After as soon as occupying a distinct segment area in the well being care sector, the hospital-at-home mannequin has gained vital traction.
In November, the U.S. Centers for Medicare & Medicaid Services (CMS) even introduced its “Acute Hospital Care At Home” wavier program. Under the initiative, eligible hospitals can obtain newfound flexibilities round offering hospital-level take care of sufferers of their properties.
As of March 3, there have been 109 hospitals in 29 states with the CMS waiver. While the program was an effort to extend hospital capability amid the COVID-19 emergency, hospital-at-home gamers have been working behind the scenes to push the mannequin ahead for years.
One of the corporations at the middle of this regulatory and cultural shift is Contessa. The Nashville, Tennessee-based firm helps well being techniques present hospital-level care in the dwelling via its Home Recovery Care mannequin.
To study extra about Contessa and the place it suits into the hospital-at-home takeoff, Home Health Care News just lately linked with Mark Montoney, Contessa’s senior medical advisor, for our newest episode of “Disrupt.” Highlights from the dialog are under, edited for size and readability.
HHCN: To begin, are you able to give our listeners some background on Contessa and the place the mannequin is, at present?
Montoney: Contessa launched in 2015. Our Home Recovery Care mannequin actually brings all the important parts of hospital-level care into the affected person’s dwelling. Home Recovery Care is a turn-key resolution that allows a brand new normal of take care of progressive supplier companions and payers.
Patients are handled for his or her in-patient eligible situations in the consolation of their dwelling, bypassing what would in any other case be an in-patient hospital keep. Our care mannequin has a median affected person satisfaction rating of over 90%. We’ve been capable of cut back the common size of keep by 35% and cut back readmissions by upwards of 44%.
As I mentioned, we launched six years in the past. We’ve partnered now with seven well being techniques to create joint ventures that function Home Recovery Care. There’s Mount Sinai Health System in New York City and the Marshfield Clinic Health System in Wisconsin. More just lately, there’s Gundersen Health System, which can also be in Wisconsin. We work with Ascension Saint Thomas in Tennessee, Prisma Health in South Carolina, Allegheny Health Network in Pennsylvania and Dignity Health, which is a component of the CommonSpirit Health System out in Arizona.
We’re slated to launch a number of extra markets in 2021, however we worth all these partnerships and have been capable of advance our Home Recovery Care mannequin in every one of these areas.
In phrases of the Home Recovery Care mannequin, how is Contessa’s mannequin like different hospital-at-home ideas? And what is likely to be a differentiator? What is the scientific method?
Our scientific method is, we carry all of the mandatory assets to bear, in phrases of working a hospital-at-home program. We arrange the scientific assets, using native suppliers and incorporating them into the mannequin to offer hands-on scientific care. We carry all of the scientific protocols, the order units. We arrange all of the ancillary community that’s mandatory for bringing acute-level care providers into the dwelling for sufferers, comparable to infusion providers, DME and some other extra providers that is likely to be mandatory.
We even have a system referred to as “Care Convergence,” which is proprietary, that permits us to trace sufferers via an episode of care. It basically gives the capability to handle all the logistics, that are fairly vital if you’re offering acute providers in a affected person’s dwelling. All these logistics are tracked via that system.
Finally, we even have a digital care unit that features nurses, social employees and different administrative assist workers who truly present digital assist for the on-the-ground scientific assets which can be offering direct affected person care.
You talked about your well being system companions. How do these relationships often come about?
We set up a three way partnership partnership with the well being techniques, whether or not they’ve made an inquiry to us, or perhaps we’ve been linked to them and there’s an curiosity in exploring the mannequin. Typically, it begins from introductions, to all the means via an implementation part, to establishing a program in a specific market.
What now we have discovered over these previous a number of years is the curiosity in hospital-at-home continues to speed up. There continues to be a big curiosity amongst well being techniques to pursue this kind of mannequin and be capable to provide it as a service to the sufferers they serve of their neighborhood.
Over the final yr, as you simply talked about, curiosity has ticked up. How has the CMS Acute Hospital Care At Home initiative modified issues for Contessa? How do you assume it’s going to change issues for hospital-at-home applications, typically, transferring ahead?
Let me offer you a bit bit of background on that.
Back in March, after we began seeing the first COVID surge, CMS introduced a “Hospital Without Walls” waiver. It truly provided comparatively broad regulatory flexibility for hospitals offering care exterior of its 4 partitions.
Then in November, they moved it a bit additional by offering eligible hospitals with regulatory flexibility to deal with eligible sufferers of their properties. At that time, it actually began to open up the alternative for Medicare fee-for-service beneficiaries to be eligible for hospital-at-home providers.
In truth, our associate in New York, Mount Sinai, had labored carefully with CMS in phrases of the growth round some of these regulatory modifications. They have been one of the first techniques in the nation to be authorized for the mannequin. Since then, our different extra 5 markets … have additionally been authorized by CMS to simply accept the Medicare fee-for-service sufferers into their applications.
In phrases of that partnership with Mount Sinai, I do know just lately they’ve doubled down on their partnership with Contessa to launch a extra expansive palliative care program. Can you clarify the function behind that?
This is part of our technique to repeatedly develop our service traces. This is an space specifically of nice want throughout affected person populations.
Of course, the Mount Sinai Health System has run a nationally acknowledged palliative care service for a quantity of years. Partnering with them on this area permits the alternative to carry palliative care in the affected person’s dwelling. Essentially, it’s bringing coordinated and specialised care into the properties of these chronically unwell sufferers, serving to them oftentimes to keep away from pointless hospitalizations.
We couldn’t have a greater associate to launch this extra program with.
Why do you assume palliative care has solely just lately turn into extra well-liked? It looks like one thing that suppliers are rather more desirous about today.
Even although you’re proper, it’s been round for some time, I don’t assume it was at all times understood in addition to it maybe could possibly be, or ought to have been. It generally will get confused with hospice care. Hospice care is, of course, an outlined profit acceptable for sufferers which can be usually decided to be in the final six months of their life.
Palliative care is bringing supportive providers and symptom administration to sufferers who’ve a persistent illness. They’re nonetheless receiving all acceptable administration for his or her persistent situations which means, there’s no discount in phrases of remedy that sufferers are receiving. It’s actually assembly the wants of sufferers holistically. I feel culturally it’s taken some time to turn into extra accepted and mainstream, however we undoubtedly have seen that in the previous a number of years.
Interview performed by Andrew Donlan