The poll of 1,000 U.S. adults finds strong support among those who have used the program, with more than 80% saying they’d use it again.
One of the more popular arguments for launching a hospital at home program is that patients prefer to be treated from the comfort of their own home rather than stay in a hospital. A new survey proves that point.
According to a survey of some 1,000 U.S. consumers aged 40 and older, more than 80% of respondents who have taken part in such a program have had a positive experience, and 84% said they’d participate in the program again to get home sooner.
By contrast, less than 2% reported a negative or very negative experience, and about 16% said they were not likely to try the program again.
The survey, sponsored by digital health company Vivalink, adds fuel to efforts to make Medicare guidelines and reimbursements for the program permanent, and to compel more providers and payers to support the program. Well over 300 health systems and hospitals across the country are receiving Medicare reimbursements under the Acute Hospital Care at Home (AHCaH) model developed by the Centers for Medicare & Medicaid Services (CMS), but CMS is on track to end that program after this year.
CMS support—especially the reimbursements—is crucial to the growth of the strategy. Many healthcare organizations launched AHCaH programs during the pandemic, when CMS unveiled the program to address overcrowded hospitals and inpatient staffing shortages. Without that support, many health systems and hospitals will likely shut down those programs to reduce costs and focus on more business-friendly services.
Proponents argue that hospital at home programs, also called acute care at home programs, can reduce costs by cutting down on expensive hospital-based services, and they will show improved clinical outcomes over the long run. That argument is based in part on the idea that patients are more comfortable at home and will be more likely to follow doctor’s orders and care plans. A more engaged patient, in turn, will heal better and more quickly.
The survey finds that patients are indeed interested in staying in their own beds rather than a hospital room. For example. some 77% of those surveyed said they’d trust their doctor’s recommendation to take part in such a program. And the top reasons they’re willing to do so are the convenience and comfort of home (46%), avoiding exposure to infections in the hospital (23%), and confidence in remote patient monitoring (18%).
The reasons for taking part in a hospital at home program are surprisingly varied, and point to the potential for these programs to treat more patients. Some 30% were treated at home for infectious diseases or respiratory disorders—the reason CMS launched the program in the first place. Roughly 46%, meanwhile, were treated for heart-related conditions, and almost 38% were involved in cancer treatment or recovery.
In addition, almost 38% of respondents taking part in a hospital at home program were being treated for neurological disorders, and 34% were being treated for diabetes.
Finally, just under half of the respondents who had taken part in a hospital at home program said the RPM devices were easy to use, while the roughly 16% who said they wouldn’t use the program again cited difficult with the RPM devices as their biggest problem.
Nurses everywhere are concerned about AI, and here's why.
On this episode of HL Shorts, we hear from Betty Jo Rocchio, senior vice president and CNE at Mercy, about why nurses are nervous about the rise of AI in healthcare. Tune in to hear her insights.
Abbott and the National Association of Community Health Centers and partnering on a national effort to develop and launch innovative programs that use healthy eating and nutrition to combat chronic diseases and other health concerns.
Eight health centers across the country have been selected to test innovative “food as medicine” strategies as part of a national effort aimed at helping providers to integrate nutrition into their care plans.
The Innovation Incubator, launched by Abbott and the National Association of Community Health Centers (NACHC), will give each health center $30,000 to develop new programs over the next six months. The goal is to create new strategies that can be adopted by the network of 1,400 health centers across the country, as well as other health systems and hospital looking to address a key social determinant of health.
"Food insecurity severely impacts the health of underinvested communities," NACHC President and CEO Kyu Rhee, MD, MPP, said in a press release. "As the nation's largest primary care network, health centers' highly effective and innovative integrated model of care reaches beyond the walls of the traditional exam room to not only prevent illness but also address the social drivers that may cause poor health. Our focus this year is to create sustainable, effective strategies that solve food challenges and improve nutrition."
The effects of food insecurity, which studies have shown affects roughly 13% of U.S. households, go hand-in-hand with clinical outcomes. Chronic diseases like diabetes, high blood pressure, asthma, COPD, and cardiac issues are hampered and even worsened by a lack of nutrition. And while the impact is most acutely felt in underserved populations who have problems accessing good food, the concept of eating for good health needs to be taught to everyone regardless of social standing.
Healthcare organizations are embracing food as medicine strategies in an effort to tackle SDOH and bend the curve on skyrocketing costs for chronic care management. Some of the tactics used so far have included programs that deliver healthy foods and prepared meals to patients, partnerships with local food markets, health eating incentive programs, even virtual cooking and nutrition classes.
The participating health centers are Affinia Healthcare in St. Louis; Asian Health Services in Oakland; Cabin Creek Health Systems in Charleston, West Virginia; Delaware Valley Community Health in Philadelphia; White Couse Clinics in Richmond, Kentucky; Mainline Health Systems in Monticello, Arkansas; Tri-Area Community Health in Laurel Fork, Virginia; and Urban Health Plan in New York.
They’ll be launching experimental projects over the next six months, and will be called on to create pitches for one of two additional awards in the fall. The NACHC will share the results of the programs with its network of community health centers, affecting some 31 million people.
"In response to higher rates of both food insecurity and chronic illnesses that can be better managed through healthier diets, Urban Health Plan and many of our community partners in the Bronx have prioritized making healthy food accessible to residents through food pantries, farmers markets, and regular food distribution events," Paloma Izquierdo-Hernandez, the health center’s president and CEO, said in the press release. "We're planning to bring in local chefs to help educate our community on preparing healthier meals with a focus on affordable and culturally relevant foods that can be found locally.
The incubator, in its second year, was launched by the NACHC’s Center for Community Health Innovation, which has been instrumental in getting health centers to tackle the digital divide through telehealth, patient portals and digital and health literacy programs.
How do CFOs balance the rise in physician compensation with the need to lower labor costs?
Hospital and health system CFOs are facing a bit of a dilemma when it comes to recruiting and retaining physicians. On one end, physician compensation is rising. On the other, slashing labor costs is a priority. So how can CFOs balance the rise in physician compensation with the need to lower labor costs?
That reality necessitates that CFOs achieve a balancing act between employing top talent while keeping expenses in check. But hospitals' bottom lines aren't just affected by how much it costs to pay a physician. There are also opportunity costs and other expenses associated with physicians walking out the door in search of better compensation.
For that reason, cutting corners with physician salary isn't at the top of CFOs' to-do list. If anything, the opposite seems to be true, with hospitals acknowledging the competitive landscape for attracting and retaining physicians and showing willingness to invest in their workforce.
Getting physicians into your hospital is important—getting physicians to stay is essential.
Staffing turnover can be costly, so much so that giving a physician a raise in salary is often less detrimental to a hospital's finances than having to replace them.
That's a big reason why hospital decision-makers are eyeing ways to cut down turnover.
Scott Wester, president and CEO of Memorial Healthcare System, recently shared with HealthLeaders how the South Florida-based nonprofit created $200 million in savings by dropping about 80% of use of outside contract labor and reducing turnover from around 21% to below their historical average of under 14% in just a year.
"We did it with the intention of understanding we had to make sure that we had a better talent acquisition team, making sure that we played more offense than defense, and by reaching out to the work community to try to figure out what are things that are maybe are limiting the people to come join our organization," Wester said.
"We work very closely getting information, understanding we needed to do some market adjustments on individual pay raises for certain job classifications, and working closely with our university and educational facilities."
When a hospital isn't losing its physicians, it can be less dependent on contract labor, which boomed during the COVID-19 pandemic and put added stress on hospitals' margins.
Hospitals can still achieve profitability by paying their physicians while reducing contract labor costs.
As hospitals move away from contract labor, they must also try to incentivize physicians with bonus programs and other benefits outside of straight compensation.
David Koschitzki, CFO at MJHS Health System, spoke with HealthLeaders about solutions his organization has focused on to retain and attract talent, such as employee recognition programs and initiatives "that speak to the personnel side of their job responsibilities."
Koschitzki said: "Staffing is primarily the largest investment that we've been making. As I said, we have to address compensation issues, and we must address the competitiveness of the industry. So, we've enhanced staff salaries as an investment in our staff, and we've enhanced programs to attract staff."
This article is part of HealthLeaders’ How Do I? series. Read the entire article by Jay Asser here.
New technologies like ambient listening are poised to revolutionize the nursing workforce.
As many health systems begin their virtual nursing journey, they must determine what technology they will use and how it will evolve over time.
Tiffany Murdock, chief nursing officer at Ochsner Health, described the current technology that the health system is using for virtual nursing, and how they plan to optimize their workforce through new innovations.
Murdock is a part of the HealthLeaders Virtual Nursing Mastermind program, in which several health systems are discussing the ins and outs of their virtual nursing programs and their goals for implementing this new strategy.
Advancing the program
Ochsner's virtual nursing initiative has been in place since 2018, and according to Murdock, the current goal is to optimize the workforce through innovation.
"We have an Innovation Ochsner lab that helps us try to find different products," Murdock said, "and then we try to develop our own, too."
So far, the technology in use ranges from iPads to fixed, in-room technology, depending on the hospital. According to Murdock, hospitals in the health system are at different stages of technological advancement, so the needs are different in each one.
Some of the technology is also being repurposed. Many of the fixed screens that were once used solely for documentation now have multiple uses.
"People can come in and out of e-consults through those as well," Murdock said. "We're just trying to figure out what works at each of our different campuses because we have different types of hospitals."
Looking to the future
The ultimate goal is to give time back to the nurse at the bedside by streamlining the extra tasks that nurses often have to complete.
"All the little tasks that take the time away from the nurse to [practice at] the very highest scope will be taken by the virtual nurse," Murdock said.
According to Murdock, ambient listening is on the list of innovations that Ochsner wants to incorporate alongside virtual nursing.
"I am so excited about the thought of even [something like] an Alexa," Murdock said, "a patient [could be] able to close their blinds, turn their lights on, adjust their air, [or] search different things."
Ochsner is also trying to incorporate devices that can take vital signs and be integrated into the rest of the technology. That way, CNAs would not have to come in and take vital signs every two to four hours, Murdock explained.
However, to Murdock, ambient listening will be the key.
"I think that will be a complete change in practice," Murdock said, "because you really will be able to document an assessment and not have to look at a screen, which I think will…change the way we practice."
The HealthLeaders Mastermind seriesis an exclusive series of calls and events with healthcare executives. This Virtual NursingMastermind series features ideas, solutions, and insights onexcelling your virtual nursing program.Please join the community at our LinkedIn page.
To inquire about participating in an upcoming Mastermind series or attending a HealthLeaders Exchange event, email us at exchange@healthleadersmedia.com.
The health system, participating in the HealthLeaders Virtual Nursing Mastermind program, sees the innovative program as just one part of a lasting ‘connected care’ digital health transformation strategy.
At Houston Methodist, virtual care is ingrained into care delivery, and virtual nursing is part of the connected care process, rather than some shiny new thing. The trick, say health system leaders, is to combine short-term ROI that shows financial benefits with long-term results that demonstrate true value-based care.
Stave Klahn, Houston Methodist’s System Clinical Director for Virtual Medicine, says the virtual nursing program was launched in June 2022, and now comprises 35 nurses and 30 FTEs across 1,400 beds in seven hospitals. The program, he says, includes many KPIs, with an understanding that each little change in the process of care can contribute to value down the road.
“We really focus heavily on time durations of each activity that we do,” he says. And to get results, one looks at the “so many feeder things that lead up to that.”
Houston Methodist is one of a dozen health systems across the country that participated in the HealthLeaders Virtual Nursing Mastermind program, which consisted of three virtual roundtable and a two-day live event this past week in Atlanta. The goal of the program is to foster intensive discussions around virtual nursing, diving into what makes a program work, how to overcome challenges to sustainability, and what metrics to track to measure success or identify pain points.
Klahn and Sarah Pletcher, MD, MHCDS, Houston Methodist’s SVP and Executive Medical Director for Strategic Innovation, say the program started with the intention of improving nurse well-being by fine-tuning workflows, and added goals from that point. Alongside addressing admission and discharge times, key elements of a patient’s length of stay, they’re looking at care coordination and management and documentation compliance.
Analytics and reporting are part of the process, Klahn says, because “you’ve got to demonstrate ROI early on.”
Pletcher says the program has to be flexible and nimble. While health system leadership is focused on reducing costs and saving money, virtual nursing programs should be showing off a mixture of hard and soft ROI—appealing to the hearts and minds as well as the wallets. And always be ready to try new things.
“You may get credit for helping with something in the beginning but then a year later people forget or are looking for new value,” she says.
Houston Methodist’s program is one of the more advanced in the country, with a dedicated virtual nursing workforce (Klahn says they look for nurses with at least two years of experience and a wide range of backgrounds) and a central virtual operations center, as well as opportunities for virtual nurses to work from home. They’re also in the final stage of installing wall-mounted technology in all of their patient rooms and using wearables to track patient vital signs.
Klahn says it’s important to include the nurses in each phase of planning a virtual nursing service, and show them the value of virtual nursing so that they’ll support it. That includes clearly identifying the roles for both virtual and floor nurses. ’Customers’ of any new care models like virtual services do notice when they’re included in the design process, and they’re more comfortable with suggesting tweaks and new ideas for making processes more efficient.
The HealthLeaders Mastermind seriesis an exclusive series of calls and events with healthcare executives. This Virtual NursingMastermind series features ideas, solutions, and insights onexceling your virtual nursing program.Please join the community at our LinkedIn page.
To inquire about participating in an upcoming Mastermind series or attending a HealthLeaders Exchange event, email us at exchange@healthleadersmedia.com
Healthcare accessibility is critical for seniors, and nurses need to be properly equipped for that, says this nurse leader.
Editor's note: Kathy Driscoll, MSN, RN, NEA-BC, CCM, is the senior vice president and chief nursing officer at Humana.
The rapidly changing landscape of health care, underscored by the resultant needs of an aging population, has magnified the demand for in-home care. The number of seniors aged 65+ is expected to climb from 58 million in 2022 to 82 million by 2050 and, of the population 50 years and older, the number of individuals living with at least one chronic disease – including those that affect mobility – is estimated to increase from 71 million in 2020 to 142 million by 2050.
Given this shift in the population and corresponding health care needs, we must expand care delivery options, such as in-home care, to ensure accessible care for our seniors. Moreover, with the push to expand in-home care delivery, there must be a transformation in how nurses are trained, prepared and supported to deliver care in the intricate and intimate nature of in-home care. As the Chief Nursing Officer for Humana, a key focus of mine has been on bolstering how we prepare nurses through innovative partnerships and training opportunities.
In-home care education
The nursing profession is already under tremendous strain because of a scarcity of providers. Making matters worse is a deficit in educators who can teach necessary clinical skills. It has become increasingly clear that we must boost investment in educational resources that specifically address in-home care, integrating these modules into traditional nursing curricula.
A career in home health care requires a holistic view of patients and their needs. Home health nurses base care on a comprehensive approach that considers not just the medical, but also the social aspects of patient health. Nursing students exposed to in-home clinical training learn to manage care within the patient's living environment, giving them insight into the real-life applications of their academic training. This includes mastering how social determinants like finances, family dynamics, housing, and nutrition impact health outcomes.
The intimate care setting of a patient's home fosters deeper patient-provider relationships, allowing for continuous and more personalized care. Given this unique environment, nursing education should emphasize the heightened importance of empathy and patient-centered care. As in-home care increasingly incorporates telehealth and remote monitoring technologies, students would also benefit from education that teaches proficiency in these modern tools, making them versatile practitioners across various care settings.
Forging academic partnerships
Health system partnerships with nursing schools are critical to in-home care education. CenterWell Home Health’s partnerships with institutions such as Emory University and the University of Houston have been pivotal in translating academic principles into hands-on skills that empower future nurses with the competencies needed to thrive in in-home care settings.
This enhanced training has numerous benefits that extend beyond patient care and has a notable influence on nurse retention and job satisfaction. The flexibility and autonomy of in-home care are attractive to many nursing professionals who seek a sustainable career that also allows for a work-life balance. By offering a blend of clinical rotations, simulation scenarios, guest lectures, and externships, our team at CenterWell Home Health, a part of Humana, provides a comprehensive view of what it means to be a nurse providing care in the home. We are proud to have facilitated 285 student placements across more than 60 schools. These programs foster individual careers and elevate the whole sector to meet future demands.
Commitment to home health care education must be a collective endeavor. Beyond the direct training of nurses, health systems must embrace a broader vision that prepares the entire industry for the future. As we anticipate the health care needs of tomorrow, we must build a resilient, competent, and dedicated nursing workforce ready to face the unique challenges of in-home care. Through targeted education, practical training, and a commitment to continuous learning, we can help ensure that our nurses and their patients thrive in the evolving health care landscape.
Editor's note: Care to share your view? HealthLeaders accepts original thought leadership articles from healthcare industry leaders in active executive roles at payer and provider organizations. These may include case studies, research, and guest editorials. We neither accept payment nor offer compensation for contributed content.
The retail giant is folding its nearly two-year-old Amazon Clinic business into Amazon One Medical, saying the move makes things easier for consumers accessing care.
Amazon is consolidating its healthcare services under one brand, bringing its on-demand virtual care offering together with its primary care platform.
Amazon Clinic, which launched nearly two years ago to give members access to virtual care visits for more than 30 non-acute health issues, is being rebranded as Amazon One Medical’s pay-per-visit telehealth service. The platform, available in every state, offers single-visit prices of $25 for a messaging visit or $49 for a virtual visit, alongside monthly and annual subscriptions.
“It’s simply too hard to get the medical care you need, when you need it, and affordably—long waits, high costs, and impersonal care make it unnecessarily difficult for many patients today,” Neil Lindsay, senior vice president of Amazon Health Services, said in a blog on the company’s website. “We’re focused on improving both the occasional and ongoing medical care experience.”
The announcement—coming on the same day that Walgreens announced plans to rid itself of VillageMD and close a significant number of pharmacies in the U.S.—gives the retail giant a more focused footprint in the increasingly volatile primary care market. And it gives health system and hospital leaders a clear model to compare or contrast their own direct-to-consumer strategies, particularly in telehealth.
The challenge for industry decision-makers is understanding where Amazon is competitive with traditional brick-and-order healthcare organizations, and why. Analysts have often said the retail giant could be a true disruptor in the space by offering more convenient access to care to consumers put off by the bloated hospital or clinic healthcare experience.
And yet Amazon has had as many misses as hits in the space, including the failed Haven and Amazon Care programs. Health system and hospital executives argue that primary care is a very difficult field in which to establish a foothold, particularly for organizations that focus on profit rather than long-term health and wellness.
The group, comprised of health systems and vendors, has released an Assurance Standards Guide for AI in healthcare and is seeking public comments for the next 60 days.
A coalition of health systems and AI companies working with the federal government on AI standards is seeking public comments on a new draft framework for responsible use of AI in healthcare.
“Shared ways to quantify the usefulness of AI algorithms will help ensure we can realize the full potential of AI for patients and health systems,” Nigam H. Shah, MBBS, PhD, chief data scientist for Stanford Health Care and a co-founder and board member of CHAI, said in a press release. “The guide represents the collective consensus of our 2,500 strong CHAI community including patient advocates, clinicians and technologists.”
Formed in 2023, CHAI includes Stanford, the Mayo Clinic, Vanderbilt, Johns Hopkins, Google, and Microsoft. It now boasts more than 2,500 members and has been working with the National Health Council and health standards organization HL7.
CHAI executives say the guide, part of a package of documents called the Assurance Reporting Checklists, aligns with the National Academy of Medicine’s AI Code of Conduct, the White House Blueprint for an AI Bill of Rights, several frameworks from the National Institute of Standards and Technology, the Cybersecurity Framework from the Department of Health and Human Services Administration for Strategic Preparedness & Responses.
Also included are six use cases for AI:
Predictive EHR Risk Use Case (Pediatric Asthma Exacerbation)
Imaging Diagnostic Use Case (Mammography)
Generative AI Use Case (EHR Query and Extraction)
Claims-Based Outpatient Use Case (Care Management)
Clinical Ops & Administration Use Case (Prior Authorization with Medical Coding)
Genomics Use Case (Precision Oncology with Genomic Markers)
“We reached an important milestone today with the open and public release of our draft assurance standards guide and reporting tools,”. Brian Anderson, MD, CHAI’s president and chief executive officer and an associate professor of biomedical informatics at Harvard Medical School, said in the press release. “This step will demonstrate that a consensus-based approach across the health ecosystem can both support innovation in healthcare and build trust that AI can serve all of us.”
A session at the HFMA Annual Conference dives into a people-first approach to solving one of the biggest pain points facing CEOs.
Healthcare leaders understand that labor strategies must adapt to meet an evolving workforce, but recognizing it is one thing and committing to it is another.
Though the strength of a workforce is still very much measured in numbers such as costs and turnover rate, prioritizing less easily quantifiable areas like employee satisfaction and happiness has the potential to result in a more sustainable workplace model.
The head of the Southern California-based health system emphasized the importance of leaders setting organizational values that create transparency, humility, and genuine caring for all caregivers, as well as agreed-upon metrics that organically lead to better outcomes both clinically and financially.
How can it be done?
To achieve that, Keck has programs focused on professionalism, resiliency, and well-being that aren’t one-offs, but instead woven into the fabric of the organization.
For example, physicians and nurses can share concerns about co-worker behavior through the Daily Incident Reporting System, leading to peer messengers sharing the incident with the person named and accountability/goal setting discussed if patterns of concern continue. The whole process is meant to be non-punitive and off the record, creating an environment that encourages to reporting and development.
Even instituting a relatively innocuous change like keeping Fridays meeting-free has resulted in people getting their work done and meeting milestones in the other days of the workweek while cutting down employee stress, according to Hanners.
Setting a workplace culture should start from the top and permeate to the ground level, but the role and impact of middle management can often get overlooked.
Hanners believes you need buy-in at middle management, which is more challenging today than it’s ever been due to a multitude of priorities, hundreds of emails, and lack of responsiveness. You also need your modern mid-level manager to be empathetic, trustworthy, transparent, mindful, and accountable, on top of being a good developer of talent.
CEOs should not lose sight of mid-level leaders and afford them opportunities to discuss their experiences, which will help with organization-wide healing during a time when labor strikes and shortages are hampering workplaces. Surveys to receive feedback from both caregivers and leaders are vital to understanding which areas need improvement.
The commitment to the people in its organization has led to Keck Medical Center dropping their total turnover rate from 12.4% in July 2022 to 9.2% this past April. Less turnover has also made it easier for Keck to reduce contract labor by over $13 million year-over-year.
The proof is undeniable: Cultivate a positive environment for your workforce and the results will follow.
