As home hospitals gain momentum, healthcare systems are increasingly turning to outside companies for help running programs.
The home-hospital model, in which patients receive scheduled acute care at home, has existed for decades, but the COVID-19 pandemic has created a rapid wave of investment and use. increasing use as inpatient beds become scarce. Healthcare research firm Chilmark released a report earlier this month predicting home hospitals will grow into a $300 billion industry by 2028, with most of the growth. that is driven by third-party companies that provide turnkey services.
“It’s a complicated process to get up and on,” said Dr Robert Moskowitz, medical director of home care company Contessa Health. “For those who haven’t tried it, I think they look at all the gears on the wheel that need to be in place and it can get completely overwhelming.”
According to the Centers for Medicare and Medicaid Services, 283 hospitals across 37 states have been approved for home hospital plans.
Providers say home care can control readmissions, ease capacity constraints and save money for patients and hospitals. A study published earlier this year in the Annals of Family Medicine found that readmission and return to the emergency department for patients hospitalized at home were not significantly different from those receiving care. care in a traditional hospital. Research shows that home-hospitalization is associated with a shorter inpatient stay.
By enlisting the help of outside companies, providers see an opportunity to effectively reach more patients and tap into new resources, while saving some upfront costs. to develop their own programs.
Charlotte, North Carolina-based Atrium Health, part of the larger Advocate Health, launched a home hospital program in less than two weeks in early 2020 as COVID-19 was spreading. A $27 billion system today, most of Atrium’s services are run internally, but it recently turned to Best Buy’s Current Health for additional support as it expands its program.
With that partnership, Atrium will have access to Best Buy Geek Squad employees to provide and help set up remote monitoring equipment in patients’ homes.
“People who have started home hospital and chronic disease management programs [in-house]”They’re all calling us,” said Deborah DiSanzo, president of Best Buy Health, which acquired the existing Health platform in 2021. [in-house] because they have to. … Who ran those programs? It’s the doctor and the nurse. [But] you know doctors and nurses are overwhelmed with work.”
Colleen Hole, home hospital manager at Atrium, says the goal is to reach 50 patients a day by the end of the year, compared with more than 20 patients now. Since its launch, Atrium’s program has served more than 7,000 patients with more than 150 medical conditions, including congestive heart failure, pneumonia, and chronic obstructive pulmonary disease.
Atrium is also looking to work together to support home X-rays and ultrasounds, she said.
“We often hear, ‘We don’t have enough acute care beds [in hospitals],’ … and with the population aging, our acute care needs will increase exponentially,” Hole said. “I think we have enough beds. They’re just in people’s homes.”
Worcester, Massachusetts-based UMass Memorial Health has partnered with Current Health for remote monitoring, VNA Care for physical and occupational therapy, and Trident for home ultrasounds and X-rays.
Dr Taki Michaelidis, medical director of the system’s home hospital program, said one of the system’s biggest challenges was making sure personal care assistants were quickly available to patients. Home health authorities are used to responding to requests for several days for less acute patients, he said.
UMass Memorial, which kicked off its program in 2021, is working with local agencies to keep response times in the one-hour range. The nonprofit system wants to find more partners to help with logistics throughout the central Massachusetts area.
“If you leave our medical center, you can be in a metropolitan city in 5 minutes, you can be in suburban areas in 10 minutes, and you can be in farmland in 15 minutes. , so it’s a very, very diverse area in our part of the state,” Michaelidis said.
Ania Wajnberg, professor of geriatrics and palliative medicine at the Icahn School of Medicine at Mount Sinai, New York, said running a home hospital means battling decades of centralization in care. acute and Mount Sinai seek out suppliers who are not afraid of standard deviation. The system launched a home hospital in 2017 through a joint venture with Contessa and in 2020 also began a partnership with Current Health.
Mount Sinai is open to additional partnerships and vets potential vendors based on timeliness, reliability and communication, in addition to scalability, she said.
“We were really trying to figure out who were the most innovative providers, who were really willing to work on something that is changing the healthcare industry,” says Wajnberg.
