Revolutionizing Care for the Elderly and Chronically Ill: The Promise of Hospital-at-Home Models
As healthcare swiftly transforms, high acuity at-home care stands as a beacon of innovation and compassion. With decades’ experience in Part A intermittent home care and hospice within hospital systems, I recognize this model as nothing less than a revolution — one that is deeply personal and groundbreaking in its professional implications.
Treating patients at home isn’t a novel idea, but it’s taken on new life in today’s healthcare landscape. Although hospital at home programming has been around for more than 20 years, accelerated adoption has been buoyed by a CMS waiver during the pandemic.
The ‘Hospital-at-Home’ movement has quickly shifted from a novel concept to a robust, recognized healthcare model. Still, its full potential, particularly for our rapidly aging population and in managing common and costly health conditions, remains untapped.
In a recent comprehensive study spearheaded by DispatchHealth, we turned a critical eye on the healthcare landscape through the lens of 1,000 patients who opted for our Advanced Care program — a home-based high acuity alternative to hospital stays. With over 4,000 cumulative days of care monitored, our findings reveal a resounding endorsement of this model’s efficacy and potential.
The average participant in the study was 76 years old, managing an average of eight different health conditions simultaneously — a testament to the complexity of their healthcare needs. Despite this, the effectiveness of in-home care has been nothing short of luminous.
Our strategy has significantly outshone in-patient national benchmarks, slashing the expected 20% hospital readmission rate to just 9.3%. Whereas one in four Medicare beneficiaries hospitalized for acute medical illness is typically transferred to a skilled nursing facility, only .3% of our study’s patients required such care — this represents a monumental shift, not a slight uptick, in healthcare delivery, particularly for prevalent conditions seen in U.S. hospitals such as heart failure and pneumonia.
These illnesses, traditionally marked by high rates of hospital return, have seen a readmission rate cut in half under our in-home care model.
Moreover, the quality and safety benefits of in-home care are indisputable. According to the Centers for Disease Control and Prevention, on any given day, about one in 31 hospital patients has at least one healthcare-associated infection, leading to billions in medical costs annually.
Yet, within our patient cohort treated at home, not a single secondary infection was recorded. The implications of this finding alone could revolutionize infection control practices and substantially reduce healthcare expenditures, particularly for elderly patients who are more susceptible to infections because of their weaker immune systems.
The finding also illuminates the fiscal prudence of in-home care. According to published data, an acute care episode at home is 38 percent less expensive than its traditional hospital counterpart. This model not only reduces the use of laboratory and imaging studies but also minimizes the need for consultations, leading to estimated savings of $500,000 to $700,000 for our study’s 1,000-patient sample size.
Given that 74 percent of the patients had conditions that rank in the top 20 reasons for hospital stays, the potential for broader economic impact is immense.
This research is a call to action for a transformative approach to treating our elders, those with chronic illnesses, and post-surgical episodes, advocating for in-home care as a foundational element of future healthcare strategies.
It highlights a vision where patient experiences and quality of life take precedence while offering stakeholders the dual benefits of enhanced care and reduced costs. By pivoting from institutional settings to the comfort of home, we’re not just changing the venue of care; we’re reimagining healing and wellness at their core, setting a new standard for healthcare’s evolution.
Author Bio
Erin Denholm, MSN, RN, is a distinguished healthcare executive recognized for her transformative leadership in aligning clinical expertise with business strategy.
With over 35 years in healthcare, Erin currently serves as Chief Nursing Officer at DispatchHealth, spearheading innovative care coordination models focused on health equity, social determinants of health, and virtual care strategies.
She notably pioneered Colorado Medicaid’s reimbursement for telehealth visits and established foundational 24/7 virtual care nursing programs at Trinity Health. Erin is dedicated to infusing social determinants of health awareness into clinical strategies to improve patient outcomes and lives.
