How home-based care is helping health systems engage more patients at scale

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Many hospitals and health systems are strategizing how to implement successful care-at-home initiatives, which have been accelerated by the impact of the COVID-19 pandemic.

During an April 29 webinar sponsored by Dina and hosted by Becker's Hospital Review, industry leaders discussed the expansion of home-based care, which virtual services Medicare reimburses, and keys to building a successful Hospital-at-Home program.

Participants were:

  • Kate Behan, MD. Senior vice president and chief population health officer at Philadelphia-based Jefferson Health
  • Kristen Vogl. Enterprise vice president of post-acute care and musculoskeletal services at Jefferson Health
  • Ashish V. Shah. CEO and co-founder of Dina, a Chicago-based care-at-home platform and network

Four takeaways:

1. The rise of home-based care. Several market forces are shifting care to lower-cost environments, with patients' homes arguably the lowest-cost, most convenient setting. President Joe Biden's American Jobs Plan features a $400 billion investment to expand access to Medicaid home and community-based services for older adults and people with disabilities, which would enhance programs that allow patients to receive care at home. "It's become more and more important for health systems and provider groups to really develop competent care delivery models that can actually deliver on lower cost, higher quality of care," Dr. Behan said.

2. More virtual services are being reimbursed. Telehealth is one component of virtual care that has significantly expanded over the past year. Now, there are more than 135 services that can be covered via telehealth, including emergency department visits, inpatient nursing facility visits, remote patient monitoring and discharge day management services, according to Mr. Shah. "These services can all be delivered and then reimbursed via telehealth." Remote patient monitoring, for example, has expanded CPT codes to reimburse providers for time spent and equipment used to deliver care, including training and onboarding services

3. Hospital-at-Home expands. The Acute Hospital Care at Home program, an expansion of CMS' Hospital Without Walls initiative launched in March 2020, is designed to increase hospitals' capacity to provide care outside the inpatient setting and within a patient's home. There are currently 57 systems and 128 hospitals enrolled in the program, which "creates an opportunity for hospitals, health systems or other providers" to receive payment for at-home treatment that's equal to what they would receive if the patient was treated in a hospital, Mr. Shah said. There are up to 60 conditions, including asthma, pneumonia and congestive heart failure, that can be treated at home through the initiative. Successful outcomes require hospitals to reimagine the post-acute experience, Mr. Shah said. This means replicating the hospital room with a marketplace of home-based services including telehealth, remote patient monitoring, courier services, home modifications, pharmacy, home infusion, non-medical home care and mobile imaging/radiology.

4. Evaluating at-home models. There is no one-size-fits-all solution for healthcare organizations looking to establish a Hospital-at-Home model. Key pillars to ensuring the success of these programs include: establishing a geographical fit; aligning with innovative payers, hospital finance and contracting teams; and researching targeted patient populations for launch, according to Ms. Vogl. It's also critical to install executive champions capable of developing and executing the vision. "You want to maximize your expertise and your resources to make this work," Ms. Vogl said. 

Click here to learn more about Dina and here to view the full webinar.

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