Image of caregiver showing tablet to homebound person on couch

While congressional Democrats continue to wrangle over the Biden administration’s Build Back Better plan, administrators at Pennsylvania’s Geisinger hope a legislative deal will help it to expand healthcare to rural residents.

Richard Martin, M.D.

“We really have put all of the pieces in place so that we can move care into people’s homes,” Geisinger Health System Medical Director Richard Martin, M.D., told McKnight’s Home Care Daily Pulse.

Geisinger operates nine hospitals, a health plan, two research centers, a medical school and a Program of All-Inclusive Care for the Elderly in northeastern Pennsylvania. The PACE program, known as Life Geisinger, allows roughly 400 dual eligible Medicare and Medicaid patients, who qualify for skilled nursing care, to remain in their homes. Martin said the program could accommodate even more patients if Congress increased funding for home-and-community-based services and relaxed eligibility rules for PACE.

“It’s our opinion that by the time (patients) become nursing home-eligible, they are pretty far down the slippery slope of aging and fragility and we can’t do a whole lot for them. If we could get them in our programs a bit earlier, we could do a lot more for them,” Martin said.

Geisinger has been actively moving care into the home after a review of its health plan claims a few years ago revealed many patients were using Geisinger’s hospitals for primary care.

“There were a couple thousand people that were members of our health plan that never had any outpatient claims,” Martin said. “Some had social issues; they didn’t have transportation. Others lived so far in a rural area, they just didn’t have any interest in going to a doctor’s office.

Geisinger at Home, which provides care to homebound patients with complex medical needs, is the cornerstone of the healthcare system’s in-home efforts.  Geisinger is also tapping technology to help other patients monitor their health with an app, connect to services through an online hub and visit virtually with physicians through telehealth. But those services are only useful if patients can access them. Unfortunately, many in rural Pennsylvania can’t.

“Some of the people we take care of just don’t have the resources to pay for the internet and in other areas we just don’t have internet service,” Martin explained.

Martin is hopeful the Biden administration will solve that problem Congress approves funding to build out the nation’s broadband infrastructure. That could help rural healthcare systems, such as Geisinger, stay better connected to patients and keep them healthy in their homes.

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