Provider Brings Hospital Care to People’s Homes

Increasingly, providers are meeting consumer demand by offering more robust care in people’s homes. One company on the forefront of this trend is treating high acuity patients at home with a new model of care and the backing of venture capital.

Medically Home, a Westport, Connecticut-based technology-enabled services company, brings together care providers—including home health—to offer high quality care at home. It is essentially creating a “micro setting” of a hospital at home, according to CEO Richard Rakowski.

The story of Medically Home began eight years ago, when Rakowski lost his father to medical error in a hospital, and he set out to realize a new care concept. After spending nearly a year on research and development, the concept was tested in a pilot with Johns Hopkins—a pioneer in the hospital-at-home movement—before Medically Home started treating patients. The company raised $4 million in a series A funding round last fall, and while it is currently treating fewer than 100 people, has plans for growth.

“That’s the holy grail—everyone is moving care to home, and we went for the highest end,” he said.

Now, with its partner, Atrius Health—a Massachusetts nonprofit health care group with a network of more than 740,000 patients and a home health subsidiary, VNA Care—Medically Home is taking on patients who would otherwise receive inpatient care, and expanding to other hospital partners.

The model works on a 30-day care plan, at roughly 30% less cost compared with a hospital, according to Rakowski.

The model pulls care providers from all settings—physician oversight, therapy, home health care services, telehealth and more—to make the home a safe site of care. There are three components to the care, including supplies and services delivered at home, physician oversight with full integration into the care team, and a mission control team that is available at any time and connected digitally.

So far, the company has been taking on patients that meet their qualifications, which include ensuring that the home environment is stable enough to set up shop. Many of the patients are diagnosed with some of the most frequent causes of hospitalizations, including congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), pneumonia, sepsis, and diabetes.

Medically Home is soon adding the ability to take care of patients who underwent “a whole suite of surgical procedures,” such as total hip and knee replacements. The company expects to cover 100 diagnoses by the end of the year, Rakowski said.

While the model does not provide surgery in the home, the micro hospital units allow patients to receive all their outpatient care at home, enabling them to be discharged much sooner and skip further institutional care. Medically Home draws the line at pediatric care and ICU patients, Rakowski added.

The model, which breaks down some of the boundaries of the four walls of a hospital, somewhat follows Amazon’s direction—which broke up the brick and mortar requirements of retail past.

“The idea that a hospital is a more efficient way to deliver care is already debunked,” Rakowski said. “The Amazon model is you distribute the care rather than centralize it. All the fixed costs of the hospitals are saved to deliver care over a longer period.”

Medically Home even utilizes Amazon’s Alexa voice technology, which enables a patient and their family to connect, via a telehealth system, with a physician at any time, on demand. In addition to an iPad, the system can connect patients to their doctors if they have concerns or questions.

The cost to a patient is “on par with a deductible,” according to Rakowski, who said the company is working with insurance groups to design what the benefit looks like under a plan. However, he has his eyes set on Medicare reimbursement in the future.

“Medicare is our future,” he said. “We believe the Medicare level reimbursement will be in 16 months to 18 months.”

Though, he admits uncertainty with the federal government makes the outcome harder to predict.

So far, Medically Home is only available with Atrius patients who meet the standards in Massachusetts, but the company will launch in Indiana in March, and New Jersey later this year.

Investors appear to be drawn to the potential for technology to improve care coordination and keep people out of the hospital. Call9 is another example; the startup has raised $34 million and aims to prevent skilled nursing residents from going to the emergency room.

Written by Amy Baxter

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Amy Baxter
Assistant Editor at Home Health Care News
When not writing about all things home health, Amy fulfills her lifelong dream of becoming a pirate by sailing in regattas and enjoying rum. Fun fact: she sailed 333 miles across Lake Michigan in the Chicago Yacht Club "Race to Mackinac."