Home is where the health is: Home-based solutions revolutionizing care

As the shift continues towards home healthcare, providers need to deploy technology to face challenges and achieve a profound impact on patient outcomes.

Apr 24 245 min read

Kevin Riley

This article is part of Bringing Care Closer to Home - June/July 2024 COVERstory.

The healthcare industry is experiencing a significant transformation, transitioning from traditional facilities to more personalized, home-based care. This major shift, highlighted in McKinsey's February 2022 report, projects an annual increase in home care spending between $180 billion and $265 billion. This trend positions the home as a primary site for healthcare services and reflects a broader change in healthcare delivery.

Significant acquisitions and investments in the industry are a testament to this confidence in the future of home healthcare. CVS's $8 billion acquisition of HRA company Signify, Humana's acquisition of Kindred, and UnitedHealth Group's acquisitions of NaviHealth and Landmark illustrate the industry's substantial investments in this direction. Additionally, the rise of telehealth and virtual-first care models is reshaping the healthcare sector, emphasizing a model that prioritizes personalization, accessibility and integrated care.

The drivers behind the shift

This shift to home-based care is driven by various factors, including the aging population's desire to age in place, the increasing prevalence of chronic illnesses, and the digital transformation in healthcare. Telehealth and remote patient monitoring technologies play a pivotal role in facilitating this shift, offering innovative models of care that prioritize patient comfort and convenience.

Several significant challenges emerge as the industry shifts toward value-based payments, an approach designed to deliver higher-quality care at lower costs. While holding great promise for improving healthcare efficiency and patient outcomes, this transition involves navigating a landscape marked by complex management challenges, system-wide changes, and the need for new healthcare delivery and financing strategies.

Management challenges. Identified by the Department of Health and Human Services Office of Inspector General, these include overseeing health insurance marketplaces, transitioning to value-based payments, ensuring the appropriate use of prescription drugs in Medicare and Medicaid, and more.

Waste in health spending. In 2009, the Institute of Medicine concluded that a significant portion, estimated between 20 to 30 percent, of health expenditures in the United States, amounting to approximately $750 billion, was not used effectively. This finding highlights the critical need to shift towards more value-based and efficient healthcare practices.

Designing payment mechanisms. Creating payment models that incentivize quality outcomes and cost efficiencies while avoiding unintended outcomes like over-utilization or under-provision of care is a complex challenge. This includes managing risks associated with hybrid models that combine fee-for-service and value-based payments.

Program design and integrity. Implementing new payment models within the expansive Medicare and Medicaid programs presents management and program integrity challenges. Continuous monitoring and adaptation of payment structures are required to mitigate emerging risks.

Progress in value-based care. Despite these challenges, there has been progress. For instance, the Pioneer Accountable Care Organization (ACO) program reported positive results in its first year, with all ACOs achieving quality goals and generating significant savings.

Navigating the complex dynamics

The transition towards home-based healthcare presents a blend of challenges and opportunities. Healthcare providers must navigate various factors to deliver care in home settings effectively.

Prioritization and population stratification. Developing effective strategies to identify patients who will benefit most from home-based care is essential. Evaluating patient needs and optimizing resource allocation are critical steps in this process.

Innovations in remote patient monitoring. Technological advancements are critical in monitoring patient health and coordinating care from a distance. The future of this technology is expected to become more specialized, enhancing personalized care in home settings.

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Optimizing digital and virtual care

Advanced solutions are being developed to enhance virtual health and value care strategies, enabling providers to engage effectively with patients in remote environments. These solutions are designed to fit seamlessly into both fee-for-service and value-based care models, ensuring providers can offer affordable, quality in-home care while maintaining positive margins.

The shift towards home-based healthcare has a profound impact on patient outcomes. Patients are more likely to engage actively in their treatment plans by providing care in a familiar and comfortable setting. This leads to better management of chronic conditions, reduces the likelihood of hospital readmissions and improves overall patient satisfaction.

Emerging platforms are revolutionizing home-based healthcare delivery by offering comprehensive services that range from routine care to specialized support for chronic conditions. These platforms aim to improve the quality of life for patients by bringing healthcare services directly to their homes. They are designed to be adaptable, ensuring personalized care that meets each patient's unique needs and supports the overarching goal of value-based healthcare.

Data and analytics play a crucial role in the effective delivery of home-based care. Healthcare providers can gain insights into patient behavior, treatment efficacy and potential health risks by leveraging data. This enables a more proactive approach to care, ensuring timely interventions are based on accurate, data-driven insights.

Patient engagement and education are essential components of successful home-based care. Educating patients about their health conditions and the importance of adherence to treatment plans empowers them to take an active role in their healthcare. This improves outcomes and enhances the patient's sense of control and satisfaction with their care.

Shaping the future of integrated home care

The transition to home-based healthcare reflects a commitment to adapting to the needs of modern patients, signifying a shift towards a more personalized, accessible and integrated approach.

This trend will continue to shape the future of healthcare delivery, fostering innovation and enhancing patient care, particularly in the context of outcomes-based healthcare models.

As the industry navigates this transition, the focus remains on delivering high-quality, patient-centered care that meets the population's evolving needs.

Kevin Riley is CEO and president of Zyter|TruCare.

Return to Bringing Care Closer to Home - June/July 2024 COVERstory.

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