Why Home Healthcare is Exploding
Guest Column by Steven Wogen, Chief Growth Officer, CareCentrix
When it comes to healing, there’s no place like home. It’s where many of us would prefer 
to be as we age or recover from an illness or hospitalization, and, as it turns out, it usually costs less and is more convenient. For decades, the home was where patients healed — and, quite frankly, died. The emergence of the acute care hospital system changed all of that, and facility-based care became the norm. Fortunately, for those of us who would like to heal and age in the comfort of our homes, shifts in health care delivery and advances in technology are making it increasingly easier to obtain high-quality care at home again.
Home-based health care is the fastest-growing segment of care in the U.S. today. From 2010-2019, it’s projected to grow at more than 9 percent on a compound annual growth rate. In the last several years, there have been more than 2,000 new home health agencies in the market — approaching 13,000 today — and while most of them are smaller, mom-and-pop organizations, some larger organizations are beginning to emerge through a combination of consolidation and organic growth.
The health care system is recognizing the power of home-based care in promoting healing and aging. New government, delivery system and payer programs are focusing on coordinating care in home and community-based settings and improving care transitions.
Sudden Shift or Inevitable Trend?
The question is, why the sudden shift to receiving care in the home? And how is it better for us?
There are a lot of answers to that, but one is basic demographics. The U.S. population in general is getting older, sicker and, honestly, fatter. We’re living longer. The Medicare population is growing by 10,000 patients per day, and it’s going to double by 2020. This creates strain on our hospitals, nursing homes and caregivers. It also significantly increases costs, which can be reduced through improved care coordination models that leverage the home. We need alternative care models.
Additionally, studies indicate that $45-$75 billion in costs could be cut simply by better coordinating care, and using the home is a logical choice. But coordination and follow up are critical. 50 percent of patients discharged from acute care in a hospital don’t follow up with their physicians. Sixty-four percent don’t take medications appropriately after discharge. Caregivers are stressed to provide the level of support care necessary; in fact, it is estimated that nearly $34 billion is lost each year in employee productivity due to caregivers supporting an elderly parent or relative.
Home care is also generally more cost-effective. Up to 50 percent of all care costs are for care that occurs after a hospitalization. A day of care at home costs about 25 percent of what the cost would be within a skilled nursing facility and about 5 percent of what it would be in an acute care facility.
The Next Best Thing To Being There
So if home health care is the answer to happier patients and lower costs, how do we make it work? How do we help people more effectively transition to (and remain in) their homes, while facing the reality that there has been a dramatic shift in the ratio of people who need care versus those able to give it?
The answer is in technology. In addition to advances in equipment that enable more care to be done at home, new technologies enable us to have caregivers monitor what’s happening in a home-based setting from afar. Using remote monitoring, wearable devices, connected patient surveys and a host of other technology-driven tools, caregivers can monitor home care and manage potential adverse events and chronic conditions on an exception basis. The data created can be used for predictive analytical models that further enhance care and help us get the right care to the right patients in the future.
We can diagnose illness in the home through remote tests supported by secure messaging. We can, via video-chats from a tablet or our television, consult with a nurse or physician seamlessly. And when the time comes, we can support patients by enabling dying at home with dignity. All this technology enables one common purpose: improve the patient and caregiver experience while also driving efficiency in the overall health care delivery system.
Of course, there are and will continue to be challenges to the new trend in home and community-based care, and we will need to view it differently than we have in the past. For example, we will need to carefully coordinate resources, better engage caregivers and care teams using standard care plans, train nurses and caregivers on new standards for what care can be delivered safely in the home, and ensure accurate administration of care. Government regulations and reimbursement policies may have to change as well — although that is already beginning to happen as more people see the value of value-based and home care models.
In the end, it is about patients, their health and their satisfaction. Home care is overall more pleasant, it’s more personalized, and it can show better results than facility-based care. Patients engage more in self-care when they’re able to heal at home. In fact, studies show that patients are four times more likely to engage in care at home — and with outcomes as good or even better.
But arguably the most important driver in the home health care trend isn’t just the cost savings and improved quality of care, but a consumer base that’s ready for it. According to a study by PricewaterhouseCoopers, 82 percent of seniors in the U.S. said they would prefer to stay in their own homes, even if they needed additional support or health care. And that’s worth paying attention to.
About the Author
Steve Wogen brings more than 20 years of experience in healthcare leadership to CareCentrix. As Chief Growth Officer, he is responsible for medical economics, new product development and the HomeSTAR® program.Steve comes to CareCentrix from Express Scripts, formerly Medco Health Solutions, where he was the SVP/GM for Prescription Drug Plan and Retiree Solutions, and led the integration of the companies’ retiree business lines. He led the launch of Medco’s Prescription Drug Plan and employer sponsored retiree products, which he grew to a $4 Billion business; became CFO of the Retiree Division and directed the cross-functional team responsible for launch of Medco’s Medicaid strategy and operational model. Previously, Steve was Regional Director of Medical Economics at Cigna.Steve holds a bachelor’s degree in economics and medical ethics from Davidson College in Davidson, NC, and a master’s in health administration from the Medical College of Virginia, in Richmond, VA. He has published and presented his work on electronic prescribing, the value of pharmaceuticals in care management, Medicare Part D and efficiency in healthcare delivery.
About CareCentrix
CareCentrix is a leader in managing care transitions to the home. Headquartered in Hartford, Conn., CareCentrix has approximately 1,400 employees and a nationwide network of nearly 8,000 credentialed provider locations. CareCentrix serves leading health plans across the U.S. with a range of products and services that leverage the home and community-based settings. www.carecentrix.com.
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