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In this series, Health Evolution is examining the year 2021 in health care through the lens of our eight imperatives. We will be examining the trends that were at the top of CEOs’ minds throughout the past year and what may come in 2022. This week: Engaging health consumers 

Previously:       

Strengthening system resilience       

Confronting the mental health crisis.     

Escalating Health Equity     

Advancing new models of care    

Securing data advantage   

Realizing medical breakthroughs 

Addressing affordability  

 

Amid the funding craze in digital health, there is an arms race happening within home-based health care as major payers, providers, retail giants, health IT companies, and other organizations work to broaden their offerings in the burgeoning space. 

Take for instance, CVS Health. At the annual JP Morgan Healthcare Conference, CVS Health CEO Karen Lynch said that said that the company will “expand our home health services capabilities that we offer in the marketplace using a model that integrates health programs for complex populations.” Meanwhile, UnitedHealth Group COO Dirk McMahon recently said on an earnings call that “home-based clinical care initiatives at Optum and UnitedHealthcare are central to improving near- and longer-term health outcomes for people with medical, behavioral and social need.” 

As another example, Humana has strategically grown its Medicare Advantage plan offerings, which often rely on home-based health care services to lower costs and improve outcomes in value-based arrangements. In 2021, it acquired one of the largest home-based health services companies in the country, Kindred at Home, for $8.1 billion. It has also made strategic partnerships with numerous companies in the home-based health care space such as DispatchHealth and Papa. In the retail world, Best Buy Health acquired Current Health, which provides a care at home platform that combines remote patient monitoring, telehealth and patient engagement for providers.  

“As seniors increasingly choose Medicare Advantage, there is a meaningful opportunity for home health organizations to engage differently with patients, and [MA] payers to more holistically address patient needs, improve health outcomes and reduce the total cost of care for health plans and share appropriately in this value creation,” Humana CEO Bruce Broussard said on a recent earnings call. 

At the center of this trend are consumers. More and more patients who would rather receive hospital-level care at home than in the hospital. According to a survey from Moving Health Home (MHH), a coalition of health care organizations advocating for improved access to home-based care, 73 percent of adults are confident in the quality of care they would receive in the home. The overwhelming majority of people who have received home-based care were satisfied (88 percent) and would be likely to recommend to family and friends (85 percent).  

Another survey, from the Partnership for Quality Home Healthcare (PQHH), found more than nine in ten Medicare beneficiaries (94 percent) say they would prefer to receive post-hospital short-term health care at home. Only 3 percent say they would prefer a nursing home. 

Mayo Clinic is all in on hospital at home 

Mayo Clinic is one prominent health system that has leaned into home-based care. The organization launched an advanced care at home model in 2020 that provides various health services to qualified patients within their home. Michael Maniaci, M.D., physician leader for advanced care at home at Mayo Clinic, said the idea was originally proposed in 2018 by the company’s CEO Gianrico Farrugia, MD.  

“He said that more care in the home, especially high acuity care, which really wasn’t done on a large scale until that time, is the future of Mayo,” said Maniaci. “We took our first patient in July of 2020, which was planned before COVID was even around. Obviously, it ended up being good timing from that perspective and the regulatory measures were moving to favor us scaling up more rapidly.” 

The regulatory measure Maniaci is referring to is CMS’ Acute Hospital Care at Home program, a waiver that allowed eligible hospitals with regulatory flexibilities to treat eligible patients in their homes via telemedicine and virtual health technologies. The program was announced in November 2020 and will be in place for the duration of the COVID-19 public health emergency. However, Mayo and a number of other hospitals are hoping to convince CMS to enact measures that will allow for this to continue permanently.