Home-based care's role in 'flattening the curve' of healthcare costs

Stephen Dorner, MD, chief clinical and innovation officer of Mass General Brigham Healthcare at Home, told Becker's that the more home-based care models are scaled, the more opportunity there is to move the needle and flatten the curve of healthcare costs in the U.S.  

Boston-based Mass General Brigham, which runs one of the largest home hospital programs in the country, has had more than 2,500 home hospital admissions since January 2022, saving 13,300 acute care facility-based bed days. 

But, the journey first began with two pilot programs launched in 2017, evolving through iterative processes to identify sustainable models. By 2019, the health system began to recognize the strategic importance of the home-based care model, and prioritized refining best practices and modifying them for scalability.

The core strategies, according to Dr. Dorner, involved transforming manual processes into standardized workflows and focusing on translating strong clinical practices from traditional facilities to home-based care without sterilizing the comfort of the home environment.

"What that typically involves is looking at our manual processes that are highly prone to dependency on individuals' actions and turning them into more of a standardized workflow, where you can eliminate the room for error and really make it more of a protocolized process that is then replicable," he said. "This allowed us to bring in additional staff, train them on the same workflow and then basically plug and play that same model to be able to deliver the same kind of care."

Since then, in its home-based program, Mass General Brigham has leveraged its electronic medical record and implemented checklists, huddles and committees to ensure uniformity in operations, reviewing successes, failures and opportunities for improvement.

Looking ahead, Dr. Dorner envisions the home-based care model playing a pivotal role in reshaping healthcare delivery. The home environment provides a unique opportunity to eliminate silos and gaps in traditional care, creating a patient-centered continuum of care, according to Dr. Dorner. 

He said by allowing clinicians to deliver care across phases seamlessly and incorporating modular technologies based on acuity levels, the home-based model aims to provide a more satisfying, higher-quality and cost-effective care solution. 

"As the demand for healthcare services continues to grow, the scalability of home-based care becomes crucial in flattening the curve of healthcare cost growth," Dr. Dorner told Becker's

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