Skip to main content

Academic Medical Center Investing in Home-Based Medical Care

Analysis  |  By Christopher Cheney  
   August 09, 2021

The Ohio State University Wexner Medical Center sees opportunities to provide home-based medical care services along the entire continuum of care.

The Ohio State University Wexner Medical Center (OSUWMC) is embracing home-based medical care.

Health systems, hospitals, and physician practices have been offering home-based medical care services for years as part of a strategy to improve access to care and to meet patients where they are instead of traditional medical settings. The coronavirus pandemic has accelerated utilization of home-based medical care services, including expansion of hospital at home programs.

Columbus, Ohio-based OSUWMC is committed to expanding the academic medical center's home-based medical care services, says Rachit Thariani, MBA, chief administrative officer of OSUWMC's Post-Acute and Home-Based Care Division.

"The pandemic has been horrible for society, but it has also shown us what is possible for healthcare in the home. Home-based medical care will be an essential part of what healthcare organizations will offer their patients and customers. It will no longer be a nice-to-have capability. We will have to figure out how to do home-based medical care in-person and how to do it digitally. Ohio State recognizes the home-based medical care trend. What we want to do is be at the frontend of this journey. Then we want to design breakthrough solutions that can transform the lives of the people we serve and the communities we serve," he says.

Drivers of home-based medical care

Four primary factors are driving adoption of home-based medical care at healthcare organizations, Thariani says.

1. Demand: Patients are demanding house calls and home health services, he says. "Demand is high, whether it is experiences patients have had receiving care in the home over the past 18 months, or whether it is because of the aging population and the ability to care more effectively for the aging population in the home. There are numerous surveys and studies that show that consumers want house calls and home health services."

2. High-value care: Home-based medical care generates value for patients and their healthcare providers, he says. "There is more evidence that when done right care in the home works, whether it is on the cost side or whether it is on the quality side."

3. Technology: Advancements in technology such as remote patient monitoring are enabling home-based medical care, he says. "There have been advances in technology that make things possible that were not possible even a couple years ago. There are digital and mobile healthcare applications that make home-based medical services possible."

4. Finance: Payment models are evolving to support home-based medical care, he says. "Specifically, value-based care is creating financial reasons for healthcare providers to offer home-based medical care."

House call resurgence

As part of the trend toward more home-based medical care utilization, house calls are making a comeback, Thariani says.

"House calls are a good solution for patients who are elderly or patients who are at high risk because of their health status. If patients have multiple complex conditions, they are a good fit for house calls. House calls are also a good solution for patients who have issues with mobility—they have difficulty leaving the home. House calls also work for patients who have been discharged from an acute hospital setting or post-acute care setting back to home. House calls are also good for patients who do not have access to transportation," he says.

House calls can involve multiple medical services, Thariani says. "When you think about house calls, you think about the patients who can benefit, then you think about the kinds of services you can offer, which is a broad range. It could be primary medical care, urgent care services, management of chronic conditions, and pharmacy needs such as home delivery of medications. Typically, many of these services would be accompanied by ancillary services such as lab work and portable X-ray."

At OSUWMC, house calls are just the tip of the home-based medical care iceberg, he says.

"If you think about the notion of personalized and comprehensive care, it is obvious that we need to create an ecosystem of care that is driving care into homes and communities. This is a kind of care that meets people where they are and helps them to remain healthy. So, when we think about what care can be provided in the home-based setting along the continuum of care, we are thinking about everything ranging from prevention and wellness to end-of-life care and everything in between, whether it is primary care, acute care, or post-acute care."

Making home-based medical care financially sustainable

There are four primary considerations to make sure home-based medical care services are financially sustainable, Thariani says.

1. Variety of payment models: "It is important to realize that the economics are very different for different home-care services. For example, the payment model for home healthcare is different than the payment model for home medical equipment, or home infusions, or house calls. Depending on the service you are providing, there is an underlying payment model that varies by service. You need to optimize the payment models for each of the unique areas of service," he says.

2. Value-based contracting: "If you go outside of the specific financial models, you need to explore value-based arrangements both with payers to establish payment models for home-based care and with potential industry partners such as technology companies or companies that facilitate unique models of care," he says.

3. Return on investment: "We need to have a more holistic view on return on investment. The traditional return on investment model is you invest then generate a direct financial return. In home-based medical care, we need to be thinking about not only the direct financial impact but also the impact on indirect elements such as clinical benefits, efficiency measures, length of stay, utilization rates, and readmission rates," he says.

4. Program size: "We also need to be mindful of the size and scale at which we launch new home-based medical care offerings. Rather than trying to launch services at scale, it can be more prudent to start small. You can prove the concept, get people engaged, show the outcomes, then scale up. Particularly once you show the outcomes, the propensity to invest might be greater."

Related: Finding Untapped Potential in the Home-Based Medical Care Market

Christopher Cheney is the CMO editor at HealthLeaders.


KEY TAKEAWAYS

Home-based medical care utilization has increased during the coronavirus pandemic.

Key drivers of increased utilization of home-based medical care include demand from patients.

House calls are a good fit for a variety of patients, including patients with chronic conditions, patients with mobility issues, and patients with multiple complex conditions.

Tagged Under:


Get the latest on healthcare leadership in your inbox.