As care continues to move into the home, traditional Medicare-approved services like skilled nursing and home health care are no longer enough. Dina CEO Ashish V. Shah (below) says services like meal delivery, transportation, remote monitoring, in-home care, and pest control are a few examples of the health benefits of the future. Read what else he says about activating a pragmatic care-at-home program.
In the next five to 10 years, every home will need to be configured to operate as a formalized care setting (e.g., primary care clinic or hospital), and providers — especially those who are part of value-based contracts — need to be ready to deliver care in this setting.
Challenge: Around-the-Clock Care
A major challenge is replicating acute-level care in the home environment: delivering around-the-clock nursing care, continuously monitoring vital signs, supporting nutrition and social well-being needs, and providing just-in-time testing and imaging when needed.
There are other big considerations as well. How do you ensure the home is safe and ready for care? After discharge, what types of modifications are required to help people age in place moving forward?
In some cases, payment is no longer an obstacle. Medicare Advantage has expanded access to supplemental benefits. New service offerings like hospital-at-home, SNF-at-home, chronic condition management-at-home, and emerging value-based care programs unlock reimbursement for transportation, nutrition, and other non-medical home-based services.
Two Trends Collide
Hospital-at-home models aren’t new; what is new is the collision of two trends. First, the Silver Tsunami has arrived. There is a large and growing number of Medicare beneficiaries, and they prefer to age at home.
Second, Covid-19 created regulatory pressure and pushed the market to move faster. Prior to the pandemic, there were no hospital-at-home waivers. There was movement around in-home services and Medicare Advantage supplemental benefits, and that has now accelerated. We saw some progress on chronic condition management and remote patient monitoring, and that’s also taking off now.
Care at home has also grabbed the attention of our lawmakers. The Choose Home Care Act of 2021 is a new bill that was introduced to support in-home care alternatives to skilled nursing facilities. If enacted, it would enable some Medicare patients to get extended care services for 30 days following a hospital stay as an add-on to the existing Medicare home health benefit.
6 Steps to Prepare For Post-Acute 2.0
How do you activate a care-at-home program? Here are 6 steps to navigate the transition:
Step 1. Think beyond traditional post-acute care that centers largely around skilled nursing facilities and inpatient rehabilitation facilities. Instead, evaluate community and home-based partners in your markets to build an organization of providers that share your values and can support at-home models.
Step 2. Determine how to evaluate courier services and other new types of partners that may not be licensed or rated by Medicare. This requires assessing their full suite of capabilities, service areas, capacity, and turnaround time. Working with forward-thinking technology organizations that can engage with you in a digital manner will be critical.
Step 3. Identify which patient populations will be managed at home and who is responsible for monitoring them. Also, consider how to evaluate the patient’s home for safety and the ability to receive care at home. Medicare, CMS, and AARP offer guidelines for evaluating the home environment.
Step 4. Activate a logistics or coordination infrastructure so you can interact with one, or many, home-based partners in a care setting that you no longer control but must have a presence around the clock.
Step 5. Plug into smart devices and connect with all types of providers (not just doctors) who can electronically engage patients for an evaluation or to answer questions.
Step 6. Consider using predictive modeling to “manage by exception” and identify higher-risk patients in real-time to determine who may require an in-person intervention.
Market Demands Change
The time is right for a change. We have consumer demand, unique market needs, care that is being decentralized in a massive way, and new regulation and payment models all coming together. We’ve seen people of all ages say they are comfortable receiving care in the home. Now is the time to start your pragmatic journey to home-based care.
Find the complete story at Forbes.
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