were in 2010 and nearly five times the amount in 2005, according to Centers for Medicare & Medicaid Services (CMS) data. MA opportunities don’t grow on trees, however. Home-based care agencies are undoubtedly worthy in the continuum of care, but each provider has to prove its value to health plans looking to reduce costs and provide better care for their members.
New York Business Journal: At-home health care company Tomorrow Health raises $25 million (4/15) – At-home health care provider Tomorrow Health said it's raised $25 million in a Series A funding round. The New York City-based company said the round was led by Andreessen Horowitz with participation from Obvious Ventures and BoxGroup. The company said it will use the money "to hire additional talent and expand its infrastructure technology to seamlessly connect every patient with home-based care." Tomorrow Health helps customers obtain durable medical equipment such as walkers and oxygen tanks and works with suppliers and insurance companies.
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Events
William Blair: Innovators in Healthcare Conference – On April 29th, William Blair will hold their second Innovators in Healthcare Conference. During the conference, they will host virtual fireside chats with the founders, CEOs, and presidents of some of the most innovative and highest-growth companies in the healthcare technology and tech-enabled healthcare services marketplace. Participating companies include 98point6, Care Continuity, Cricket Health, Dispatch Health, Innovaccer, LifeMD, Medically Home, and NowPow. You can register by clicking here.
Becker's Hospital Review: The rise of home-based care – On April 29th, Becker's Hospital Review will host a webinar to discuss the acceleration of care-at-home solutions. Today, more than 100 hospitals and 40 health systems have been approved for the CMS Acute Hospital Care at Home waiver program that allows Medicare payments for additional services provided in the home. But most hospitals are still trying to determine whether to implement care at home, how to successfully operationalize it, and how to meet all hospital conditions of participation. Attendees will learn: 1) trends in care-at-home models: how to implement, how to receive payment, and how to position organizations for value-based payment; 2) what hospitals can/can't do with/without the CMS waiver; 3) lessons learned from COVID-19 to engage patients at scale; 4) how to define and measure success. You can register by clicking here.
Save the Date: AAHCM's Home-Based Medical Care Annual Meeting – On Friday and Saturday, October 29–30, the American Academy of Home Care Medicine will hold its 2021 Virtual Annual Meeting, Home-Based Medical Care: Leadership Across the Landscape. AAHCM expects more than 400 clinicians (physicians, residents, nurses, PAs, social workers, etc.), practice administrators, academic leaders, and policy experts to attend. Together they will bring to life the new and changing opportunities in home-based medical care, all in a highly interactive, 3D virtual environment that includes an exhibit hall and networking opportunities. Registration opens July 1, with special rates for registering early.
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