When Quincy Medical Group (QMG) began developing a hospital-at-home program over a year ago, it recognized the concept as a way to reduce costs and risk, while simultaneously increasing hospital capacity and supporting a seamless transition of care.
But in a broader sense, QMG wanted to stick to its commitment to “transform health care” — and that’s why it began investing in the home. That’s also why the organization is clear about its hospital-at-home program’s origins.
QMG had been looking to implement something similar for at least three years. The program is coming to fruition at the peak of the COVID-19 pandemic, but that is merely a coincidence.
After a sit down with Dr. Tom Price — who formerly served as the secretary of the U.S. Department of Health and Human Services (HHS) — its physician-led board decided to pursue what was then an out-of-the-box option and invest in hospital-level care at home.
“The board has had a main purpose of delivering quality health care more cost effectively,” QMG Interim Chief Medical Officer Dr. Rick Noble told Home Health Care News. “We realized the federal government was looking at all out-of-the-box options on being able to deliver quality care, … and that’s when we started looking at the hospital-at-home model.”
Quincy, Illinois-based QMG has over 155 doctors, nurse practitioners and physician assistants that offer care to about 250,000 people in 16 locations throughout Illinois, Iowa and Missouri.
Hospital-at-home models have always made sense, at least from cost-savings, comfortability and logistical standpoints. What was lagging was a reimbursement method from the U.S. Centers for Medicare & Medicaid Services (CMS) that made it worth it.
That has begun to change, and CMS has now approved over 50 hospitals under its new hospital-at-home initiative. Dubbed “Acute Hospital Care at Home,” the initiative is designed to give hospitals unprecedented flexibilities to treat hospital patients where they live.
“We thought that the federal government may at some point in time be moving toward this type of a program,” Noble said. “And so we stuck to it.”
John Hopkins and others pioneered the model in the 90s, with Mount Sinai and others hopping on board since.
QMG will be doing the same. It has entered into a licensing agreement with Johns Hopkins to facilitate its own version of the organization’s hospital-at-home model.
“This way, we won’t have to reinvent the wheel,” Noble said. “We basically purchased their best care protocols that we’re going to implement.”
It’s been a process that’s taken over two-and-a-half years to materialize. QMG is hoping to be fully operational with its program by mid- to late-2021.
“I think we were way out ahead of the curve,” Noble said. “We started it for the right reasons. And then all of a sudden, here’s a situation that shows not only us — but hopefully others such as CMS — that these programs are really needed and that they should be reimbursed. Because this isn’t going to be the last health issue that’s going to occur in the next 50 years and put a burden on our health care system.”
QMG put out a press release announcing its hospital-at-home efforts in November, though the program is not fully operational yet.
It did so because it wants to accomplish a few things first through awareness, Noble noted.
“What we want people to know is that they can expect change to occur, that we in the health care community are fluid, and we’re willing to change and look outside the box,” Noble said. “We don’t want to feel like they only have one option. I want them to know that we are proactively looking at a way to [make sure they have options] in the future.”
Generally, the hospital-at-home program is set to treat low-acuity patients that would normally have shorter hospital stays. For instance, patients who have mild congestive heart failure, shortness of breath, COPD, emphysema, skin infections or pneumonia, among other conditions.
Those patients, if they qualify and would like to be treated in the home, will be overseen by a team of physicians, therapists, nurses and rehab specialists when applicable.
“If we can really refine this and allow physicians to lead, it will just show how much we can change the scope of healthcare delivery,” Noble said. “And it’ll benefit us down the road as well.”