Despite the considerable headwinds that COVID-19 has created for the U.S. health care system, there are still a few sectors in which investment remains strong.
Those areas include telehealth, behavioral health and artificial intelligence. Each has had steady backing since President Donald Trump declared a public health emergency in mid-March, according to a new report from the law firm Foley & Lardner.
While at-home care was not explicitly identified as one of the hottest investment targets in the report, home-based care agencies building out their operations could benefit by leaning into the aforementioned opportunities during the COVID-19 crisis, Chris Donovan, a partner at Foley & Lardner, told Home Health Care News.
Mental and behavioral health
Amid the public health emergency, many home health agencies have already started refocusing their operations to prioritize mental health issues.
Take AccentCare and Elara Caring, for instance. Both have been vamping up their mental health care plans due to COVID-19, they recently told HHCN.
“We are already dealing with patients who, for the most part, are homebound oftentimes due to other functional disabilities,” Dave Davis, chief clinical innovation officer at AccentCare, told HHCN. “There was already a layer of disconnect from their usual activities of daily living and communities. And then on top of this, having further isolation definitely exacerbates depression as well as anxiety.”
Moves by home-based care providers to embrace mental health could be wise from an investment perspective, according to the Foley & Lardner report.
Investment funding for mental and behavioral health startups hit a record high in the first quarter of 2020, according to the report, which is especially notable because of the economic downturn experienced everywhere else.
“While medical care providers are increasing their efforts to combat isolation and loneliness as Americans comply with state ‘“shelter in place’” orders, the mental health and behavioral health sectors are seeing increased investment activity including investment in startups along with established companies,” the report said.
While home-based care providers have started to introduce behavioral health initiatives more recently, many have been using telehealth for years. As such, agencies are no strangers to the benefits of telehealth or the obstacles that come with it.
Those challenges are especially prominent in home health right now. Despite recently loosening restrictions on telehealth in light of the coronavirus, the Centers for Medicare & Medicaid Services (CMS) still does not offer a pathway for providers to be reimbursed for remote visits.
Additionally, telehealth visits do not count toward providers’ LUPA thresholds.
On one hand, the continued investment in telehealth while home health agencies are unable to monetize it could be a cause for concern among industry stakeholders. But on the other hand, it could also push the pedal further to the floor on telehealth reimbursement advocacy.
On top of that, telemedicine adoption has been accelerated during the COVID-19 crisis, as home health agencies have implemented remote visits when possible as a way to cut down on person-to-person contact and the risk of virus transmission that comes with it.
“I see telemedicine as really having turned the corner, due to both payer and patient acceptance during COVID-19,” Donovan told HHCN. “The convenience, cost savings, safety and flexibility of this modality will be difficult to roll back. Regulators have the same tools to prevent abuse as with in-person treatment … It will [also] have great reach and application in payment and certain diagnostic areas.”
As health care at large is becoming more remote, home health agencies should continue to invest in their telehealth capabilities so they can be ready to provide those services when and if CMS allows them to be reimbursed properly.
“CMS has issued new waivers under its interim rule,” Donovan said. “If [those] waivers stick post-COVID-19, providers that have invested will be at a competitive cost and service advantage. Moreover, if payment is capitated or at-risk under a bundle or value model, the cost saving of remote monitoring and telemedicine will be central cost and outcomes tools in the future.”
While much of it is out of providers’ control, home health agencies don’t want to be left behind as the telehealth wave gets closer to shore.
Artificial intelligence (AI) in health care will likely continue growing despite COVID-19, the Foley and Lardner report predicts. Growth in the AI health care market is expected to reach $6.6 billion by next year.
“AI will be an attractive tool to home health in two areas: payment and treatment,” Donovan said. “AI and machine-learned tools that drive efficient revenue cycle management, coding and diagnosis will drive great efficiency in home health beyond the current dominant software platforms. AI models that provide predictive analytics that limit hospital admission or readmission will drive higher quality outcomes that agencies can use to rationalize higher pricing with commercial payers and referral/discharge sources.”
Many home health providers have already begun partnering with predictive analytics companies, including Nashville, Tennessee-based Medalogix.
The investment world is telling a story about what the future of health care will look like after COVID-19. If they have the capabilities, home health agencies should listen.