Home health provider looks to scale hospital-at-home model

• Dispatch Health’s Advanced Care program, a hospital- at-home pilot, saved an average of $6,200 per individual by keeping people out of the hospital setting, according to a Home Health Care News article.
• In terms of quality, no one was readmitted within 30 days, died unexpectedly or experienced a serious safety event, according to the article.
• This capability positions Dispatch Health as an ideal partner to Medicare Advantage plans or PCPs in risk-sharing models with MA plans to reduce the total cost of care while maintaining high-quality outcomes.

Home Health Care News is reporting that Dispatch Health’s Advanced Care program — a hospital- at-home pilot, run by a home health provider in collaboration with a payer — saved an average of $6,200 per individual by keeping people out of the hospital setting.

The pilot was limited to 27 patients who received hospital-level services in their homes. In terms of quality, no one was readmitted within 30 days, died unexpectedly or experienced a serious safety event, according to the article.  And only 7% of the cases resulted in an ED visit.

Like other hospital-at-home models, the objective of the program is to provide hospital level care at home for common relatively low-acuity (compared to other inpatient admissions) conditions such as COPD, pneumonia and heart failure.

 “On average, patients within the program completed a high-acuity phase in 3.8 days and a transitional phase in 12.5 days with care from a team of nurses, advanced practice providers, therapists and physicians,” said the Home Health Care News article. DispatchHealth specializes in at-home urgent care. According to the article, “about two-thirds of its referrals are from within its own network, with one-third coming from primary care providers (PCPs) that are now familiar with the advanced care option for their patients.”

Takeaway

We’ve seen a number of acute care providers roll out hospital at home in the past year. It should come as no surprise that a home care provider that specializes in urgent care would launch a hospital-at-home pilot with one of its payers. This capability positions Dispatch Health as an ideal partner to Medicare Advantage plans (or PCPs in risk-sharing models with MA plans) to reduce the total cost of care while maintaining high-quality outcomes.

It wouldn’t be a surprise to see a large national MA plan, like Humana or UHC, that has care delivery assets stand up a similar program in the near future as the chart below, from a recent HFMA article maps out which types of organizations might stand up a hospital-at-home model.

Potential participants in a hospital-at-home payment model

Source:  HFMA

While the Center for Medicare & Medicaid Innovation has not yet launched a hospital-at-home model within fee-for-service, it may be on their to do list given several models have been recommended by the Physician Technical Payment Advisory Council. As this model of care delivery expands, along with the proposed sunsetting of the inpatient-only list, it will expand competition for conditions that previously had no substitute treatment for a hospitalization and put downward pressure on hospital admissions.