Home hospital pioneers often rely on partnerships with providers and insurers to overcome challenges with technology and reimbursement.
The Mayo Clinic Home Advanced Care program based in Rochester, Minnesota, began in January 2020, in partnership with Medically Home. In 2021, the Mayo Clinic, along with Oakland, California-based Kaiser Permanente, invested $100 million in the company.
As part of all its partnerships with health systems, Medically Home helps identify the right doctors and nurses to participate in the model; install devices such as blood pressure cuffs, scales, and Bluetooth-enabled stethoscopes in the patient’s home; establish performance dashboards and clinical outcomes; and ensure data is sent to the patient’s electronic health record. The entire program implementation process can take up to six months.
“First, we figure out what we need to get the right data, then our partners,” said Dr. Michael Maniaci, medical director of the Mayo Advanced Home Care program. I am Medically Home out and they are looking for suppliers of these devices.
The bedside tablet acts as a hub, displaying the patient’s daily schedule, providing information about their condition and allowing them to take pictures of their physical symptoms and communicate via video with the nurse and doctor. Tablet data feeds to a central command center that health systems use to coordinate virtual visits and dispatch in-person clinicians to patients’ homes twice a day to perform Treatment is like injection.
Over the past two years, the program has served nearly 3,500 hospital inpatients who received approximately 7,500 days’ worth of in-home services. About 85% of patients are Medicare or Medicaid beneficiaries who are cared for by the current CMS waiver. For people with commercial insurance, health system payer relations teams try to work out agreements to pay for their treatment, building personal relationships with companies. coverage on a state-by-state basis, Maniaci said.
The health system says 30-day readmission rates for home hospital care are lower than rates at traditional settings, although it doesn’t provide specific numbers. . It also declined to say how much money went into the program. But Maniaci says the investment has proven worth it so far, with quality metrics on patient safety and mortality equal to or better than those in hospital settings. . He said more than 90% of Home Advanced Care patients said they were satisfied with their care experience.
In the long term, Maniaci said Mayo hopes to save 10% to 15% in costs when rolling out the program at scale.
“You have to take good care of 25 to 30 patients as an average daily investigation to at least break even or make this affordable,” he says. “But for now, we really want to push the model of care and show that it works and that’s a better way of taking care of people.”
Leaders in the medical community are working together with government officials and helping draft rules for quality and safety standards in hospital home care, Maniaci said. .
“We, along with other people we work with, have learned a lot,” he said. “We have a coalition of many academic institutions where we sit down and just talk.”
Some systems use simulation to attempt to pre-empt any issues related to device setup, connectivity, clinician response times, and quality of care. Wilmington, Delaware-based ChristianaCare requires hospital nurses, advanced practice clinicians, and digital professionals to undergo three weeks of training.
“If any part of that simulation fails, we start over,” said Patty Resnik, executive vice president of the ChristianaCare Center for Virtual Health. “This is very intensive work.”
The health system launched the Home Hospital Care program by the end of 2021, also in cooperation with Medically Home. Most of the 200 patients treated so far are Medicare beneficiaries suffering from illnesses such as COVID-19, chronic obstructive pulmonary disease, heart failure, sepsis and cellulitis.
