Susan Diamond runs what’s called Humana’s home solutions business and said coronavirus has accelerated countless medical innovations, including virtual doctor’s visits and now, the hospital-at-home model.
“In the absence of COVID, I think it probably would have taken three or more years to reach the level of interest and adoption that we're likely to see in 2021,” Diamond said.
She said as hospitals fill with coronavirus patients at a time of year when they are already busy treating people with other respiratory illnesses, there is more of an incentive to use the model than before.
“Oftentimes they had unused capacity in their brick and mortar,” Diamond said. “And so wasn't a lot of motivation to create additional capacity in a home-based setting that might divert patients from their facilities.”
Another incentive came in November when the Centers for Medicare and Medicaid Services announced it would issue a waiver and reimburse hospitals for hospital-at-home care. The move is particularly significant since policy decisions by federal insurers often pave the way for innovation by private insurers.
Hospital-at-home care isn't the right fit for intensive care, though.
The approach isn’t for everyone since most patients undergoing treatment at home need to have some ability to fend for themselves. It’s typically used for older people who have common chronic conditions. Experts say it wouldn’t work for a patient who needs intensive care level treatment or who might need to undergo surgery.
Advocates like Dr. Bruce Leff, a professor of medicine at Johns Hopkins University who advises Dispatch Health and another similar company, began to mull over the concept years ago when he was a resident offering primary care at the homes of elderly patients with chronic conditions. Problems would arise when those patients had more severe medical complications, whether it was a heart attack, heart failure or pneumonia
“And we would recommend, ‘Hey Mrs. Jones, Mr. Smith’, you should really go to the hospital for this,” Leff said. “And they would refuse to go.”
In particular, Leff remembered a house call to one older patient they’d been treating who had emphysema, heart disease, hypertension, arthritis and then later developed pneumonia.
“We said, ‘Hey, Walter, you really need to go to the hospital,’ and he kind of looked at us like we were a little bit crazy,” said Leff. “And he said ‘You know, I am so sick and tired of you geniuses from Hopkins. You’re great doctors but you run a crappy hotel and I'm not going to the hospital.’”
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December 10, 2020 at 06:01PM
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Another COVID-19 Effect: Hospital-At-Home Care Is Starting To Pick Up - Colorado Public Radio
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