ARTICLE | WEBINAR RECAP
Key Takeaways:
Over the years, home-based care has become a cost-effective option, in part due to the emergence of technologies like remote monitoring, telehealth, and technologies that enable critical social support.
Demand for home-based care models as a valuable alternative to facility care will also continue as the baby boomer population ages.
Layered on top of these trends was the COVID-19 pandemic, which transformed healthcare delivery with advancements that enabled comprehensive remote patient monitoring. These advancements have made it possible for home-based care models to address a wider array of conditions from chronic to acute.
"“When we say ‘home-based care models’, we’re not explicitly referring to hospital at home or something specific. We’re referring to the concept that you’re taking care previously delivered in an acute setting, and it’s now being delivered in the home.”
The number of providers and payers participating in home-based care is only going to grow from here, especially with the rise of Hospital at Home programs like the CMS Acute Care at Home waiver, which 400+ hospitals are currently participating in.
McKinsey & Company predicts that healthcare will continue to be delivered in the home, to the tune of $265 billion by 2025.
“Patient safety is now happening in the home, and we need to educate...these things all used to happen in the facility, and are now happening in the home. We really need to provide the full care team in the home with what they need.”
As this care continues to move into the home, there is one resource many providers and healthcare systems overlook– the role of the family and informal caregiver. If a patient is receiving care in the home, chances are very high that there is a spouse, adult child, or other family member living with them to help monitor and provide the care that is needed.
In home-based care models, providers and clinicians lose the constant monitoring and oversight that takes place in hospital and clinical settings. So, these caregivers really become so critical–they are the eyes and ears of what’s happening in that home. Even with the most advanced remote monitoring technology and regular check-ins, in complex care scenarios, every moment matters. And family members can often pick up on changes before anyone else, since they know the patient best. They can provide the best form of care management in the world.
For this reason, providers and clinicians should be recognizing caregivers as a critical extension of the care team in the home, and as a resource to document and communicate these critical pieces of information.
One of the primary challenges in a lot of today’s home-based care models is the burden placed on caregivers. These family members are expected to take on the physical, mental, emotional, and often clinical needs of the patient with little to no training or resources. This can cause a sense of overwhelm and lead caregivers to a state of burnout, which has been proven to result in worsened outcomes and higher healthcare costs.
CMS and the Biden administration have been very clear that efforts to reduce caregiver burden & burnout must be acknowledged with tangible options for support. For example, with the rise of HaH programs, President Biden and HHS communicated that participating hospitals must properly evaluate and set expectations for family caregivers, and should not “expect families to provide any care in the home, as that is the responsibility of hospital personnel.” They’re acknowledging that without support at home, these programs that are so beneficial to our healthcare system will burn caregivers out and become unscalable.
CMS continues to address this with investments in models that will empower the informal care team with innovative and accessible support. A new payment model from CMS, called GUIDE (Guiding an Improved Dementia Experience), places emphasis on caregiver supports including training, respite, expert guidance, and care navigation.
Throughout the webinar, the audience sent in lots of great, thoughtful questions. Our panelists didn’t have a chance to answer each question live, so we wanted to feature some of those questions below, with answers from our experts:
Barry Jacobs, Psy. D.: “The research is clear, and the research has been clear…different cultural groups have different cultural traditions, different cultural expectations. And as we get to know family caregivers in their individuality, we need to understand that. How those cultural traditions impact the way they’re going to approach caregiving.”
Dr. Marcy Carty: “What hospitals want to be able to do is know about the next bed. Is it open for that next patient? One of the things that myLaurel has started to do is just to say, how do we change that? To say, let’s take you out of the hospital 2 days early, do some of the work at home and then gradually pass things off to the family caregiver. How do you keep risk lives out of the inpatient world, keep people out of the ED, out of observation, or taking people home early.”
Dhruv Vasishtha: “I think the largest shift has been entry into risk based contracts for individuals where home care is a large component of the care model. One area that is emerging is also carving out risk for long term services and supports or home based care services where some companies believe we can lower overall costs by providing greater amount of home care.”
Dhruv Vasishtha: “Telehealth usage during COVID was a by-product really of the inability to receive routine outpatient care in-person. That being said the new baseline of telehealth is still much higher than where it was pre-COVID.
I think the difference between telehealth and home-based care is where there is a focus on in-person care delivery in the home vs. trying to virtualize or over-use telehealth in place of in-person care in the home.”
If you’re interested in learning more about empowering family caregivers in home-based care models, book a free consultation today.
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