Home Health Care For The Frail Elderly In Focus This Week

Home health care for frail, elderly patients is making headlines this week.  The Atlantic recently featured a piece on the economic benefits home-based primary care can offer to the US health care system going forward.

Focusing predominantly on Dr. Brad Stuart, the founder of Advanced Illness Management (AIM) at Sutter Health, the article takes a look at how treating frail, elderly patients with a comprehensive home-based plan can be more efficient and cost saving in many cases. The AIM program takes an overarching approach to patient care, managing patients’ chronic conditions with in-home visits and care coordination. Each patient is assigned a team of doctors, nurses, specialists, and more under the direction of a primary care physician. Patients remain in the AIM program for the duration of care, utilizing each individual resource as needed. This approach allows care to prevent hospital readmission, saving the patient and health care system time and resources. Earlier this year the Alliance held a webinar with Dr. Stuart and his colleague from the Coalition to Transform Advanced Care (C-TAC), Tom Koutsoumpas, on treating advanced illness, which touched on the AIM program. (Slides from their Innovation Perspectives webinar can be found here.)

Examples of successful home-based care stories in the article included those from MedStar Washington Hospital Center’s Medical House Call Program. One patient, a 92-year-old male had been in and out of the hospital before becoming a part of the MedStar program. The self-proclaimed hospital-hating patient has not been back to the hospital since joining the Medical House Call Program. We profiled the Practice Director for the Medical House Call Program, Dr. Stephanie Bruce, in September as part of our Innovation Perspectives Capitol Hill briefing on how health care delivery reforms are leveraging home health care. The full profile of these innovations at MedStar featuring Dr. Bruce can be found here, and a replay of the briefing can be found here.

Healthcare at home may offer a solution to the costs driving health care spending in the United States. As the article contends, with the Affordable Care Act penalties for hospitals with high rates of readmissions, many hospitals are less eager about readmitting Medicare patients. In addition, many Medicare demonstrations, pilots and programs have been created to pursue and explore innovative new models of care, offering home health care an opportunity to show its value in improving patient care and reducing overall cost of care. Sutter estimates in the article that the AIM program saves Medicare upwards of $2,000 per patient per month. Over time, the savings seen by including more comprehensive home-based care could be significant to providers and the health care system as a whole.

The article contends that the future is currently bright for home-based comprehensive care, as both the logistical and financial opportunities are there to see a push in the implementation of programs such as AIM and the Medical House Call Program. As part of our educational mission, the Alliance is proud to continue the discussion of affordable and high-quality home-based care with innovators such as Dr. Stuart and Dr. Bruce.

 

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If you’re interested in learning more about the Alliance’s Innovation Perspectives series, click here for more information. Dr. Joanne Lynn, Director of the Altarum Institute’s Center for Elder Care and Advanced Illness, will be the next featured guest on our December 5th webinar at 2:30 pm ET. Dr. Lynn will speak on reforming care delivery to better support frail and elderly seniors who need both health care and long-term care. Click here for more information on next month’s webinar, and here to read Dr. Lynn’s recent opinion piece in the Journal of the American Medical Association.