The American behavioral health system is irreparably broken and demands urgent action. People are struggling, and the wait time to get them help is backing up our healthcare systems, burning out our healthcare workers. In worst-case scenarios, it is causing widespread harm, as we have seen too often in mass shootings and other tragic acts stemming from untreated mental illnesses.
In many states, it’s impossible to access care at all because their Medicaid systems do not cover home health services for behavioral health or chronic care situations. Even in areas that have significant access to hospital-level services, there is still not enough access to aftercare for patients with behavioral illnesses who need it. For too long, it has simply not been a top priority. It is imperative for society, state Medicaid programs, and the federal government to do better.
Unfortunately, proposed solutions to the current crisis are often imprudent because they put too much focus on hospitals instead of communities. This approach does nothing to improve patient outcomes and often leads to overcrowding, with behavioral health patients stranded at hospitals because they simply have nowhere else to go.
Time to embrace a new behavioral healthcare model for this population
We can remedy this untenable situation by bringing behavioral healthcare services into the home for those with chronic conditions. These services exist, are available and scalable. The hospital should always be considered a failure point on the care continuum, not the destination. The home should be the hub — especially in those states and regions that are literal behavioral health deserts, devoid of any healthcare equity.
Home healthcare has seen consistent success treating these complex and behavioral health patients in the community, using technology as a platform for enhanced clinical decision making, and data to better understand social determinants and create optimal outcomes for patients. The cost savings are undeniable: industry data shows the average cost of each hospital stay for these patients is approximately 50% more expensive than a year’s worth of daily home healthcare services.
Proven success in Massachusetts and beyond
As a clinician for almost 30 years and the CEO of a behavioral home healthcare company for over two decades, I can tell you first-hand that without a system in place to support long-term behavioral health patients out of the hospital, people will not get the treatment they need, and this crisis will continue. In far too many cases they are taking up hospital beds they don’t necessarily need, or worse, they aren’t receiving effective care at all.
When we started our program in Massachusetts, the same problem existed (albeit on a smaller scale.) Today, our model provides in-home behavioral care to complex patients and currently conducts over a million patient visits annually. An example of the typical patient we service is a 55-year-old male identifying and suffering from a severe mental illness like schizophrenia and who on average suffers from up to 20 comorbidities or complications. In addition, they are among the highest-cost patients in the healthcare system – taking up to 10-15 medications and often living in communities with less access to care.
Our success in Massachusetts has led us to expand our services into Colorado. Since multiple studies have shown home healthcare reduces readmissions to hospitals, we project that behavioral home healthcare can help save states up to $200,000 a year per patient, improve patient outcomes, and take pressure off the healthcare sector.
Collaboration and data sharing will pave the way for a brighter future
Looking ahead, home healthcare providers stand poised and ready to provide relief to the overburdened healthcare system as an integral part of the care continuum. We are well positioned to scale up by partnering with accountable care organizations (ACOs) that are already stretched too thin to adequately care for behavioral health patients.
By working with ACOs, home healthcare providers could compile data from a patient’s relevant clinical stakeholders – psychiatrist, primary care physician, diabetic specialist, cardiac specialist, etc. — and build predictive models to find out what caused a patient’s situation — implementing an aftercare plan that keeps them out of the emergency room.
A collaborative approach with the home as the hub not only makes sense from a human perspective, but also a financial one. Home healthcare agencies are already providing incredible service and value to the entire healthcare ecosystem, and we stand ready to take a more central role to help create better lives for our patients.
Joseph P. McDonough is the CEO of Innovive Health, a behavioral home healthcare company.
