Travis Messina, CEO, Contessa
Travis Messina, Contessa

The expansion of the hospital-at-home segment is just beginning, said Travis Messina, CEO and founder of Contessa, a leading hospital-at-home firm.

“If everyone that is a part of the hospital-at-home or high-acuity-care-in-the-home industry were honest with themselves, they’d say this is truly the top of the first inning,” said Messina in a podcast with Home Care Daily Pulse at the Home Care 100 conference in Scottsdale, AZ, earlier this month.

The decision by the Centers for Medicare & Medicaid Services to reimburse for hospital-at-home during the pandemic helped to drive adoption of hospital-at-home services. So far, about 200 hospitals have signed up for it and less than 2,000 patients have been treated, he said. “So it’s very, very early days,” he said.

Contessa, which also provides skilled nursing facility (SNF)-at-home and palliative care-at-home services, was the first company to secure reimbursement from national payers for hospital-at-home, Messina noted. Having more insurance companies offer hospital-at-home will change the dynamic, he said.

“Having more health systems sign up for it, having more health insurance companies sign up for it will lead physicians to be more comfortable referring patients to this and generate pretty explosive growth for the industry,” he said.

Paul Kusserow, CEO of Amedisys, which purchased Contessa last summer, said in a podcast with McKnight’s Home Care Daily Pulse that “everyone wins” with the hospital-at-home model. Hospitals like it because they share in the profits; health insurance companies are keen on it because hospital-at-home companies do it at a discount; and patients prefer it because they can stay at home, he said.

“Payers save money, hospitals make money where they normally lose it. Patients are much happier, and the outcomes are better,” he said.

SNF-at-home potential

Another potentially major market disruptor is SNF-at-home, which Messina projects will be even bigger than hospital-at-home. Because of the staffing problems facing SNFs, as well as their stringent COVID-19 protocols, patients are staying in hospital beds for “unnecessarily long lengths of stay,” Messina said.

“I actually think that skilled nursing facility at home may grow at a faster pace than traditional hospital at home, the reason being the challenges that are plaguing the SNF industry currently,” he said.