Analysis: Jumping on the ‘hospital-at-home’ bandwagon

To remain competitive, provider organizations should consider taking steps toward offering acute-care-at-home services.

Acute-care-at-home delivery services emerged out of necessity during the COVID-19 pandemic, when inpatient hospital beds were at capacity. These services proved to be both cost-effective and popular with patients. Continued patient demand likely will drive expansion of these services.

Advancing technologies - telemedicine, cloud computing, voice recognition, artificial intelligence, remote patient monitoring and more – can help enable safe and reliable acute-care services to be delivered in the home. This emerging market opportunity is driving new vendor solutions and is enticing larger technology companies to develop solutions and services.

Healthcare is entering a new era of service capabilities supported by emerging technologies and high levels of connected communications that will force providers to re-engineer care delivery.

A necessary move

During the pandemic, so-called “hospital-at-home” services provided infection protection for both the patients and the providers while enabling providers' services to be more widely distributed. The new acute-care-at-home delivery models improved the elasticity of the provider organization for delivering services; they were also met with high levels of patient satisfaction.

A key challenge for many provider organizations in adopting higher levels of services for acute-care at home is their current portfolio of fixed assets, including hospitals, clinics and skilled nursing centers. This raises a number of questions:

  • How will CFOs minimize their financial expense risk that has been established over several years of acquisitions and mergers?
  • Can clinics be converted into telemedicine/telehealth service centers?
  • Can current hospital floors/wards be converted into outpatient same-day service environments?

Some providers are now adding "access" fees to patient service bills for using clinic/outpatient facilities or telehealth services. This approach won’t succeed because patients won’t accept this egregious practice and will demand that state legislatures ban it.

A new advocacy group

Last year, some healthcare provider organizations and a technology vendor created an advocacy group that aims to extend and expand federal hospital-at-home waivers that enable reimbursement for Medicare patients and create an advanced care at-home delivery model at the Center for Medicare & Medicaid Innovation.

Founded by Mayo Clinic, Kaiser Permanente and Medically Home Group, a hospital-at-home technology company, the Advanced Care at Home Coalition has 11 other members. It’s advocating the creation of an advanced care-at-home delivery model. The coalition hopes to use a combination of advocacy, education and data collection/sharing to win regulatory approval to extend and expand the existing acute-care-at-home Medicare waivers to help drive higher utilization of this care delivery model.

Mayo and Kaiser Permanente have invested in Medically Home Group, whose platform they use to support and manage their hospital-at-home care delivery services.

A key success factor for any hospital-at-home care platform will be the ability to effectively integrate with electronic health records, patient portals and remote patient monitoring environments.

A competitive issue

Healthcare provider organizations that fail to integrate hospital-at-home services into their offerings could find it challenging to remain viable in competitive markets.

Technology companies such as AmazonGoogle, and Microsoft are adding hospital-at-home solutions and partnering with clinicians to offer services. But they’ll also need to establish relationships with hospitals that can treat patients who become sicker and need a higher level of services.

Keep an eye on whether more healthcare providers and technology vendors join the Advanced Care at Home Coalition – or other major tech vendors launch their own initiatives.

In addition to Medically Home Group, other players in the acute-care-at-home market include Trapollo, which offers a cloud-based remote patient monitoring solution; Current Health, which offers a care-at-home platform; and DispatchHealth, which provides urgent care to patients in their homes.

Action items

In light of the nascent “hospital-at-home” movement, healthcare provider organizations should take three steps:

  1. Assess remote care services rendered during the pandemic to identify successful and failed ventures;
  2. Determine what clinical systems can be used or extended for use to support acute-care-at-home services;
  3. Identify additional care support systems that are needed, and review the ability of these systems to integrate with EHR, population health and patient portal environments using FHIR (Fast Healthcare Interoperability Resources) APIs.

Read the original blogpost from KLAS Research

Mike Davis is an analyst for KLAS Research

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