Bringing healthcare “home”
In the 1950s and 1960s, the doctor’s housecall was a normal occurrence, and regular visits by doctors to patients’ homes to treat their illnesses and provide a personal level of care was considered quite normal. That practice obviously went away as more and more hospitals began to pop up and technology changed, but the idea of more healthcare being provided in the home has returned in recent years.
In fact, over the last decade, essentially since the Accountable Care Act became law in 2010, how the industry views home care has changed. Advanced reimbursement and payment models – as well as technology and an overall trend toward consumerism – have changed how both providers and health insurance companies view home care, and there’s been a shift toward creating value and affordability, improving quality, and creating a better patient experience.
Think for a second about all of the devices and services patients have access to today which allow them to receive healthcare and communicate their health status with their providers – blood pressure monitors, digital scales, peak flow meters, etc., as well as mobile integrated health platforms and complex care management programs, such as BCBSRI’s HouseCall by Blue program.
Of course, the notion of healthcare from home got quite a boost in 2020 due to the pandemic, when more patients – especially the senior population – were advised not to leave their homes for care. This accelerated an already growing trend toward telemedicine and other virtual primary care platforms as a viable alternative for basic medical treatment. Today’s available technology, coupled with patients’ desire to stay in their homes, has fueled a renewed trend toward home care. Home healthcare is one of the fastest growing segments of the U.S. healthcare industry, with revenues of roughly $97 billion.
There are some other factors helping to drive this trend. Perhaps most important as it pertains to a growing and aging “Baby Boomer”/senior population is meeting their preference to be healthy and receive healthcare in their home environment rather than in hospitals or other inpatient care facilities. By 2030, 18 percent of the U.S. population will be age 65 or older (compared to 13 percent now), and a 2018 AARP survey showed that 75 percent of adults age 50 and older prefer to stay in their homes as they age. So, the market for home healthcare will only continue to increase dramatically, presenting more opportunities for new technologies to emerge to create new, more cost-efficient solutions for home healthcare, all while providing excellent service to patients and helping to close gaps in care.
Cost is an integral factor as well, with unsustainable costs leading the industry to find alternative methods of care. For example, over 20 percent of Medicaid’s nearly $554 billion in total federal and state spending in 2015, or roughly $111 billion, was for long-term care services. In fact, long-term care services, including nursing homes, are Medicaid’s biggest single expense, and it is the nation’s primary payer for those services. Medicaid serves millions of Americans, including children, adults, and seniors who need long-term care services because of disabling conditions and chronic illnesses.
We also know that patients are at a higher risk of complications and readmission when discharged from a hospital to a nursing home or other long-term facility. Discharging to the home, with the appropriate level of home healthcare, can be a safer, more affordable option in many cases.
Obviously, this is just the tip of the iceberg when it comes to addressing healthcare in the home, but it hopefully gives us some perspective that our industry is indeed changing very rapidly. I look forward to exploring more about this important topic in future columns. As always, thank you for all you do to keep our members and all Rhode Islanders safe and healthy. Also, just a reminder that August 23-29 is Health Unit Coordinators Week, a time to recognize and thank those who coordinate this important healthcare function for all they do!