Widespread access to hospital-at-home could be one answer to the workforce crisis, industry leaders said Friday during the World Hospital at Home Congress in Barcelona, Spain.
Medically Home co-founder and CEO Rami Karjian told the global gathering of clinicians 65% of costs for a hospital stay are associated with building infrastructure, with 35% going to patient care. Karjian said acute care at home can flip the mathematics of patient care and potentially attract more clinicians to healthcare.
“We can take those fixed costs and put them into more clinician time for a longer period of time [with patients],” Karjian explained. “Patients will heal much better than they would in a brick-and-mortar facility and the clinicians are going to feel so much better about it. We’ll talk less about [staff] burnout and we’ll talk less about massive nursing shortages in some countries like the U.S.”
The three-day conference drew clinicians from across the world to discuss technological and clinical innovations to advance hospital-at-home. In the United States, approximately 400 hospitals and hospital systems are currently participating in the Centers for Medicare & Medicaid Services’ Acute Hospital Care at Home waiver program, which allows some patients to receive acute-level care at home. Some home health firms are also getting in on the act. Two years ago, home health giant Amedisys bought hospital-at-home firm Contessa for $250 million.
Boston-based Medically Home partners with hospitals and provides turnkey hospital-at-home solutions, including technology, staff and a command center to direct acute-level care to patients in their homes. Rochester, MN-based Mayo Clinic is one of Medically Home’s partners.
Machael Maniaci, MD, who leads Mayo’s Center of Digital Health, told the audience that scaling hospital-at-home is key to the model’s success, and technology can help accomplish that. He explained how Mayo leveraged analytics to determine which patients were best suited for in-home care.
“It helps us choose faster,” Maniaci said. “Are they good for the program; are they not good for the program? We can then push them forward. That is important to scalability, which is important for any program to be successful.”
The future of hospital-at-home in the U.S. remains murky. The CMS waiver program is set to expire at the end of 2024 and there are no guarantees it will be extended. However, the program’s popularity with providers and payers could make it permanent. To that end, Karjian said hospital-at-home programs must attract more patients and convince payers that the quality of in-home care is the same, if not better, than hospital care.
“If we let people pay us less than the hospital, we are somehow saying the care is less than,” Karjian added.
