The unexpected upside of the pandemic has been accelerated innovation and connectivity that changed our ways of interacting. The concept of providing hospital care at home, introduced more than 20 years ago, gained traction in response to the concern for widespread hospital overcrowding and an attempt to mitigate the risk of life-threatening infection. We’re seeing more evidence that hospital-at-home models optimize patient outcomes and reduce costs to health care organizations.
Management consulting firm McKinsey & Company estimates that up to $265 billion worth of care services for Medicare fee-for-service and Medicare Advantage beneficiaries could shift to the home by 2025.1 Using clinically appropriate and cost-effective methods, organizations could shift specific services for those patients without reducing care quality or access.
How Does Hospital at Home Work?
Hospital at home programs offer care at home for those meeting inpatient admission criteria, including nurse and physician home visits, around the clock access to a registered nurse via video communication, remote patient monitoring of biometrics, in home testing and acute treatment. Eligible patients are clinically, socially, environmentally and functionally stable enough to be cared for in their own homes.
According to the Centers for Medicare & Medicaid Services, “treatment for more than 60 different acute conditions, such as asthma, congestive heart failure, pneumonia, and chronic obstructive pulmonary disease (COPD) care, can be treated appropriately and safely in home settings with proper monitoring and treatment protocols.”2
What are the Benefits of Hospital at Home?
Investigators at Harvard-affiliated Brigham and Women’s Hospital found that home hospital care reduced costs by as much as 38%.3 Reduced lengths of stay, fewer clinical tests and consultations, and lower overhead costs contribute to the savings.
They also found that hospital-at-home models support quality and patient outcomes. Patients benefit from more physical activity at home compared with usual hospital care. They experience fewer falls and skin injuries, lower 30-day readmission rates and a lower risk of inpatient-induced delirium.4
A Conduit hospital-at-home model offers advantages to both patients and providers:
- Decreases potential ED holds
- Expands inpatient capacity for higher-acuity patients
- Lowers risk of patient harm, including hospital-acquired infections and mortality
- Reduces patient anxiety and stress
- Improves patient experience
Nursing Capacity: A Key Component of Acute Care at Home
Providing acute hospital care in patients’ homes requires a significant paradigm shift. It involves physician buy-in, skilled nurse staffing, telehealth technology, and systems for coordinating services, schedules and supply deliveries.
Developing a hospital-at-home program is complex. Staffing for virtual nursing care can be a significant obstacle. Acknowledged in 2012, the current nursing shortage is greater than ever before5 and is compounded by the aging of Baby Boomer patients as well as nurses. As of 2022, nurses who are 65 years of age or older comprise the largest age category in the profession and represented, up from 14.6% in 2017 and 4.4% in 2013.6
Fortunately, it’s not necessary for your organization to recruit and manage additional nurses to virtually support a hospital-at-home program. Conduit Health Partners can augment your staff with virtual skilled nursing services to relieve that burden. Consider that we:
- Hire only experienced acute care nurses vetted through a stringent hiring process
- Work with your existing technology and customize our program as needed to reduce your costs
- Provide the staffing levels you need to maintain a successful program and support care quality
- Collaborate with your team to educate patients and enable them to promote self-efficacy and wellness
As acute hospital care in the home expands, organizations can leverage its benefits for greater financial stability. With expanded bed capacity, hospitals can retain profitable patients to increase revenue while providing less costly care to those patients at home.
A successful program depends on reliably executing and coordinating all components. Your skilled nursing staff bandwidth will play a critical role, and partnering with Conduit can ensure that you meet your patients’ needs and maintain care quality.
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Sources:
1 From facility to home: How healthcare could shift by 2025. February 1, 2022.
2 CMS announces comprehensive strategy to enhance hospital capacity among COVID-19 surge. November 25, 2020.
3 Home hospital model reduces costs by 38%, study says. December 16, 2019.
4 Acute care delivery at home. April 2021.
5 Confronting the nursing shortage. August 2016.