A pilot program between Cedars-Sinai’s Medical Center, Honor and 24Hr HomeCare has evolved into a full-fledged partnership.
The program between the three companies offers additional support to the Los Angeles-based hospital’s high-risk discharged patient population by extending Cedars-Sinai’s care management services through the use of non-clinical caregivers, referred to as “Care Extenders” under the partnership.
Home care services were provided by both 24Hr HomeCare and Honor in similar capacities.
“The overall idea of it was to be able to extend [Cedars-Sinai’s] eyes and ears into the home, be able to improve some of those outcomes and control some of those costs,” Zachary Morgan, regional director of strategy and partnerships at 24Hr HomeCare, told Home Health Care News.
El Segundo, California-based 24Hr HomeCare is a private duty in-home care company. In 2017, the provider served about 5,000 private-pay clients across its offices in California, Arizona and Texas. Among its offerings, 24Hr HomeCare provides companionship, transportation and meal preparation services. It was recently named one of the fastest growing U.S. companies in 2018, according to Inc. magazine.
Cedars-Sinai Medical Center is a part of the Cedars-Sinai Health System. Throughout its operations, the health system serves more than 1 million people each year across more than 40 locations, working with more than 4,500 physicians and nurses.
San Francisco-based Honor — backed by $115 million in venture capital since launching in 2014 — is a non-medical home care company that provides care to clients in California, Texas and New Mexico. As part of its business model, Honor partners with local home care agencies to manage their caregiver recruiting, scheduling, payroll and other back-office logistics, while also sharing from its large pool of care professionals.
The three-way program between 24Hr HomeCare, Cedars-Sinai and Honor focuses on patients with multiple comorbidities, including those managing conditions such as diabetes, asthma and heart failure. The program also provides care for patients with challenging social and economic circumstances, frail patients and patients who have generally experienced acute or catastrophic events, Kelley Hart, executive director of care coordination at Cedars-Sinai Medical Network, told HHCN via email.
“I would say that we learned the value of having a partner who could be in the patient’s home as an extension of the office-based care manager,” Hart said. “We saw the positive impact of having patients return to their homes instead of going to another level of care.”
Specifically, the program targeted Cedars-Sinai’s full-risk United Healthcare Medicare Advantage population of 2,800 patients.
For 24Hr HomeCare and Honor, the pilot was a perfect opportunity to showcase to patients and hospital systems the benefit of home care, executives from each told HHCN.
The 30-day acute-care episode rate was 14% under the Care Extender program, according to 24Hr HomeCare, well-below the general population’s acute-care episode rate of 18%.
Preventing patients from returning to the hospital after discharges — an idea that has become a rallying cry for home health and home care agencies alike — is a key part of the shift toward value-based care. Moving forward, health systems that are able to successfully slash readmission rates will thrive, while those that cannot will likely suffer penalties and payment reductions.
“Cedars-Sinai is another example of a progressive health care organization setting new standards for quality and innovation in patient care, ” Nita Sommers, president of Honor, told HHCN via email. “Their commitment to Care Extenders demonstrates the critical value of providing qualified, in-home care to help older patients recover and reduce re-admissions rates. We believe this is one of the best practices for ensuring an optimal care experience from in-hospital to in-home care.”
Hospital readmissions cost Medicare about $26 billion annually, with about $17 billion spent on avoidable hospital trips after discharge, according to data from the Center for Health Information and Analysis.
Humana, Inc. (NYSE: HUM) and other insurance giants have previously highlighted their interest in working with organizations that have proven methods for curbing hospital readmissions. Humana, in particular, has turned its attention to home-based care.
Decreasing SNF stays
Cedars-Sinai has formalized the Care Extender program and plans to roll out services to its patients in November.
The total costs associated with initially testing the program were slightly more than $28,000, or roughly the average cost of one United Healthcare admission to Cedars-Sinai, according to data provided by Cedars-Sinai Finance.
Cedars-Sinai used foundation funds to pay for the pilot.
“When we started this pilot program, the belief was that we could provide a much-needed service to patients who needed a little extra assistance to get by and remain in their homes,” Hart said. “With the rising cost of health care, we all need to think outside the box and find ways to lower the cost of care while improving the quality of care patients receive.”
In addition to reducing acute-care episode rates, the Care Extender program was also shown to shorten the number of days patients spent in skilled nursing facilities (SNFs). Under the program, SNF length of stay was decreased by one day, dropping from 22 days to 21 days.
Cedars-Sinai wasn’t alone in reaping the benefits from the partnership, as patients seemed to appreciate the Care Extender program, leading to potential new business opportunities for both 24Hr HomeCare and Honor.
In some cases, patients hired a care provider to stick around longer after experiencing the benefit of having one in their homes, Hart said.
“We received a greater than 80% extremely satisfied response from those patients who experienced the Care Extender program,” she said.
24Hr HomeCare and Honor were chosen after a selection committee interviewed agencies that sent proposals to partner with Cedars-Sinai.
Leaders from 24Hr HomeCare and Cedars-Sinai were keynote speakers for a recent C-Suite Invitational Event in Oakland. The event was the first time that Cedars-Sinai and 24Hr HomeCare had publicly spoken about the hospital and home care collaboration.
Written by Kaitlyn Mattson