Last November, in-home care provider DispatchHealth partnered with a payer and launched Advanced Care, its own hospital-at-home model.
The initial results of that model are in, after the provider “hospitalized” 27 patients within their own homes.
Of the patients treated at home by DispatchHealth’s team, none were readmitted to the hospital within a 30-day period, none died unexpectedly and none experienced a serious safety event. Additionally, only 7% of cases were escalated to the emergency department.
Another major result that further underscores the value of hospital-at-home models: DispatchHealth’s Advanced Care saved an average of $6,200 per individual by keeping them away from a traditional hospital setting.
“We’ve been successful in helping our patients with complex medical needs avoid unnecessary hospital admissions and post-acute facility-based care,” DispatchHealth CEO Dr. Mark Prather told Home Health Care News in an email. “These outcomes show we’re ready to continue leading the industry shift to provide more advanced clinical care in the home.”
Denver, Colorado-based DispatchHealth offers a variety of health care services in the home through its mobile, emergency medicine-trained teams. Those services, for example, include the delivery of IV fluids for seniors dealing with dehydration or intervening with cardiology-focused care when a patient is experiencing congestive heart failure exacerbations.
Once the provider’s services are requested — either via its mobile app or website — a care team arrives at the patient’s home, typically within a two-hour time frame.
The company is now in over 20 cities and continues to grow rapidly, especially as the ongoing COVID-19 crisis has kept seniors at home. Its first hospital-at-home program was focused in the Denver market, though more markets are likely on their way thanks to Advanced Care’s promising results and a recent influx of capital.
In June, DispatchHealth announced it had landed $135.8 million in growth capital led by Optum Ventures in a Series C funding round. Since it launched in 2013, DispatchHealth has raised more than $216.8 million in total.
Launching Advanced Care
For DispatchHealth, launching a hospital-at-home model was the next logical step to extending its services across the health care continuum, Dr. Patrick Kneeland, the company’s VP of medical affairs and its leader of the Advanced Care program, told HHCN.
“This is even more true with COVID, that if you give an option for safe, high-quality and reliable care in the home as a substitution for hospitalization, patients are likely to want that and like that,” Kneeland said. “And that’s certainly borne out. We similarly expect and have built a model that provides that high-quality, high-acuity care at a lesser cost than what it would be in an in-patient setting.”
The objective of the Advanced Care program is to effectively treat the more common issues among seniors that cause hospitalizations, such as COPD, pneumonia, heart failure and other, similarly severe conditions.
“In some ways it was a logical extension of the model that already existed,” Kneeland said. “And in other ways, it was a new opportunity to apply similar concepts to hospital-level care in the home.”
On average, patients within the program completed a high-acuity phase in 3.8 days and a transitional phase in 12.5 days with care from a team of nurses, advanced practice providers, therapists and physicians.
Because DispatchHealth’s background is in at-home urgent care, its referral system works seamlessly with its new model.
About two-thirds of its referrals are from within its own network, with one-third coming from primary care providers (PCPs) that are now familiar with the Advanced Care option for their patients.
And that one-third from PCPs is increasing quickly, Kneeland said.
Historically, a “predictable percentage” of patients within each of DispatchHealth’s markets would have a condition that caused an escalation that required hospitalized care. Now, the alternative is for the on-site team to report back the condition of the patient and see if they are fit for the Advanced Care model.
“At that point, we actually walk through a set of evidence-based algorithms that we’ve created and integrated into our software platform to check for clinical safety,” Kneeland said.
The Advanced Care model is built for high-acuity patients, but not for patients who will need to be transferred to the ICU, for example.
DispatchHealth also conducts an environmental risk assessment to ensure that the home is suited for a multiple-day hospital-at-home plan of care.
The data that has come back from Advanced Care in its early stages puts it ahead of a lot of similar programs, Kneeland said. For instance, 30-day readmission rates are significantly lower than what DispatchHealth has observed in those other programs.
“We were aiming to achieve outcomes like this,” Kneeland said. “At the same time, I think what we’re seeing is probably more impressive than what myself or other team members maybe would have expected in terms of those outcomes. And we do think we’ll be able to continue to achieve these outcomes as we scale.”
Outcomes lead to scale
Dispatch Health is building momentum off the data and the outcomes it has achieved in its patients.
In August, the Pacific Northwest-based health system MultiCare reported that its urgent care partnership with DispatchHealth led to a reduction of $1,509 in cost, on average, per patient.
That led to MultiCare’s interest in working on a hospital-at-home program with DispatchHealth. The company is now hoping to scale the model across more of its current markets, and new markets as well, as its footprint expands.
“There’s a lot of interest in this model, and there’s a lot of folks who are wanting to work with DispatchHealth, whether they’re payer partners or health systems,” Kneeland said. “We’re in discussions right now with a number of groups.”
In the coming weeks, it’s set to announce its most recent partnership, which should be launching next month.
Additionally, DispatchHealth hopes to launch Advanced Care in at least four new markets in 2021.