The vast majority of U.S. health care consumers would prefer to receive care in the comfort of their own homes instead of a medical facility. Most payers, too, see the home as the safest and most cost-effective site of care.
That’s according to a new report unveiled Wednesday by CareCentrix, a national at-home care organization that manages more than 26 million lives across over 8,000 provider locations.
While the coronavirus has solidified those views, the bulk of consumers and payers began to support in-home care long before the calendar turned to 2020, CareCentrix CEO John Driscoll told Home Health Care News. That’s partly why, he said, the Hartford, Connecticut-based CareCentrix has invested so heavily in the technology, data and ancillary services needed to support home-based care.
“We at CareCentrix believe that care at home should be the main course, not an alternative dessert,” Driscoll said.
Originally founded in 1996 by major home health provider Gentiva, CareCentrix coordinates a wide range of services delivered in the home — everything from traditional post-acute care services to innovative community-based palliative care models and more.
Since then, the Summit Partners-backed CareCentrix has grown to a company that does “a couple billion dollars in revenues” each year, according to Driscoll, who took over as CEO in 2013.
“We want to be the ‘connective tissue’ that provides the care management, data and analytics as part of this care-traffic-control [concept],” he said. “We want to support plans and their goals of transitioning more care into the home. And we want to support patients with the information they need to make sure they’re getting what they deserve.”
To better understand the U.S. health care system’s shift toward the home, CareCentrix enlisted Quadrant Strategies to poll 1,000 U.S. adults on their care preferences and perceptions. At the same time, the company teamed up with KRC Research to survey several dozen health plan executives on how home-based care fits into their current and future strategies.
The findings couldn’t be any more encouraging for in-home care providers.
“What jumped out at me in this report was how high the demand is for home alternatives for patients — and how clear plans were that more options need to be provided,” Driscoll said.
Consumers call for more
For years prior to the COVID-19 pandemic, it had been widely reported that Americans would rather age in place than move into a senior living community or nursing home. But as consumers live through the ongoing public health emergency and read about the dangers of facility-based care, many are hoping all health care shifts into the home.
Of the 1,000 adults surveyed by CareCentrix and Quadrant Strategies, nearly three-quarters said they would prefer recovering at home instead of a medical facility following a serious health event.
Additionally, nearly seven in 10 said they would prefer to get health care at home if their other options included a trip to the doctor’s office, hospital or skilled nursing facility (SNF).
The U.S. set another single-day record for coronavirus cases on Tuesday, as the total number of new infections exceeded 136,000, according to Johns Hopkins data. There have been more than 10 million cases overall, with many linked to long-term and acute care facilities.
As hospitals again face capacity problems, some have turned to technology to monitor patients in the home setting. But that only goes so far, according to Driscoll.
“COVID exposes both the opportunity and the challenge to provide more care at home,” he said. “COVID accelerated telehealth, for example, but it has also exposed the fact that you do need a partner like CareCentrix — or somebody like us — to provide the support, the management and the follow-on care to make sure patients aren’t lost.”
While consumers are interested in receiving intermittent care in the home, perhaps in the form of increasingly popular hospital-at-home or SNF-at-home models, they’re also open to more preventive-focused care, the CareCentrix report suggests.
Of those surveyed by CareCentrix and Quadrant Strategies, 63% of consumers said they would prefer to get preventive care at home to avoid the doctor or a hospitalization. Their interest isn’t limited to traditional home health or home care services, either.
Broadly, the report suggests consumers want to receive a variety of services in the home, including physical and occupational therapy, as well as mental health support, nutrition assistance and chronic disease management.
That’s one of the reasons CareCentrix recently expanded into palliative care, acquiring Turn-Key Health in May.
Payers eager to embrace home care
Arguably, the most exciting highlight from the CareCentrix report is how bullish payers are on home-based care.
Of the 76 health plan executives that CareCentrix and KRC Research spoke with, 97% said they agreed that more care at home is better for insurers and their members. A similarly high percentage said they agreed that treating members at home is often more cost effective in the long term than treating them in a facility.
“I think the message from health plans is that, universally, they want to transition more care to the home,” Driscoll said. “But as you get into the details, they’re clearly going to need partners to help them get there.”
CareCentrix — recently rumored to be on Anthem Inc.’s acquisition wish list — has seen that heightened interest firsthand.
Historically, the company has predominantly operated in the fee-for-service and commercial spaces, Driscoll explained. Currently, though, 80% of its new business is coming in the form of Medicare and Medicaid managed care, plus new value-based care agreements.
When it comes to technology, 91% of surveyed payers said advancement in telehealth or remote care monitoring has encouraged them to shift care into the home. Almost all of them said telehealth and remote monitoring have now made it easier to provide continuous care in the home.
“As our technology gets better, you should be able to do more and more at home,” Leslie Norwalk, former acting administrator for the U.S. Centers for Medicare & Medicaid Services (CMS) under President George W. Bush, said in the report. “And the more of that you can do in a setting that’s the patient’s home, the better.”
Of the payers surveyed, 49% said they have already increased the availability of at-home health care options for their members where possible. Nearly one in three are in the process of increasing at-home care options.
More than anything, payers want in-home care partners that can demonstrate cost reductions and provide smooth hospital-to-home transitions, the report states. Additionally, payers want partners that can control long-term costs and reach members wherever they’re located.
Having experience in both government and commercial lines of business is also a positive, according to the report.
“We’ve continued to invest in providing more options to patients and plans,” Driscoll said. “We’ve continued to invest in providing care in the home.”
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