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.
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Brightstar Care Joins Alliance to Redefine Care in Home
On April 26, BrightStar Care, a leading national private duty home care and medical staffing franchise with over 340 locally owned and operated locations, announced that they joined Moving Health Home. "Based on evidence, we know that it is possible for Americans to receive health care in their homes, and we want to ensure that we work with leaders in the health care industry that can support our mission to change the culture around institutional care,” said Krista Drobac, Founder, Moving Health Home. “We are excited to welcome BrightStar Care to the coalition as we believe their reputation and experience with home care will move our mission forward.”
Hospice News:Moving Health Home Engages Hospice, Palliative Care Providers (4/16) – Moving Health Home is a coalition of health care organizations that advocate for the expansion of home-based care. Moving Health Home was established in March by founding members Amazon Care, Landmark Health, Signify Health, Dispatch Health, Elara Caring, Intermountain Healthcare, Home Instead and Ascension. The coalition’s mission is to build support for home-based care by educating policymakers about the benefits to patients and potential cost savings. Other new members include University of Pittsburgh Medical Center, U.S. Medical Management, Advocate Aurora Health, and Vituity.
Healthcare Dive: 3 takeaways from CHIME21: EHRs, Big Tech and VCs look to the future of health (4/19) – "I don't know how much of this is new, but much of this is accelerated," said Keith Figlioli, general partner at LRVHealth. Hospital-at-home is especially hot, according to Figlioli, citing Optum's reported acquisition of in-home medical group Landmark Health, value-based homecare provider Signify Health's $564 million IPO in February and the creation of the Moving Health Home coalition, which includes Amazon and hospital giants Ascension and Intermountain, in March. "We're in the first inning of that, but it's a huge trend," Figlioli said.
Becker's Hospital Review:6 recent big tech partnerships in healthcare: Amazon, Google & more (4/22) – UPMC and Advocate Aurora Health became the two latest health systems to join Moving Health Home, a new healthcare coalition founded by Amazon Care, Intermountain and Ascension.
Home Health Care News: BrightStar Care Joins Amazon, Landmark Health on Home-Based Care Coalition (4/26) – BrightStar Care has joined Moving Health Home(MHH) — a home-based care advancement coalition that counts Amazon Care and Intermountain Healthcare as members, among nine other organizations. BrightStar Care is one of the largest home care franchises in the nation. The Chicago-based company’s overall network spans 340 personal care locations in 38 states, reaching about 75% of the U.S. population. MHH announced the formation of its organization last month. Broadly, the coalition is focused on making the home a sustainable clinical site of care and changing the way policymakers think about the treatment of patients.
Pauline Lapin, Direct for Seamless Care Models Group at CMMI Remarked on Home-Based Care at NAACOS(4/30) – On April 30, 2021, Pauline Lapin, Direct for Seamless Care Models Group at CMMI spoke at NAACOS' final day of their Spring 2021 Conference. She said, "I am hoping we can learn more and that we can continue some of those flexibilities after the public health emergency to allow more access to telehealth and more home-based care." Further noting that CMMI is "using this opportunity to think about the future of home-based care and health in the home. For hospital at home, there are some really interesting interventions and some benefit enhancements we can test in the model."
Annals of Internal Medicine: Is Comprehensive Geriatric Assessment Admission Avoidance Hospital at Home an Alternative to Hospital Admission for Older Persons? (4/20) – Hospital at home, a model of acute hospital-level care at home, is beginning to be adopted as evidence of the model's efficiency and safety accumulate. In their article, Shepperd and colleagues contribute to this growing body of research with the report of their trial of hospital at home. This multisite trial evaluates the outcomes of hospital at home combined with comprehensive geriatric assessment (CGA) for older patients experiencing an acute event requiring hospital-level care. The authors conclude that admission avoidance hospital at home with CGA led to similar outcomes as hospital admission in the proportion of older persons living at home as well as a decrease in admissions to long-term residential care at six months. This type of service can provide an alternative to hospitalization for selected older persons, the authors noted.
The Associated Press-NORC Center for Public Affairs Research:Government should help Americans age at home (5/3) – A majority of Americans agree that government should help people fulfill a widely held aspiration to age in their own homes, not institutional settings, a new poll finds. There’s a surprising level of bipartisan agreement on some proposals that could help make that happen, according to the late March survey from The Associated Press-NORC Center for Public Affairs Research. Still, Republicans lag Democrats in support of some policies, including the most far-reaching idea: Only 42% of Republicans favor a government long-term care insurance program for all Americans, compared with 78% of Democrats. Overall, 60% of the public supports that approach.
HealthAffairs: Outcomes After Shortened Skilled Nursing Facility Stays Suggest Potential For Improving Postacute Care Efficiency (5/3) – Reducing postacute care in skilled nursing facilities (SNFs) in favor of home-based care is a leading cost-saving strategy in new payment models. Yet the extent to which SNF stays can be safely shortened remains unclear. We leveraged the exposure of fee-for-service Medicare beneficiaries without supplemental coverage to cost sharing after SNF benefit day 20 as a cause of shortened stays. Marked reductions in length-of-stay because of cost sharing shifted patients to home more than a week earlier than expected without cost sharing, producing a discharge spike. These reductions were not associated with clear evidence of compromised patient safety as measured by death, hospitalization for fall-related injuries, or all-cause hospitalization within nine days of the spike. Adverse consequences requiring hospitalization could not be excluded for a small proportion of shortened stays. These findings suggest potential for improving postacute care efficiency, as SNF stays may be unnecessarily long to ensure safety.
News and Market Developments
Home Health Care News: CMS Hospital-at-Home Program Closing In On 200 Participants (4/19) – The hospital-at-home concept was developed long ago, but did not gain popularity until the COVID-19 crisis. And while its stalling was due to logistical and reimbursement problems, experts believe it’s finally here to stay. For home health and home care providers, that means another area to deliver their expertise and increase their bottom lines. As of April 16, 56 health systems and 127 hospitals across 29 states have been accepted as participants in the Centers for Medicare & Medicaid Services’ (CMS) hospital-at-home initiative, which is officially dubbed the “Acute Hospital Care at Home” program.
Mcknight's Senior Living:Should home healthcare be a new focus for Medicare Advantage? (4/20) – It’s intuitive; when we get sick, we bundle ourselves into our cars and go to the doctor. The American healthcare system concentrates its care providers in hospitals, clinics and practices for the sake of efficiency, service quality, and equipment availability. It’s far more convenient to provide care in a centralized facility than it is to schlep doctors, nurses and devices to a patient’s home. In this context, home healthcare appears to be a rarity intended for patients for whom travel is difficult — the last vestige of a care delivery system that fell out of vogue in the early 20th century. But now, homecare is on the rise.
Home Health Care News:DispatchHealth Makes First Acquisition, Acquires Mobile Imaging Company – (4/27) DispatchHealth has officially transitioned from “up-and-coming startup” to “active acquirer.” The company announced Tuesday that it has made its first-ever purchase by landing Professional Portable X-Ray (PPX), a mobile imaging provider. Denver, Colorado-based DispatchHealth offers hospital-at-home and mobile high-acuity services through its emergency medicine-trained teams. It currently operates in 29 markets across the U.S., with backing from some of health care’s biggest names.
Humana:Agreement to Acquire remaining 60 Percent Interest in Kindred at Home, Accelerating Integration of the Nation’s Largest Home Health Provider into Humana’s Payer-Agnostic Healthcare Services Platform (4/27) – Humana announced it signed a definitive agreement to acquire the remaining 60 percent interest in Kindred at Home (KAH), the nation’s largest home health and hospice provider. KAH employs approximately 43,000 caregivers providing home health, hospice, and community care services to over 550,000 patients annually. KAH has locations in 40 states, providing extensive geographic coverage with approximately 65 percent overlap with Humana’s individual Medicare Advantage membership.
Home Health Care News: In Speech to Congress, President Biden Again Shines Spotlight on Home-Based Care (4/29) – In a speech delivered to Congress Wednesday, President Joe Biden again mentioned the importance of providing care to seniors in their own homes. Specifically, he touted his administration’s previously announced American Jobs Plan, which would include $400 billion for home-based care. Much of that money would go to the workforce, with home health and home care agencies fighting to recruit and retain workers as the demand for services rises. “The American Jobs Plan will help millions of people get back to their jobs and their careers,” Biden said.
Politico: Will the nursing home of the future be an actual home?(4/30) – Not all Americans will have the luxury of choosing where they live when they’re old, whether it’s because they can’t afford to, their insurance coverage won’t pay for it, or a sudden illness forces them into a nursing home. Others may choose to live in a facility, and advocates are pushing to reform not just the nation’s financing structure, but to revamp traditional nursing homes with strengthened staffing ratios, better infection control measures and increased wages for nurses, which improves patient care as well as staff morale. Several legislative proposals are working their way through Congress to bolster care for seniors both inside and outside the nursing home.
HealthAffairs Blog: Navigating Care Transitions From SNF To Home During A Pandemic—Lessons Learned (5/6) – Transitions of care have long been recognized as a vulnerable time for patients and their caregivers, particularly among the frail elderly with chronic diseases and complex medical issues. Various models of care and interventions have been deployed to improve transitions of care and reduce readmission when patients move from acute care to a skilled nursing facility (SNF) or to home. Far less attention has been paid, however, to the process of preparing patients to transition from a short stay in a SNF back to their homes. National data from the Centers for Medicare and Medicaid Services reveal undeniable room for improvement, with only 50 percent of patients with Medicare Part A coverage successfully returning to home or community following a short stay in a SNF.