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.
In a new Harvard Business Review article, authors describe how health systems can build capacity by embracing innovation and by keeping patients out of facilities in the first place. They explore five key areas of innovation that should be embraced:
Increase Capacity with Home-Based Care - Health systems can build on existing home-based primary care models and new pandemic-era home monitoring programs to increase “slack” for hospital care by reducing the likelihood that frail, elderly patients will require scarce resources during periods of high demand.
Redesign Point of Entry with Walk-In Care - To improve management of low-acuity cases during high-demand periods after the pandemic, health systems could incorporate features of walk-in clinics such as expanding the hours they are open and increasing the locations where members of the community can access services.
Use Telemedicine to Triage Patients - A “seasonality” approach to virtual care would use telemedicine as a platform for rapidly activating parallel care pathways in response to fluctuating patient needs.
Reduce Demand for Hospital Beds with Hospital-at-Home Care - By scaling such models, health system leaders can not only bolster surge capacity for future public health emergencies but also reduce costs and make care more convenient.
Accelerate Value-Based Payment Reform - Value-based payment, which offers risk-adjusted reimbursement for the full scope of care that a patient experiences for a given condition, presents a path forward. Under this model, health systems are incentivized to design staffing models that distribute physician time according to patient needs rather than optimizing solely for the volume of services needed to cover fixed costs.
Forbes: Disrupting a Stagnant Industry to Meet Patients Where They Are (10/13) - In an op-ed by Leslie Trigg, the CEO of Outset Medical, she discusses reimagining the future and empowering patients to dialyze on their own schedule at home will require broad commitment across the kidney disease community. She highlights the CMS progress made in moving the needle via the mandatory ESRD Treatment Choices (ETC) Model and discussed participation in organizations such as Innovate Kidney Care and Moving Health Home to educate, empower and change the status quo to do what’s right for patients.
Hospice News: Best Buy Acquires Current Health (10/12) - The electronics retailer announced it is buying Current Health. Before the Current Health deal, Best Buy spent at least $1 billion on acquisitions, the bulk of that on GreatCall in 2018, a seller of emergency-response systems for the elderly that serves more than 1 million people. In 2019, it bought Critical Signal Technologies. Earlier this year, Current joined the Moving Health Home coalition, a collaborative of companies that advocate for home-based care.
Entrepreneur: How 8 Women Leaders in Franchising Are Overcoming the Industry's Greatest Challenge (10/5) - Shelly Sun, Founder and CEO of Brightstar commented on joining Moving Health Home and the challenges the healthcare sector has faced during the pandemic. "We need permanent legislation that permits affordable in-home care as an integral part of patient care. We also need to drive new policies that support the workforce, like access to affordable childcare."
House of Representatives: Choose Home Introduced in the House (10/8) - On October 8, Rep. Cuellar (D-TX), Rep. Comer (R-KY), and 13 bipartisan cosponsors introduced the Choose Home Care Act of 2021 (H.R.5514) in the House of Representatives, which would improve extended care services by providing Medicare beneficiaries with an option for cost-effective home-based extended care under the Medicare program. U.S. Sens. Debbie Stabenow (D-Mich.) and Todd Young (R-Ind.) are the lead sponsors of the Senate version. Choose Home is supported by NAHC, AARP, LeadingAge, Allies for Independence, the National Council on Aging, Moving Health Home, the Council of State Home Care & Hospice Associations and the Forum of State Associations.
Reconciliation Process: Home- and Community-Based Services Funding Level Depends on Top-Line But Advocates Continue Push (10/8) - As reconciliation negotiations slow down while lawmakers wait to see a new top-line for the package, advocacy for home- and community-based services investments -- one of the few health reform priorities for which Sen. Joe Manchin (D-WV) has offered some support -- has continued, with economists and public policy experts circulating a letter calling for investments and disability and direct care worker advocates holding a 24-hour vigil.
Department of Health and Human Services (HHS): Public Consultation on the Draft HHS Strategic Plan Fiscal Year 2022-2026 - HHS is seeking public comment on its draft Strategic Plan for Fiscal Years 2022 - 2026. The draft Strategic Plan is provided as part of the strategic planning process under the Government Performance and Results Modernization Act of 2010 to ensure that HHS stakeholders are given an opportunity to comment on this plan. The draft for comment can be found here.
Research and Polling
Journal of the American Geriatrics Society: Current Practices of Family Caregiver Training During Home Health Care: A Qualitative Study (10/7) - Since 2018, the Medicare Conditions of Participation has required home health agencies to provide training to family caregivers. However, little is known regarding current practices of family caregiver assessment and training during home health care. In this article, researchers found that while caregiver training is currently integrated into clinician workflows in home health care and helps determine visit intensity and discharge timing, clinicians face a lack of structured assessment instruments or training materials. Efforts by policymakers and home health agencies to facilitate clinicians' training efforts could positively affect the cost and quality of Medicare-funded home health care
New England Journal of Medicine Catalyst: Huntsman at Home, an Oncology Hospital at Home Program (10/6) -The University of Utah Health Huntsman Cancer Institute has developed a hospital at home model for oncology patients that features ongoing monitoring and rapid response for patients with unstable, acute illness. Nurse practitioners, home health registered nurses, and other staff provide hospital-level care in the patient’s own home. Services are available within 2 hours of the patient arriving home and in response to emergent calls. Early results show reductions in hospitalizations, hospital length of stay, ED use, and cost of care.
Journal of the American Geriatrics Society: Skilled Home Healthcare Clinician's Experiences in Communicating with Physicians: A National Survey (10/2) - A recent survey measured the experiences of skilled home healthcare clinicians (SHHC) in communicating with physicians. Multilevel logistic regression models examining odds of adverse patient outcomes associated with communication failures. Researchers found that SHHC clinicians experience significant communication barriers with physicians who order SHHC services. They concluded that strategies to enhance meaningful communication between SHHC clinicians and physicians must be developed.
News and Market Developments
Fierce Healthcare: Walgreens Doubles Down on Primary Care, Home Health with Major Investments in VillageMD, CareCentrix (10/14) - Walgreens Boots Alliance announced the rollout of Walgreens Health, a new business segment focused on consumer-centric, tech-enabled healthcare that ramps up the company’s capabilities in primary care, post-acute care and home care. As part of this new strategy, Walgreens also announced a $330 million investment in post-acute and home care company CareCentrix, which will also be operated under Walgreens Health. Walgreens Health aims to provide equitable, personalized, whole-person healthcare to local communities across America to meet where consumers they are—in the store, at home, in the doctor’s office and via mobile app.
MorningStar: Sprinter Health Collects $33 Million in Series A Financing to Join Home-Healthcare Race (10/14) - Sprinter, which formed in January, sends nurses and phlebotomists to patient homes to perform more-routine services such as blood draws and Covid-19 testing. The company, whose investors include Andreessen Horowitz, targets customers such as health systems and telehealth companies seeking to extend their services to patient homes, said co-founder and Chief Technology Officer Cameron Behar.
19th News: Protestors Push Congress for Home Care Funding (10/12) - Dozens held a 24-hour vigil, telling stories of disabled people, family members and professional caregivers as Congress considers legislation that could help make home care more accessible and provider better pay for workers. Before the vigil, ADAPTers had gone to protest outside the office of Sen. Joe Manchin of West Virginia. Sixteen people were arrested. Some members of Congress stopped by the vigil including Rep. Pramila Jayapal (D-WA).
Fierce Healthcare: PopHealthCare Launches New National Medical Group, Emcara Health (10/11) - PopHealthCare, a subsidiary of GuideWell, is launching a new national medical group that aims to offer a slew of value-based care services to payers nationwide. Emcara's goal is to reduce the total cost of care by 10-20% without compromising on quality and patient experience. Emcara will serve a number of insurance segments, including Medicare Advantage, Medicaid managed care and Affordable Care Act exchange plans. Other services on its slate include short-term options like in-home assessments, social determinants of health risk assessments, transition of care services, emergency room diversion and in-home palliative care.
Home Health Care News: 'The Waiver Program is Tough': Issues with the CMS Hospital-at-Home Program (10/11) - The U.S. Centers for Medicare & Medicaid Services’ (CMS) “Acute Hospital Care At Home” waiver program has allowed more health systems and home-based care agencies to get involved. However, as it is currently constructed, it does not represent the best way forward for the concept. Participants point out that the flaw with the CMS waiver is in how patients are identified for participation and then brought into the program. This process is dependent on busy ER doctors being able to identity these patients once they have come through the ED doors causing patient acceptance into the program to be lower than non-waiver HaH programs.
Home Health Care News: At Signify Health, the Home Serves as an Anchor for Holistic Care (10/11) - Signify Health Inc. kicked off 2021 by going public. Since then, they hasn’t been shy about its mission to position the home as a major part of the care continuum. Currently, Signify has partnerships with roughly 2,500 post-acute facilities.
Home Care: How Remote Patient Monitoring Can Bolster Aging in Place (10/8) - The increased use of telehealth during the pandemic exposed some of the limitations of the technology. Vital sign readings such as blood pressure, temperature and oxygen saturation were missing from the conversation. Remote patient monitoring (RPM) fills this gap, allowing for the collection of vital signs. Despite the benefits of RPM, reimbursement is a challenge right now for home health agencies.
Hospice News: SCAN Health Plan Rolls Out Home-Based Integrated Care Model (10/7) - SCAN Health Plan, subsidiary of SCAN Group, recently launched a new integrated care delivery model focused on seniors who are home-bound or reside in assisted living and skilled nursing facilities. Members of the company’s Embrace Medicare Advantage plan are eligible to participate in the model, which integrates primary care, geriatric and palliative care medicine. Through the model, SCAN will deliver clinical care typically provided in physician offices and hospitals to patients wherever they reside.
Home Health Care News: Former CMS Chief Seema Verma: Government Programs Must Keep Pace with Home-Based Care Innovation (10/6) - One of the last CMS initiatives that Verma helped develop, of course, was the “Acute Hospital Care At Home program,” aimed at boosting hospital capacity during the public health emergency. In an interview with Home Health Care News, Verma said that “The shift to home-based care is a positive development. The advent of new technology, from telehealth to remote patient monitoring, is supporting the rapid adoption of home-based care.”
WKYC Studios: The Future of Healthcare is Taking a Nod From the Past with House Calls (10/6) - The future of healthcare is going back to the past. House calls are coming back and thanks to the pandemic, local hospitals got their programs off the ground and into people's homes. "We truly are creating an inpatient hospitalization, delivering all aspects of care to the patients at the home," said Jodi Arth, University Hospitals Cleveland Medical Center systems operation manager for clinical delivery.
MedCityNews: Mount Sinai, Empire BlueCross Blueshied to Extend Access to Home-Based Care Models (10/4) - The two have entered into a new agreement through which Empire members will gain access to three new care models: Mount Sinai Emergency Triage, Treat, and Transport; Mount Sinai Community Paramedicine; and Mount Sinai Visiting Doctors Program. All three programs focus on providing in-home services to keep patients out of the hospital or serve homebound members.
Fierce Healthcare: UnityPoint Health, Henry Ford Health System expand SNF- and hospital-at-home care services with new partnerships (10/1) - The two health systems announced new tech vendor partnerships aimed at ramping up their ability to extend skilled and high-acuity care to patients’ homes. The first is a collaboration between UnityPoint at Home, a subsidiary of Des Moines, Iowa-based UnityPoint Health, and WellSky, a healthcare and community care coordination technology company. The other will see Detroit-based Henry Ford Health System build and launch hospital-at-home, SNF-at-home and palliative-care-at-home programs for its communities alongside Contessa, a provider of home recovery care services and a subsidiary of Amedisys.