Why the Rise of In-Home Care Couldn't Come at a Better Time

Beyond transitioning oftentimes unnecessary and costly care, it’s a way of treating patients in a preferred, familiar venue

Health systems and hospitals are at a crucial crossroads when it comes to financial challenges and delivery of care. At the nexus of these two trends lies a major opportunity.

The challenges are clear: Workforces, supply chains and capital are all constrained, and inflation is taking a bite. As a result, margins and quarterly financials are stressed. These issues may be even more of a challenge for the long-term thinking that goes into master facility planning. Divining insight into the care landscape a year from now is hard enough. Projecting that out five or 10 years is considerably harder.

Patients, on the other hand, have a wider variety of choices for how and where they receive care as healthcare becomes even more consumer driven. This trend isn't just seen in the encouraging telemedicine adoption trendlines accelerated by the pandemic. It's also noticeable in the higher acceptance of in-home care.

In an increasingly polarized world, in-home care is stunningly popular. In a recent national survey, a majority of consumers said the federal government should prioritize increasing access to clinical care in the home, an answer that stood out as the only one to receive a high percentage of bipartisan support.

As patient-consumers look for more diverse ways to access healthcare, companies are taking notice and making moves to fill those gaps. Looking at the industry landscape we see consumer-first companies, such as Amazon, shelling out billions to play in the healthcare space. While traditional hospitals and health systems have established and trusted brands in their communities, they could lose market share if they don’t look for innovative partnerships to meet patient-consumers where they want to receive care.

The rising cost of providing care inside of a hospital and the rising acceptance of patients willing – and often eager – to be treated at home would mean far less if the latter didn't relieve pressure from the former. But in case after case, that's exactly what's happened.

Take the recent collaboration between United Healthcare's Health Plan of Nevada and in-home provider DispatchHealth in the Las Vegas market for example. The partnership began prior to the pandemic, yet proved its worth many times over in part because of the challenges posed by COVID-19.

Meant to supplement its acute-care offerings, Health Plan of Nevada engaged DispatchHealth to support members in the post-acute setting who were unable to see their PCPs directly after an acute hospital stay. The program, first implemented in April 2019, identified more than 8,000 members as part of this program and as patients were recovering, the need to keep them safe at home and reduce readmissions was a top priority. The innovative partnership extended care into the home which led to the prevention of 3,500 hospital visits, savings of $3.2 million and a 35% increase in primary care engagement, and also reduced the burden on overwhelmed hospital workers.

That last statistic is particularly important, given that the program targeted patients from a population that often eschews or even avoids early intervention. And it goes a long way toward potentially reducing emergency department misuse, a phenomenon that, as of a few years ago, accounted for some $32 billion and counting in annual wasteful spending. As executives and administrators well know, two key drivers of emergency department overuse are lack of access to timely primary care services and hospitals' obligations to treat all patients who arrive in the emergency department. Acute care, however, is just one of the potential relief points provided by an expanded in-home offering.

The systematic incorporation of in-home care is now an established part of the treatment process for health systems across the country. Beyond transitioning oftentimes unnecessary and costly emergency department care, right-sizing care is a way of providing desirable pre-hospital and transitional stays to patients, many of whom would prefer to be seen in the familiar surroundings of their own homes.

Inova Health System, for example, is exploring the creation of a mixed-use facility space to continue to meet the inpatient demand in the market. They are leveraging DispatchHealth to drive operational efficiency to reduce observation stays and improve capacity management from within their emergency departments. Additionally, UCI Health is developing a new hospital campus and mitigating the $2 million construction cost per in-patient bed with a wider range of in-home options.

There is a litany of other statistics that enumerate the promise of in-home care: There are drastic reductions in patient readmissions, in the cost of hospital stays of patients who were rerouted home and, in perhaps the biggest surprise, there is significant improvement in the number of medical errors that occur during in-home care, driven in part by rapidly accelerating technology miniaturization and connectivity.

If it were only about cost and effectiveness, it wouldn't actually matter if many patients didn't prefer it. Sensitivity to care settings has been another growing trend among providers. It only makes sense then, that in that same cited survey, 70% of patients said a reduction in anxiety was one of the biggest positive effects of having medical professionals treat them at home.

Too often, proper care comes with tradeoffs. Not often enough do the right decisions for patients overlap with the most financially prudent paths for health systems and hospitals.

Mark Prather, MD, MBA is CEO and Co-Founder. DispatchHealth is the nation’s first comprehensive in-home medical care provider with services ranging from same-day, high-acuity care to a 30-day alternative to a hospital stay, all delivered straight to the patient’s door. Including mobile diagnostics, DispatchHealth is delivering care to patients in 57 markets across the country and growing.

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