A New Mexico health care system reported findings in June that patients who receive home heath care rather than hospital care demonstrated 19% savings, CMIO reports.
The findings, published in the June edition of Health Affairs, indicate the savings were due in large part to lower average length of stay and fewer lab and diagnostics tests compared with patients in hospital acute care.
Presbyterian Health Services is a private, nonprofit system consisting of eight hospitals who adopted “Hospital at Home” in October 2008, a model developed by investigators at the Johns Hopkins University Schools of Medicine and Public Health, to serve an aging population with increasing prevalence of chronic disease.
The Hopkins group theorized that the hospital is an unsafe environment for many older adults and that most patients do not want to stay in a hospital, the authors wrote. “The [Hopkins] group speculated that these patients would instead do better at home, where providing acute care is far less expensive.”
Hospital at Home was initially open at PHS to Medicare Advantage and Medicaid members covered through Presbyterian Health Plan. The program expanded its coverage in November 2010 to include commercial health plan members through a bundled-payment rate reimbursing for the total care provided.
Nine diagnostics groups were selected based on suitability for at-home care and frequency of acute care admissions: exacerbations of congestive heart failure, chronic obstructive pulmonary disease, community-acquired pneumonia, cellulitis, deep venous thrombosis, pulmonary embolism, complicated urinary tract infection or urosepsis, nausea and vomiting and dehydration.
…For care provision measures, patients in Hospital at Home received an average of 3.5 physician visits and 6.4 nursing visits per admission, according to the authors. Eight patients (2.5 percent) were transferred to the hospital to complete their admission, mostly because their condition worsened. After-hours and unplanned patient visits because of additional assistance needs totaled fifteen nursing visits and three physician visits.
“Hospital at Home can provide integrated systems with the ability to manage and improve health across the continuum, while accounting for and reducing costs,” the authors concluded. “In response to the favorable results Presbyterian has seen for its Hospital at Home program, it has expanded the qualified patient population by increasing the catchment area, extending the time for accepted referrals, allowing participation from commercial health plan members, and adding more diagnoses to the Hospital at Home repertoire.”
Read the original article.
Written by Elizabeth Ecker