A group of healthcare organizations announced this week the launch of the Advanced Care at Home Coalition, an advocacy effort aimed at creating a pathway toward safeguarding access to hospital-level services.
Founded by the Mayo Clinic, Kaiser Permanente and hospital-at-home vendor Medically Home, the coalition says it hopes to work with Congress to ensure continuity of care beyond the COVID-19 public health emergency.
“The advanced care at home model has been the apple of our eye for the past two to three years,” said Dr. Stephen Parodi, executive vice president of the Permanente Federation, part of Kaiser Permanente, in an interview with Healthcare IT News.
Because of the public health emergency and its attendant regulatory flexibilities, Parodi explained, “we’ve been able to jump-start and provide services in the home that include remote patient monitoring.”
Those services allow a select group of patients to receive hospital-level care from their own homes, through the use of connected monitoring devices and mobile tools such as iPads.
“The pandemic helped accelerate things,” added Dr. Michael Maniaci, physician leader for advanced care at home at Mayo Clinic. “The pandemic winding down is great from a public health standpoint, but we know Congress doesn’t want to just open the floodgates” with no virtual care regulations.
The coalition’s perspective, he said, is that regulators should “put guardrails on, but let us continue the good work.” Key to moving forward will be a delivery model through the Centers for Medicare and Medicaid Services Innovation Center that will enable testing and implementation of a long-term advanced care at home framework.
However, given the time launching a center could take, the coalition plans to urge Congress to extend PHE flexibilities and bridge the gap. Following in the footsteps of other coalitions such as Moving Health Home, It plans to build momentum via educating policymakers about advanced home care’s importance and benefits, protecting the current flexibilities and expanding on them through the creation of the aforementioned center.
So far, coalition partners include Adventist Health, ChristianaCare, Geisinger Health, Integris, Johns Hopkins Medicine, Michigan Medicine at the University of Michigan, Novant Health, ProMedica, Sharp Rees-Stealy Medical Group, UNC Health and UnityPoint Health.
Parodi noted that policymakers often want to be shown the data, as if to say: “Show me this improves care. Show me that it’s more cost-neutral than current models.”
But Maniaci said it’s a bit of a chicken-and-egg situation: The data can’t exist without patients enrolled in the programs. That said, some information is emerging from pilot programs, including the partnership between Mayo and Medically Home announced this past year.
At Mayo, said Maniaci, readmission rates for advanced home-care patients are 65% lower, with equivalent if not lower rates of infections and falls.
Parodi also flagged the patient satisfaction component: “We’re consistently running at 4.95 out of 5,” he said. Part of the reason for that involves provider responsiveness. “We’re able to measure it more readily. We can tell someone has answered that person’s virtual call. We can tell how fast we dispatch someone and when they arrive in the home,” he said.
Patients also have much more agency over their days, rather than waiting in a bed for providers to come to them.
From a social determinants of health standpoint, too, the advanced home-care model allows providers to get a new perspective on food security and medication adherence.
“These are the things that are somewhat intangible,” Parodi said. “We’re going to need to have a few different ways of measuring this.”
Through the work of the coalition, the organizations hope to develop common solutions for implementing a hospital-at-home model at scale, such as common definitions to hold themselves – and the rest of the industry – to the same standards.
“There’s no vanity here. We want to help everyone,” said Maniaci. “We just need our handcuffs taken off to show it’s an important model of care.”
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