Health Systems, Care Delivery Groups, Amazon Launch Hospital-at-home Initiative

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With Moving Health Home, Amazon Care, Ascension, Intermountain, Landmark Health and others say they want to “change the way policymakers think about the home as a site of clinical service.”

A new advocacy group called Moving Health Home launched on Wednesday, bringing together some heavy hitters – major health systems, care delivery services and technology vendors – who say they want to effect a shift in thinking about treating patients at home, and want to adjust reimbursement models accordingly.

Founding members of this coalition include Amazon Care, Ascension, Dispatch Health, Elara Caring, Intermountain Healthcare, Home Instead, Landmark Health and Signify Health.

Together, these organizations want to “fundamentally change the way policymakers think about the home as a site of clinical service,” they said in announcing Moving Health Home.
They noted that the upsurge in virtual adoption over the past year has shown not only that Americans have an appetite for at-home care, but that the data has borne out its feasibility, safety and efficacy.

Telehealth, remote patient monitoring, ...
... digital therapeutics, provider home visits and sharable medical records have “shown that care in the home can be at least equivalent to, if not better than, care offered in facilities.”

Now, they said, it’s time to “change reimbursement models and the culture around institutional care to allow for Americans to choose their home as a site of care.”

Among the group’s policy priorities:

Expand the services covered in a home-based setting.
Retain important “Hospital without Walls” site of care flexibility to support home-based hospital services.
Ensure equal access for seniors through fair reimbursement for home-based evaluation and monitoring codes.
Advocate for a bundled-payment model for extended care in the home.
Encourage greater flexibility for home-based care services to meet commercial and Medicare Advantage network adequacy standards.
Moving Health Home members point to an array of statistics they say bolster their case for more technology-enabled virtual care. They point, for instance, to an AARP survey that saw three in four adults 50 years and older preferring to age in their homes and communities.
Beyond that, the quality and cost improvements are apparent, they said, noting CMS estimates that show home health care in Medicare saves at least $378 million a year in just the nine states that are part of the Home Health Value Based Purchasing.

They also point to research showing home-based care to reduce likelihood of hospital readmissions. Patients using home-based care services within 14 days of discharge from hospital are about 25% more likely to avoid readmission within 30 days of discharge.

Many healthcare leaders have seen the trend moving in this direction for some time.

Mayo Clinic Platform president Dr. John Halamka, for instance, has said he foresees a future of “virtualist centers in what were formerly known as hospitals. It’s going to be the emergency department for heart attacks or strokes, [and] an ICU tower right next door, which will take care of the sickest of the sick that can’t possibly have home health care.

“They’re going to need a level of intensity that could never be moved out of such a place. But other than that? All the ambulatory care stuff, and all the simple stuff? It all gets moved into the home.”

On the policy front, the Centers for Medicare and Medicaid Services launched its Acute Hospital Care at Home program this past November. Building off its Hospital Without Walls initiative, it’s offering new flexibilities around telehealth and remote patient monitoring as the country enters “a new level of crisis response” during the autumn COVID-19 surge, said then CMS Administrator Seema Verma at the time.

Changes in policy like that have helped spur innovation on the provider side, too. Early this year we reported on Brigham and Women’s Hospital in Boston, which has been working with Biofourmis to co-develop a suite of home hospital technologies.

“Over 17% of Medicare beneficiaries are living with six or more chronic conditions,” said Nick Loporcaro, CEO of Landmark Health, in a statement. “In-home, patient-centered care is critical to managing the complex health needs of our nation’s older adults. We need a public policy agenda that ensures access to innovative in-home care.”

“We are pleased to join the other founding members of the Moving Health Home Coalition to advocate for the expanded use of the home environment as a venue for robust patient care,” added Elara Caring CEO Scott Powers, noting that the “current state of technology, care coordination, and caregiver capability is aligned to permit patients to choose treatment in their homes.”