There are indications that ‘home’ already is the new hospital. Consider this:
1. Stories in the news recently about Mayo Clinic and other hospital systems have brought attention to the use of remote patient monitoring to provide care at home for some COVID-19 patients who otherwise would have to be hospitalized. For patients who test positive for COVID-19, home-based monitoring for symptom escalation can help reduce the risk of transmission and can target the need for hospital-based care on a timely basis, should the need arise. As the surge of COVID cases created a growing hospital bed shortage across the country, the use of remote patient monitoring freed up valuable hospital resources to treat the most critical cases.
2. When CMS recently announced its new Acute Hospital Care at Home program giving health systems the opportunity to reduce inpatient volume by treating certain acute care patients at home through a telemedicine platform that allows for daily check-ins and monitoring, it was a major step forward for value-based care.
3. Care management, including RPM, was recently named as one of the top home care trends for 2021.
Home care is on the rise. One of the reasons is home care’s role in new delivery systems designed to treat higher-acuity patients such as those with an increased risk for hospitalization and those with chronic disease – either newly diagnosed or recently discharged – and both have a higher probability for rehospitalization.
Home health care providers aim to provide a continuous care experience by using programs like RPM. While home health’s in-person provider visit may only be for a limited amount of time, RPM is with the patient 24/7. RPM is not a substitute for home health visits. Rather, RPM upgrades home health services, improving the quality of care for patients leading to better patient outcomes. Clinicians and clinical staff can communicate modifications in medication and other self-care to the patient in real-time without any delays in the communication process. If symptoms and the disease progress to the point that hospital services are needed, providers will be able to arrange for care and transport that will ensure safety of the patient and health personnel.
Medicare recognizes that RPM can help home health agencies improve the care planning process. In October 2018, CMS released a final rule allowing home health agencies to bill for remote patient monitoring. To incentivize the adoption of RPM, the costs of necessary equipment, set-up, and related services can now be included as allowable administrative costs on the home health agency’s cost report. However, home
health agencies are only responsible for the collection of data, not the 20 minutes of data interpretation and intervention the same way a physician would be.
Using RPM allows home health agencies to collect more data to better understand the patient’s condition on a daily basis. It also helps to quickly identify fluctuations in vital signs and get the physician to intervene right away and adjust the treatment plan.
Home is where the heart is, and in the future, home is where the hospital cares for the heart.