In this week's The Winning Edge webinar, executives from three leading health systems discussed how the platform improves clinical outcomes, reduces hospital overcrowding and costs, and boost patient satisfaction and engagement.
Despite challenges with reimbursement and complexity, the Hospital at Home strategy will be a key element of value-based care from here on.
That's the opinion of executives from three leading health systems who took part in this week's HealthLeaders The Winning Edge panel. They said the program, which enables patients to receive acute-level care in their homes rather than a hospital through a mix of virtual, digital and in-person services, has already proven its value.
Tuesday's panel featured Stephen Dorner, MD, MPH, MSc, chief of clinical operations and medical affairs for Mass General Brigham, which serves roughly 400 patients a month in a program launched in 2017; Daniel Davis, MD, senior medical director of primary care for the greater Charlotte market and senior medical director of continuing health for the Southeast region for Atrium Health, whose program includes one of the first pediatric Hospital at Home platforms in the country; and Logan Davies, MD, MBA, hospital medical director of access and throughput for Ochsner Health, which launched its first acute care at home program a little more than a year ago and is not following the Acute Hospital Care at Home (AHCaH) model favored by the Centers for Medicare & Medicaid Services (CMS).
The three programs follow a familiar pattern but have their own unique variations, which is a strength of the strategy. While roughly 400 health systems and hospitals are following the CMS model and receiving Medicare reimbursements through a pandemic-era waiver due to expire this fall, many others are developing their own programs, with the goal of taking patients out of crowded hospitals, reducing excessive hospital-based costs and enabling patients to recover at home.
Davis said the CMS model offers "an important sign of legitimacy," but it's not the be-all and end-all of the program. Healthcare organizations across the country are struggling to redesign care in a more efficient and effective format, and a model that takes care out of the hospital and puts it in the home fits that plan.
Here's the You Tube presentation of this week's webinar:
The announcement speaks to a subtle shift in the Hospital at Home strategy, and an understanding that care needs to be more integrated and personal
Sometimes the retail experience just doesn't work out for healthcare.
Less than four years after acquiring digital home health company Current Health, Best Buy has sold the company back to its co-founder and former CEO, Christopher McGhee.
The move ends an interesting chapter in the Hospital at Home strategy that saw health systems like OSF HealthCare, Baptist Health, Geisinger, UMass Memorial Health, Atrium Health and Virtua Health use the ‘Geek Squad' to set up patients for home-based care and handle daily monitoring.
"Compared to 2014, many more patients across the U.S. now have access to healthcare outside the hospital," he wrote. "But, ultimately we are still in the early innings of the shift from hospital-based care to home and community-based care."
The Hospital at Home concept focuses on delivering hospital-level care at home to certain patients who would otherwise be hospitalized, using a mixture of telehealth, remote patient monitoring and daily in-person care. The Centers for Medicare & Medicaid Services' (CMS) model, called Acute Hospital Care at Home (AHCaH), took off during the pandemic and now boasts close to 400 health system and hospital partners, with a pandemic-era waiver enabling participants to receive Medicare reimbursement.
While some healthcare organizations have developed their programs internally, using their own doctors, nurses and Mobile Integrated Health (MIH) programs to handle home visits, others rely on home health agencies or even vendors. Many outsource the technology part of the program, using companies like Current Health to evaluate patient homes, set them up with the right technology and handle daily monitoring.
Health systems who partnered with Current Health saw the relationship as a much-needed shot of retail strategy, and the idea of sending the Geek Squad to a patient's home to set them up for home-based care was a good one, enabling the hospital to handle oversight and escalations and leave the daily monitoring to someone else. But Best Buy's decision to get out of the home health business shows there is still work to be done.
Critics of the Hospital at Home strategy say the concept – particularly the CMS model - is too complicated, resulting in more costs and complexity than either the health system or the patient wants. They also question whether patients and their caregivers really want that much care in their homes, disrupting their daily lives and habits, and that those patients should be receiving care in a hospital.
Many of those invested in the Hospital at Home strategy say the program will go on with or without the Medicare waiver, which is set to expire at the end of September unless Congress takes action. But there's also a lot of discussion that the program needs to evolve to become more sustainable, and that a Hospital at Home program will look much different in a year or two than it does today.
The Best Buy decision may force health systems and hospitals to look more closely at how that care is delivered to the home, and to consider a more personal approach.
With that in mind, some providers are either rethinking their approach to the home or putting more effort into working with patients and their families to make the program less intrusive. That would mean replacing the Geek Squad with a hospital-based (or hospital-supported) team.
In his letter, McGhee said Current Health will be "recommitting to our mission" and working on a platform that integrates healthcare with the home setting. That might come as a relief to patients who'd rather see their healthcare delivered by a health system rather than a Big Box store.
Executives from three health systems taking part in this week's The Winning Edge webinar say the strategy is reducing hospitalizations and costs, improving outcomes and scoring very high in patient satisfaction.
Hospital at Home programs are here to stay, regardless of the fate of the Medicare waiver, but they may look a lot different a year from now.
That was the biggest takeaway from Tuesday's The Winning Edge webinar, which featured executives from two of the strategy's leading proponents, Mass General Brigham and Atrium Health, and Ochsner Health, which launched its program a little over a year ago and is pursuing sustainability beyond the model supported by the Centers for Medicare & Medicaid Services (CMS).
Hospital at Home, which aims to treat selected patients at home with a combination of virtual care, remote patient monitoring and daily in-person visits instead of keeping them in the hospital, took off during the pandemic, with support from a waiver that enabled health systems and hospitals following the CMS model to receive Medicare reimbursement. That waiver is due to expire in September, and while there's a strong lobbying effort to make it permanent, many hospital executives have said the program has proven its value and will go on regardless.
Robust Outcomes Point to Sustainability
Daniel Davis, MD, senior medical director of primary care for Atrium Health's greater Charlotte market and senior medical director of continuing health for Atrium's Southeast region, said the CMS model offers “an important sign of legitimacy” for healthcare leaders, but the more important arguments are reduced pressure on overcrowded hospitals, improved health outcomes and very high patient satisfaction scores.
Davis said Advocate Health, the parent health system of Atrium Health, has 13 hospitals participating in the Hospital at Home program, including one of the first pediatric programs in the nation. Advocate's Hospital at Home program, which has been in operation for about five years, serves roughly 115-120 patients a day, or about 16,500 patients since the program began.
Davis said the program, which accepts both waivered (eligible for Medicare reimbursement) and non-waivered patients, has resulted in tens of thousands of saved bed days, a key factor for hospitals who are above capacity every day.
Mass General Brigham runs its Hospital at Home program through five acute care hospitals in the greater Boston area, said Stephen Dorner, MD, MPH, MSc, chief of clinical operations and medical affairs for Mass General Brigham's Healthcare at Home program. The program, which began in 2017, comprises some 70 beds across 72 towns in eastern Massachusetts, serving roughly 400 patients per month.
Dorner said MGB, which pursued Hospital at Home programs separately as Mass General Hospital and Brigham and Women's Hospital before the two merged in 2019, approached the strategy as a means of improving care for growing populations, including the elderly and those with chronic care needs. Leadership understood that these populations would need more care than the health system's brick-and-mortar facilities would be able to give them.
Dorner said the program has shown continued positive results in reducing readmissions and complications, while the patient experience is "off the charts." He said those results will keep the program valuable regardless of the Medicare waiver.
While Ochsner Health is nationally known for its digital health and RPM programs, the New Orleans-based health system is a relative newcomer to the Hospital at Home concept, said Logan Davies, MD, MBA, hospital medical director of access and throughput.
Ochsner's program, which is called Acute Care at Home, centers on three hospitals in and around New Orleans and, after going through what Davies called a “series of stops and starts,” launched roughly a year and a half ago to focus on value-based care patients, which number more than 200,000 in New Orleans alone. Davies said the program cares for about 250 patients a month through a contracted care provider and isn't following the CMS model so that Ochsner can be more creative with how it delivers care in the home.
Davies said Ochsner includes the CFO in planning because the financial and clinical aspects of the Hospital at Home concept should be combined. Just by factoring in the costs of caring for a patient in the hospital against the costs of caring for a patient at home, he said, the Hospital at Home strategy yields an ROI of anywhere between three times and eight times better than the cost of hospital care.
Davies said Ochsner, like every other health system, is waiting to see how Medicare and, especially, Medicaid are affected by the current federal budget negotiations. If the worst-case scenario comes true and drastic cutbacks occur, health systems will need to adjust their Hospital at Home strategies – and that might make the strategy even more important in providing value-based care.
Not a One-Size-Fits-All Model
While all three health systems follow a similar structure, there are many differences that point to the ability of a health system to tailor its program around what leadership wants and needs. For instance, Ochsner Health outsources part of its acute care at home program to a vendor, while Atrium Health uses its own doctors and nurses, as well as paramedics trained through a Mobile Integrated Health program. And while MGB targets populations in defining who would benefit from the Hospital at Home Program, Ochsner looks at the individual patient.
All three agreed, nonetheless, that the concept is a key part of the health system of the future, and it will continue to evolve. They said such programs will improve with the use of more sophisticated RPM technology, enabling providers to track patient biometrics at home and in real time. And they said AI will make a significant impact on care as well, reducing the burden on clinicians and giving them better insights into care management and coordination at home.
Please check back with HealthLeaders on Friday for the You Tube video of this Winning Edge webinar.
Executives from three health systems leading the way in developing Hospital at Home programs will discuss the benefits, drawbacks and future of the concept in this week’s Winning Edge webinar.
Hundreds of health systems and hospitals across the country are using Hospital at Home programs to treat acute care patients at home instead of in the hospital, yet the future of the program is still uncertain.
Advocates swear by the program, saying it reduces wasteful costs and improves clinical outcomes, while critics say the program is complex, leads to extra costs and isn’t best for patients or their families. And the Centers for Medicare & Medicaid Services (CMS), which crafted waivers for its Acute Hospital Care at Home (AHCaH) program during the pandemic to help providers collect Medicare reimbursement, is currently planning to end that waiver in September.
Against this backdrop, HealthLeaders will convene executives from three health systems to discuss the benefits, drawbacks and future of the Hospital at Home program in its latest Winning Edge webinar on Tuesday. The Winning Edge for Moving Forward With the Hospital at Home Strategy will take place at 1 p.m.
The panel promises to be informative. It features Stephen Dormer, MD, MPH, MSc, chief of clinical operations and medical affairs for the Healthcare at Home program at Mass General Brigham, which developed one of the earliest and most successful Hospital at Home programs in the country; Daniel Davis, MD, senior medical director of primary care and senior medical director of continuing health (Southeast Region) for Atrium Health, another front-runner in the Hospital at Home movement; and Logan Davies, MD, MBA, hospital medical director of access and throughout for Ochsner Health, which has developed one the country’s most extensive telehealth and remote patient monitoring platforms.
The panel will discuss how healthcare leaders are defining and developing ROI for these programs, which combine telehealth, remote patient monitoring and in-person care to treat selected patients in their won homes instead of hospitalizing them. We’ll also talk about how technology is integrated into the home setting, how in-person visits by care teams are scheduled, and how patients and their families are included in the planning process.
Close to 400 hospitals and health systems are following the CMS ACHaH program, which features a rigid structure but offers Medicare reimbursement. Many others are trying out different versions of the acute care at home strategy, which eliminates reimbursement but gives them the freedom to develop their own structure.
Advocates say the model could be a key strategy in reducing crowded inpatient units and improving outcomes for rural patients, as well as populations like children, veterans and those with chronic care needs.
An evolving healthcare landscape means the CIO's role is changing. A new HealthLeaders Exchange will take a look at this new hierarchy, where collaboration is the key.
The healthcare C-Suite is evolving, and no position better encapsulates these changes than the CIO. Once considered solely a technology-based role, focusing on EMR adoption and integration, the CIO – be it the chief information or innovation officer (or both) – is assuming more strategic and management duties as the industry embraces new concepts like digital health and transformation.
"Because of those disruptions and because of that focus, now you're a force-multiplier," Aaron Miri, MBA, FCHIME, CHCIO, Baptist Health Jacksonville's EVP and Chief Digital & Information Officer, said during a CHIME CIO panel at VIVE 25 this past spring in Nashville. "It changed the lexicon of CIOs to be talking more like a CFO, or a COO, or a Chief Human Resources Officer."
"I spend part of my day looking at recruitment, part of my day looking at P&L [profit and loss], part of my day looking at futuristic digital transformations and what we can do [to be] disruptive, as well as strategically, where are we going as a health system," he added.
Indeed, while the EMR/EHR still occupies a large chunk of C-Suite time and effort, the onset of new technologies like digital health, virtual care and AI
In a 2024 study supported by surveys of 51 executives from 33 health systems, the National Institutes of Health summarized the newly evolving CIO as having three roles:
Enabling strategic change and transformation;
Developing technology and leadership talent; and
Driving organizational culture.
"As healthcare continues to evolve, the role of the CIO is expected to expand further, requiring a blend of technical and strategic business skills," the article, written by researchers at the Georgetown University Department of Health Management Policy and the University of Alabama at Birmingham', concluded. "This evolution presents opportunities for health systems to enhance their leadership development programs, preparing leaders for the complexities of the contemporary health system sector."
In addition, healthcare leadership is not only redefining the CIO but in some cases reorganizing the C-Suite, either due to budget concerns or the changing face of healthcare transformation. Chief strategy and partnership officers are helping to address disruptors and extend the healthcare organization's traditional footprint, while chief digital health and transformation officers are handling the growing integration of technology in patient care, especially as healthcare moves out of the hospital and into the home. Some organizations are even carving out a leadership role for AI development and management, with the idea that this technology requires full-time stewardship.
At the VIVE panel, Tessa Springman, SVP and chief information / digital health officer at LifeBridge Health, noted she's become more of an educator and facilitator.
"I am the person who is the glue in the organization," she said. "I am constantly educating my peers on what their peers are doing."
"I spend most of my day thinking about, OK, how am I going to improve this business function, how are we going to partner to make this improvement, and will technology help that particular function or not?" she added.
The gist of this evolution is that the CIO is being called upon to work more closely with others in the executive chain, particularly as new programs and strategies require input from a wide variety of sources, including the CFO, the CMO, the CNO, and even the CEO. The top job description of the future may well be "works well with others."
To address this shifting role, HealthLeaders is launching a new Exchange aimed at bringing together top CIOs, chief digital health officers, chief transformation officers and others to network and discuss how technology strategy is changing their roles.
This week’s The Winning Edge panel set the stage for AI in clinical support, from compiling a better patient record to identifying the care gaps in population health.
Clinical care is the next big thing for AI integration, and healthcare leaders have a lot of ideas about how the technology can be used.
In this week’s The Winning Edge, sponsored by Lightbeam Health Solutions, Michael Wells, president of OSF HealthCare’s Saint Francis Medical Center in Illinois, and Ishani Ved, MHA, CPHQ, FHELA, director of transformational population health and outcomes for Saint Peter’s Healthcare System in New Jersey, explained how AI is slowly and carefully being used to help with care management.
Ved noted the benefits to population health, particularly in gathering and assessing data from disparate and siloed sources to understand the social determinants of health that are keeping underserved populations from accessing the care they need. And Wells pointed to the possibilities in improving inpatient care, from capturing conversations in the hospital room to improving the patient’s medical record, even monitoring patients when no one else is in the room.
Both said the key to using AI in clinical care is ensuring that the data used in AI programs is up to date and reliable, and that means good governance and continuous monitoring. It also means making the entire process transparent, and helping doctors and nurses understand how AI will improve their workflows and give them more time to spend with their patients.
As Danielle Bergman, MSN, APRN, FNP-BC, AVP of clinical development at Lightbeam Health, noted, AI has the opportunity to take a lot of time-consuming and administrative tasks off the provider’s “mental bandwidth” and help them focus on patient care.
Here’s the YouTube presentation of Tuesday’s webinar.
This week’s Winning Edge webinar focused on the benefits and challenges of adding AI to clinical care pathways
After seeing success with AI in back-end operations and the revenue cycle, healthcare executives are eager to see how the technology can benefit clinical care.
But as the executives in this week’s The Winning Edge webinar, sponsored by Lightbeam Health Solutions, pointed out, there are a lot more checks and balances in play when patient care is affected. The data used in these programs has to be reliable and up-to-date, requiring strong governance and continuous monitoring. And both providers and patients have to confident that AI is being used to make things easier.
That said, Michael Wells, president of OSF Healthcare’s Saint Francis Medical Center; Ishani Ved, MHA, CPHQ, FHELA, director of transformational population health outcomes at Saint Peter’s Healthcare System; and Danielle Bergman, MSN, APRN, FNP-BC, AVP of clinical development at Lightbeam Health noted, there are key pain points in clinical care – both inside and outside the hospital – that AI can address.
Here are three ideas. Also read today’s wrap-up in HealthLeaders and check back tomorrow for the YouTube video of Tuesday’s webinar.
Drowning in data? Healthcare teams use AI to turn information into impact.
AI is moving into the healthcare management at a rapid pace, as healthcare executives look for ways to apply the technology to care pathways both inside and outside the hospital room.
In this week’s The Winning Edge webinar, sponsored by Lightbeam Health Solutions, executives from Saint Peter’s Healthcare System in New Jersey and OSF HealthCare in Illinois discussed how they’re using AI to improve care delivery. This includes:
Using the technology to draw from disparate and often siloed data sources and create a complete patient care record for nurses and doctors, giving them ideas on future treatments and improving handoffs to other care team members;
Using ambient technology to record conversations between patients and their care team in the hospital room, sifting through the details to enter relevant data into the EMR; and
Integrating AI with video technology to monitor patients, especially when no one else is in the room, reducing patient falls and alerting care team members if someone shows signs of physical or mental distress.
Michael Wells, president of OSF HealthCare’s Saint Francis Medical Center, says the technology, while still in its earlier stages in clinical care, offers opportunities for care teams to gather and process large amounts of data more quickly, helping to fine-tune nursing workflows and improve bedside care.
Ishani Ved, MHA, CPHQ, FHELA, director of transformational population health and outcomes at New Jersey-based Saint Peter’s, sees the benefits from a population health angle. AI, she says, can address care gaps caused by social determinants of health, giving providers insights into barriers and offering recommendations on care pathways.
For example, she says, AI might better identify patients who have transportation problems and need help getting to and from the hospital or doctor’s office. Or the technology could identify environmental hazards for patients with chronic conditions, such as air quality concerns for those with asthma or COPD, and help clinicians devise care plans that can address those hazards.
The key, both executives said, is in integrating the technology with current workflows and giving clinicians the support and education they need to use AI. That might mean pointing out to reluctant doctors and nurses how AI gives them important data and insights at the point of care, or, as Wells pointed out, sometimes reining in over-enthusiastic clinicians who have seen how AI works and want to move more quickly than standards or guidelines dictate.
As Danielle Bergman, MSN, APRN, FNP-BC, AVP of clinical development at Lightbeam Health Solutions, noted, AI has the potential to “offload mental bandwidth” for clinicians, allowing them to prioritize their time, giving them the tools to know what actions to take, enabling them to see which patients need more attention sooner, and identifying at-risk populations and events.
Transparency, Reliability, And That Ever-Elusive ROI
In care management, AI tools are only as good as the data they use. And that means making sure governance and continuous monitoring have high priority.
For Ved, that means making sure AI tools are kept up to date with the latest data, so that the insights they provide accurately reflect the populations they’re addressing. Health system and hospital leaders not only need to check the data (or, if working with a vendor, meet often to discuss data quality) but ensure that both patients and clinicians see that transparency.
Both Ved and Wells noted that as AI integrates into clinical care, the idea that the technology must produce a financial return on investment will grow fuzzy. That’s because benefits like improved clinical outcomes, better workflows and reduced provider stress and burnout don’t always show clear monetary results. And that’s where the industry’s move towards value-based care will help develop new definitions of ROI.
Ved points out that population health isn’t always about profit but more about outcomes – it won’t make money for hospitals, but it will save money in reduced expenses, from better healthcare management that reduces adverse health events like ED visits and hospital stays, to more proactive care that curbs chronic and preventable health concerns.
Wells says AI improves efficiency, which has clear financial benefits when a health system or hospital can reduce hospital stays, opening up beds for more patients in need of care and enabling more timely procedures and surgeries. At the same time is frees up clinicians to be better caregivers, reducing the stress around repetitive administrative tasks and helping executives manage their workforce.
Both see AI developing into a clinical decision support tool, not only giving clinicians the date they need for helping to point them in the right direction on treatment. As well, it will give consumers the insight they need to live healthier lives, empowering them to make better decisions and to have more valuable interactions with their doctors and nurses.
AI is being developed in the inpatient space to improve clinical care. Here's what you need to know.
Many of the early wins for AI in healthcare have come in administrative tasks, where the technology can gather and assess large amounts of data faster and more efficiently than humans. Now that the technology has evolved, clinical leadership is turning its focus to care management.
Ai offers a number of opportunities to improve clinical care, from tracking conversations and compiling transcripts to developing care summaries, facilitating handoffs and even coordinating patient outreach and communications.
This week’s HealthLeaders Winning Edge panel, sponsored by Lightbeam Health Solutions, will explore how health systems and hospitals are developing AI to handle those tasks, giving clinicians better, more complete patient histories and more time to spend with them, rather than on a computer. The panel will also discuss the challenges to using AI in the clinical space, including securing clinician support, educating clinicians on how to use these tools and facilitating workflow changes.
This week’s panel consists of Michael Wells, president of OSF Healthcare’s Saint Francis Medical Center in Peoria, Illinois; Ishani Ved, MHA, CPHQ, FHELA, director of transformational population health and outcomes for Saint Peter’s Healthcare System in New Jersey; and Danielle Bergman, MSN, APRN, FNP-BC, AVP of clinical development for Lightbeam Health Solutions.
Tune in Tuesday at 1 p.m. ET to learn how AI is helping leading health systems and hospitals improve their care management strategies.
Virginia Mason Franciscan Health, part of the CommonSpirit Health network, is eliminating 116 jobs and revising its virtual care strategy following passage of the Washington state budget, which officials estimate will cost the hospital $30 million annually.
A Washington health system is cutting 116 employees, many of them in virtual care services, to remain “financially sustainable.”
Virginia Mason Franciscan Health, a Seattle-based, 1,500-bed health system affiliated with CommonSpirit Health, announced the job cuts, which will affect some 200 people in total and close an office in Tacoma, on Thursday. In a letter to the public, officials said the hospital is “realigning resources and improving operational efficiency.”
Officials cited “significant financial pressures” for the realignment, in particular a new Washington state budget that would add new taxes and reduce reimbursements for care provided to state and school employees. Officials said the changes are expected to cost the health system an additional $30 million a year.
“To protect access to care long term, we are realigning resources and improving operational efficiency,” the letter reads. “This includes transitioning several virtual services and administrative functions, which will impact approximately 200 team members. Affected employees have been notified and are receiving personalized support, including placement assistance and access to open roles within our organization.”
The impact of the 2025-27 budget, which was approved in April, is being felt by hospitals across Washington. It includes, among other things, $100 million in cuts per year to hospital payment rates in public and school employee healthcare contracts, a 1% reduction in Medicaid managed care organization contracts, and the elimination of several post-acute and long-term care programs.
On top of state cuts, health systems and hospitals are eyeing potential federal cuts to Medicare, as well as the September 30 expiration of several pandemic-era waivers that expanded the scope and coverage of telehealth services that receive Medicare reimbursement.
Telehealth advocates have warned that hospitals would curtail or even cancel virtual care programs and strategies if those waivers were not extended or made permanent.
