UNC Health is throwing its hat in the hospital-at-home ring. The North Carolina-based health system announced Monday that it has plans to launch an acute hospital care at home program in partnership with Medically Home.
UNC Health is a state-owned integrated health care system based in Chapel Hill. The organization is made up of 12 hospitals, 350 clinics and various clinical programs from the University of North Carolina School of Medicine.
Meanwhile, Medically Home is a Boston-based company that brings acute-level care into the home. As part of its model, Medically Home sends clinicians into the home, along with technology, equipment, medication and supplies.
UNC Health will offer its acute care at home program to patients at two of its hospitals by mid-year. The plan is to eventually roll out the program at UNC Health’s 10 other hospitals over time.
As part of the new program, certain COVID-19 patients will now be able to receive medical services — including IV therapies, oxygen treatments and ultrasounds — in their homes. The program will also be for some non-COVID patients with conditions such as heart failure, pneumonia, COPD, cellulitis and more.
UNC Health physicians and nurses will monitor these patients 24/7 through Medically Home’s technology platform.
The program’s model of care is predominantly a 30-day length of stay, split between an acute phase and a restorative phase.
Generally, patients will be able to enter the program through two mechanisms, Matt Smith, UNC Health’s vice president for well care and specialty services, told Home Health Care News.
“One would be through the emergency department,” he said. “They would have an opportunity, through various screenings of acceptability for the program. The other option that we’re putting forward to utilize this infrastructure is a model of an early discharge. In that case, a patient would be able to be discharged early from the hospital, after they’ve stabilized, and would finish out the remainder of their stay in the home.”
Last year saw a number of health care organizations roll out hospital-at-home or similar programs in an attempt to lessen the capacity issues the COVID-19 emergency created.
UNC Health may be the latest health system to launch a hospital-at-home program, but even prior to the public health emergency, relieving capacity issues was top of mind.
“This came just from being a large academic health system in a growing area and in a state where there are laws and regulations around how many hospital beds you can build,” Smith said. “We looked at it as, if patients are clinically comfortable and able to be effectively cared for in the home, as an alternative care environment, it was best to build an infrastructure and offer that.”
In November, the U.S. Centers for Medicare & Medicaid Services (CMS) announced “unprecedented” flexibilities that would open doors for health organizations offering hospital-level care for patients in their homes.
Since then, CMS has approved at least 56 hospitals and health systems under its hospital-at-home initiative.
While UNC Health isn’t part of the new CMS initiative, Smith believes it’s a step forward.
“I think it only helps to think through the ability to care for more patients in this model,” he said. “The [ability] to leverage [hospital-at-home] and have it in communities is a great thing. It just helps support the initial direction we had taken.”
UNC Health does have plans to eventually apply for CMS’s waiver.
For now, UNC Health is looking to the future of its own hospital-at-home program. The health system is in talks with other North Carolina hospitals about offering the service in prospective partnership arrangements.
“We’re happy to explore this model with others,” Smith said. “Patients are often transferred to Chapel Hill or from other communities because of the care that can be provided. There are already existing partnerships in terms of the coordination of patient care. I think where we can save costs together is by creating a coordinated care team that can really do the same things for those communities.”
Ultimately, Smith believes that expanding these services locally is a net positive for patients and the organizations that would potentially partner with UNC Health.
“The more that this care model is out there, the better it is for patients. And the better it is for all of our health systems working within that,” he said.