Home care delivery: To succeed, healthcare systems must disrupt themselves

In 2018, $30 billion of venture funding flowed into healthcare. Digital health and on-demand medicine are currently popular investment targets, but experts believe that over the next few years home care will become an attractive investment opportunity.

At Becker's Hospital Review's 10th Annual Meeting in Chicago, Huron hosted a workshop to explore the future of home care delivery and what role incumbent healthcare providers will play. Curt Whelan, a managing director of Chicago-based Huron's healthcare business, facilitated a panel discussion with experts from the consulting sector, as well as the provider side.

What's driving the home care market?

Payers are demanding home care because hospitals are so expensive. On the consumer side, patients would rather be treated in the comfort of their homes. Maureen Hydok, senior director at Huron noted, "Surveys show that 90 percent of the population wants to age in place. Home care improves patient satisfaction and decreases costs by 20 percent to 30 percent. Consumers also avoid hospital-acquired conditions."

While insurers and patients favor home-based care, some health systems worry about its effects on their operations.

"Anywhere from 6 percent to 15 percent of hospital admissions can be seen in the home. Health systems must determine whether they can afford to lose that volume," said John Bodine, a managing director of Huron Transaction Advisory, Huron’s broker-dealer. "We believe providers can drive the home care disruption, but they must start to build partnerships, diversify their portfolios and start delivering care outside the hospital."  

Telehealth: A proven path into home care

For healthcare providers, home care represents a huge business model change. Telehealth can be a great way to get started with patient visits outside the traditional clinic setting.

Renton, Wash.-based Providence St. Joseph Health started the journey toward home care in 2004, focusing initially on tele-ICU programs that provided remote monitoring for ICU patients. Over time, the organization developed a true telehealth program and last year conducted around 40,000 telehealth patient visits.

One key to success at Providence St. Joseph Health has been partnerships to scale telehealth-related technologies. "We aren't a technology shop, so we needed help with interfaces to Epic and our other EMRs. We also had to ensure that the data aggregation for clinicians was appropriate," said Kim Swafford, group vice president for telehealth and health technology strategy at Providence St. Joseph Health.

Louisville, Ky.-based Norton Healthcare is also exploring the home care market through telehealth. In 2012, the system started specialty inpatient telemedicine consults. Norton then launched a direct-to-consumer telemedicine program that is available 24/7. The organization handles all aspects of the program, without outside partners.

"We see telemedicine as another access point to our system," said Jennifer Murley, director of healthcare informatics at Norton. "We are focused on urgent care issues that can be diagnosed and treated through live, interactive video, and our primary users are females ages 30 to 40." Norton is now conducting pilots for remote patient monitoring of high-risk populations.

Is your organization ready to disrupt itself?

To succeed with home care, healthcare providers must embark on a journey toward transformative care. The panelists offered four recommendations:

  • Obtain organizational buy-in. To move home care strategies forward, buy-in from both clinical and administrative leaders is required. Ms. Murley noted, "If you don't have buy-in and processes, you will struggle."
  • Understand your capabilities and the competitive landscape. If competition isn't high for home care in your market, you may have time to develop capabilities in-house, rather than partnering.
  • Clinical team and operational workflows are key differentiators. Investment on the operational side is often more important than investment in technology. Ms. Hydok commented, "It's people, process, then technology. Don't implement technologies that hardwire bad behavior — it's horrible to undo that."
  • Patients may need help with technology at home. Providence St. Joseph Health, for example, is looking into "Best Buy-type" IT experts who can assist patients.

To develop winning home care business models, organizations must have clear customer value propositions, profit formulas and key processes. "If you can lay those out cleanly, accessing capital will be easier. Incumbents have a right to win in the home care space. The question is whether they are willing to disrupt themselves," said Mr. Whelan.

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