One of the country’s most aggressive health systems in terms of moving care into the home is teaming up with a new technology partner that bills itself as “the Uber” of urgent care.
Earlier in June, Louisiana-based Ochsner Health System announced it has been working with Ready Responders to reduce preventable emergency department visits and further support patients during the COVID-19 emergency. The collaboration is just the latest example of Ochsner’s in-home care efforts, according to Harry Reese, who oversees the nonprofit health system’s post-acute and home care strategy.
“Ochsner is very aggressive in moving care into the home,” Reese told Home Health Care News. “I would say we’re probably one of the leading health care organizations in the nation when it comes to moving care into the home. We take on a lot of risk in our populations, … so our goal is finding ways to keep patients healthy, to keep them at home with a better quality of life.”
As a system, Ochsner and its 26,000 employees operate across Louisiana, Mississippi and other parts of the southern Gulf region. In 2019, Ochsner and its provider partners — which include home health, hospice and personal care powerhouse LHC Group Inc. (Nasdaq: LHCG) — cared for more than 876,000 people worldwide.
Meanwhile, Ready Responders — also based in Louisiana — provides on-demand urgent care, in-home testing services, post-hospital care and more in Louisiana, Nevada and New York, plus the major metropolitan markets around Los Angeles and Washington, D.C.
Ready Responders has raised roughly $53.4 million since launching in 2016. Sunday officially marked the two-year anniversary of Ready Responders caring for its first patient, co-founder and CEO Justin Dangel told HHCN.
“We can pretty much do anything you can do during a doctor’s visit, but in the home,” Dangel said.
‘The Uber’ of urgent care
The Ready Responders model works a little bit like ride-hailing giant Uber’s. The company coordinates a network of trained emergency medical technicians (EMTs), paramedics and nurses via its mobile app, sending those front-line workers into the home on an on-demand basis or for regularly scheduled check-ins.
“The best way to describe it would be like what Uber does for rideshare,” Reese said. “A patient calls in with conditions, is triaged and possibly determined appropriate for a home visit. Ready Responders then broadcasts that out to their network of EMTs to find the one who’s closest to the home, and then that person responds to the home, typically within 30 minutes or less.”
Ready Responders doesn’t just manage those EMTs, paramedics and nurses, however. It also arms them with remote testing kits and diagnostics devices from TytoCare.
Additionally, each of the company’s responders carries a tablet linked to doctors, mental health specialists and other clinical experts.
“Telehealth alone — without someone on the scene to do vitals and [without] the equipment we have — can only handle about 40% of what happens in a doctor’s office,” Dangel said. “Our focus is on the large number of patients who need care that’s more than what telehealth can do, who do not have a clinic option nearby. And there’s a lot of patients out here who may be unsafe to go to the hospital because they represent a high-risk category.”
To support patients and maintain adequate capacity within its hospitals, Ochsner is working with Ready Responders to do in-home COVID-19 testing and treatment. Overall, Louisiana has had more than 54,700 COVID-19 cases, with more than 3,000 deaths, according to the state’s public health department.
“New Orleans was one of the national hotspots for COVID. We got hit significantly,” Reese said. “The hospitals were challenged with capacity, especially the critical care units. We needed to continually find ways to add critical care capacity in our system. That forced us to find new ways to care for patients in the home, with people quarantined or afraid to go out in public.”
Yet the collaboration with Ready Responders is about much more than just the coronavirus.
While Ochsner Health System is using Ready Responders to do “pure on-demand urgent care in the home” and COVID-19 testing, it’s also leveraging the technology company for longitudinal, community-based care.
The goal: keeping Ochsner patients out of the emergency department whenever possible.
“The second program we do with Ready Responders is for patients who seem to be using the emergency department for primary care needs,” Reese said. “Ready Responders will make several visits to the home and speak with the patient. They’ll do telephonic follow-up discussions.”
During those community care visits, Ready Responders also goes into the home and addresses social determinants of health. That could mean helping an individual replace a lost Medicaid card or schedule a doctor’s appointment with a new physician.
So far, the partnership with Ready Responders has equated to “years’ worth of a cultural shift toward home care” in the span of only three months,” Reese said.
Results wise, Ochsner has been able to lower its non-emergency ED visits by upwards of 70%.
“We play heavily in risk-based populations, so one of the areas where we continually see opportunities is for us to reduce our avoidable ED utilization,” Reese said. “Despite our several years of building access and capacity in primary care [and] urgent care, and improving access to same-day visits, we basically didn’t see much of an impact on our emergency department volumes [until now].”
Ochsner’s home strategy
Across its market, Ready Responders normally serves between 300 to 500 patients per day. The majority of the company’s patients access its services through Medicaid, though Ready Responders also sees its fair share of Medicare and commercial insurance patients.
Besides Ochsner Health System, the company has partnerships with Valley Health System, MedStar Health and others. But its “biggest relationships” are with large payers, such as UnitedHealthcare and Centene (NYSE: CNC).
Ready Readers’ likewise routinely works with home health agencies, Dangle pointed out.
“We work quite a bit with home health agencies that will refer us patients who might need a doctor’s visit and might be hard to transport,” he said.
Largely due to the coronavirus, Ready Responders has seen a fivefold increase in its patient volumes since January.
Internally, Ochsner has launched a bevvy of in-home care initiatives over the past few years, according to Reese, who took over as VP of post-acute and home care more than three years ago. Prior to his current role, Reese served as CFO for Ochsner’s main campus and its surrounding clinics.
Ochsner’s home-focused efforts include investments in digital medicine technology to manage hypertensive and diabetic patients daily. They also include an in-home COPD program, along with nurse practitioner home visit programs for palliative care patients and individuals discharged with high-risk of readmission.
“We’ll go visit those patients and help manage them over a 30- to 60-day period to ensure that they better understand their disease and get them hooked up appropriately,” said Reese, who before joining Ochsner ran home health agencies in Florida.
The health system is also working on two SNF-at-home models, expecting to roll them out later this year. The diversion of skilled nursing facility (SNF) patients into the home setting is a macro-trend likely to play out over the next several years, HHCN previously reported.