Home health firms must invest in staff and establish reliable vendor relationships if they want to offer hospital-at-home services. That was the message Thursday during a webinar sponsored by the National Association for Home Care & Hospice.
“This is really blazing a trail that many have never really been done before,” noted Colleen Hole, vice president of integration at Atrium Health Medical Group, during the webinar.
Atrium Health Medical Group, a Charlotte, NC-based healthcare system, launched its hospital-at-home program a few years ago. Hole said nurses providing acute care at home had to learn how to work collaboratively with other medical professionals who are offsite and make those interactions appear seamless to the patient.
“Because most of the interfaces are virtual, we have to make it evident to the patient that we are a team and constantly communicating and managing up,” Hole explained.
Home health agencies launching hospital-at-home programs face different staffing challenges. Summer Napier, CEO of Healing Hands Healthcare, said her home health agency had to hire nurses who were willing to work longer hours and provide more intensive patient care.
“Sometimes when home health nurses feel uncomfortable with something, they’ll say, ‘Let’s go to the ER,’” Napier said. “We had to look for clinicians that could get in there, not panic, make all of the calls they needed, be resourceful and start an IV. These are things that aren’t historically a part of home health.”
A money-making model
Hospital-at-home is becoming an increasingly lucrative business for the home care industry. Last year, home care giant Amedisys acquired hospital-at-home provider Contessa for $250 million. Other home care firms are also weighing potential partnerships with hospitals or acquisitions in the space.
The model lets patients with acute illness, such as heart failure and COPD, receive hospital-level care in the comfort of their home. It frees up hospital beds for other patients and saves the healthcare system money.
Vendor relationships
For home health firms, staffing isn’t the only challenge with launching hospital-at-home. They must also establish relationships with a number of different vendors. Those vendors include pharmacies, remote patient monitoring companies, medical laboratories and durable equipment companies that can quickly respond 24/7.
Napier said establishing reliable vendor relationships requires significant vetting that is akin to trial and error.
“There were certain DME companies that would go 48 hours without responding to an oxygen request,” Napier said. “We finally found a vendor who could provide oxygen within 30 minutes.”
Although hospital-at-home could be a lucrative business for home health agencies, it could also be a gamble. The model expanded during the pandemic under the Centers for Medicare & Medicaid Services Hospital Without Walls waiver program. However, the waivers are set to expire at the end of the COVID-19 public health emergency and there are still no guarantees CMS or Congress will extend them further.
