TRENDS
Bolstering Home Care Models Health systems look to expand care delivery services in Hospital-at-Home programs post pandemic. By Daniel Beaird
A recent report from McKinsey & Co. stated that as much as $265 billion worth of care services for Medicare fee-for-
service and Medicare Advantage beneficiaries could shift to the home by 2025, representing a three- to fourfold increase in the cost of care being delivered at home for this population.1 The COVID-19 pandemic accelerated this movement and a significant portion of it came through Hospital-at-Home (HAH) programs, which enable some patients who need acutelevel care to receive it in their homes rather than in a hospital, thus aiming to reduce costs, improve outcomes and enhance the patient experience.
CMS launched the Acute Hospital Care At Home program in November 2020, during the first year of the pandemic. It provided hospitals the flexibility to care for patients in their homes, originally helping relieve facilities of non-COVID patients to assist in tackling the surge of COVID-positive patients. As many HAH programs evolved throughout the pandemic, they shifted to enrolling COVID-positive patients as well to finish their hospitalization at home. Now, COVID-positive patients are enrolled directly from emergency departments. “One driver to more enrollments is the barrier of obtaining reimbursements for short-term oxygen,” Peter Read, MD, medical director of Des Moines, Iowa-based UnityPoint Health’s hospital-athome program, told AHA’s Advancing Health podcast in February.2 “We worked with our ACO to develop a waiver that allows us to dispense shortterm oxygen to overcome reimbursement.” UnityPoint Health has achieved $900,000 in shared savings from just its 20
June 2022
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hospital-at-home program, and many of its other home-based services were in increased demand due to the pandemic. The Midwestern health system has enrolled over 150 patients in its program and averted over 100 hospitalizations during the pandemic. In January, Baxter International, Global Medical Response (GMR) and Cardinal Health led a $110 million investment round in Boston-based Medically Home, a technology-enabled services company that provides tools to allow medical providers to shift
advanced medical care from hospitals to patients’ homes. Mayo Clinic and Kaiser Permanente also contributed. These partnerships and investments are supporting the evolution of flexible hospital capacity toward hospital care at home and utilization is expanding. Medically Home’s hospital-athome program configures a network of clinical and non-clinical services, medications, equipment and supplies to patients’ homes, enabled by the CESIA Continuum® enterprise
