stethoscope and cash

Home is the future for high-acuity care and the government won’t be driving the trend; payers will. That is the motivation behind Maribel Health, a two-year-old Hanover, NH-based firm that partners with health systems to design, build and operate home-based high-acuity care services, such as hospital-at-home.

Adam Groff, MD

“Payers are going to look for ways to deliver care as good or better than [hospitals] for lower cost while also having capacity constraints,” Adam Groff, MD, Maribel Health co-founder told McKnight’s Home Care Daily Pulse. “With technology and services around payment models, it’s inevitable that care will get pushed to the home and community. We really see ourselves as that early phase of trying to make it happen.”

Maribel got off to a promising start last week with the announcement of $25 million in series A funding led by venture capital firm General Catalyst. It also announced collaborations with Bayada Home Health Care and Mercy Hospital in St. Louis. The collaborations will help Maribel design not only a hospital-at-home model of care, but models that deliver community-based palliative care, mobile integrated health and longitudinal health to patients at home. 

Bayada CEO David Baiada told McKnight’s Home Care Daily Pulse that partnering with Maribel and Mercy was a natural next step for a company that has brought a variety of services — from private duty nursing, to hospice to behavioral health to patients — into homes.

David Baiada

“Our model over 50 years is to develop high-quality, great teams and then deliver a high quality, consistent and reliable service everywhere,” Baiada said. 

Hospital-at-home expanded during the COVID-19 pandemic through the Centers for Medicare & Medicaid Services Acute Care at Home waiver program. Nearly 400 hospital systems and hospitals are participating in the program. However, the Medicare waiver program is set to expire at the end of 2024, with no guarantees that CMS will approve a long-term program offering greater flexibility of care in the home.

But, Groff, a co-founder of several medical firms and chief medical officer of Bayada, said private payers, such as Medicare Advantage plans, hold the key. He said in an effort to lower overall healthcare costs, they will aggressively push to move more care to the home.

“The key is matching the payment model to the clinical model so that you can provide value,” Groff explained. “That value could be improving capacity and throughput for hospitals, it could be the workforce supply constraints that home health operators have or it could be longitudinal complex care to keep people out of hospitals and EDs under risk.”

While CMS originally viewed hospital-at-home as a short-term solution to hospital overcrowding during the COVID-19 pandemic, Groff and Baiada see it as a long-term solution to a healthcare system that will become even more taxed as the population ages.