A partnership between a five-hospital health system and at-home care company DispatchHealth considerably reduced emergency-room admissions and cost while improving patient satisfaction.
Denver, Colorado-based DispatchHealth offers a variety of health care services in the home through its mobile, emergency medicine-trained teams. It contracts with health systems and health plans to ease the burden on patients, reduce costs and keep seniors away from institutional-based settings.
As part of its mission to shift care into the home and lower health care spending, DispatchHealth in late 2018 teamed up with Massachusetts-based Baystate Health, which serves 850,000 patients per year. The two highlighted key results from their partnership in a case study released earlier this week.
“Baystate reached out early on in our development, looking for a partner to help them move care into the community,” DispatchHealth CEO Dr. Mark Prather told Home Health Care News. “So we worked on the structure of that partnership and our focus areas. We wanted to help them with things like readmission reduction, ER utilization reduction and [improving] access for some of the more access-challenged members under their purview.”
After partnering with Baystate Health, DispatchHealth’s mobile care teams and at-home intervention were able to save $1,729 per patient visit in the health system’s value-based care program in calendar year 2019. Overall, DispatchHealth’s team diverted an estimated 2,191 emergency room visits for Baystate, according to the case study.
In total, DispatchHealth engaged in 3,436 patient encounters — on both a pre- and post-acute care basis — on behalf of Baystate over the time period observed.
“We provide a substitute in the home for emergency room care, for hospital admission and for skilled nursing facility admission,” Prather said. “And so this core model is an on-demand intervention that brings very high-acuity care and diagnostics into the home.”
DispatchHealth is currently in 29 markets across the U.S. It plans to be in 50 by the end of the year.
The majority of Baystate’s primary care revenue is generated from risk-based contracts. If DispatchHealth can improve outcomes at a lower cost, the partnership pays for itself.
“Serving [risk-based] patients is clearly a critical component of what we do as an organization,” Andrew W. Artenstein, the chief physician executive at Baystate Health, said in the case study. “Along with other critical services such as telehealth, paramedicine and urgent care, DispatchHealth has become a useful service in our repertoire to manage and serve the high-risk population.”
Baysate has 170,000 risk-based patients in Medicaid and Medicare accountable care organizations (ACOs), as well as commercial risk contracts.
“[The prevalence] of value-based care has been a major tailwind for us,” Prather said. “Because we can do this better, faster and cheaper.”
Within Baystate’s value-based care program specifically, DispatchHealth had 1,511 patient encounters in 2019. It diverted 1,058 ER visits, 330 emergency transportations and 178 hospital observation admissions.
Throughout the overall 3,436 patient encounters, DispatchHealth intervened to mitigate 742 emergency transports and 399 hospital observation admissions.
Before DispatchHealth was on board with Baystate, there were cases where patients would take an ambulance to the hospital, go to the emergency room and eventually be admitted, even if they were at their baseline state.
“In a lot of those cases, they can be treated in the home,” Amy Roy, the director of clinical integration at Baycare Health Partners, told HHCN. “You don’t have to pay for that ambulance ride and [everything else]. It’s much less expensive.”
Baycare Health Partners is the physician hospital organization of Baystate Health. Roy oversees the staff that play a major role in referring patients to DispatchHealth.
Adding an at-home care provider also helps Baystate get a far better understanding around the context of each patient, their conditions and their living situations, Roy added.
Prather echoed those sentiments.
“We can deliver the care much more cost effectively, but in a more patient-centric way, too,” he said. “When you think about bringing somebody into the home, you have a different perspective of that individual, and that individual is more comfortable and open with the providers. The providers see the patient in context, and that’s very important when you go to make your care plan.”
In addition to the cost-saving aspect of the Dispatch’s services, it also adds that element of comfort to patients’ care journey.
“It’s been amazing,” Roy said. “Patients are so excited to be able to stay at their home. But then also when people go into their home, they can see what their home environment is like. And there’s been a lot of things that we’ve been able to do with DispatchHealth that extends beyond just treating the acute condition.”
In November, Baystate added a third DispatchHealth mobile unit to their partnership, which will help cover more patients in the health system’s network.
DispatchHealth has also found success elsewhere with developing hospital-at-home programs with health plans and providers. And while it hasn’t implemented that yet with Baystate, both Roy and Prather believe the partnership has even more room to grow.
Likewise, its aspirations to reach 50 markets by the end of December also shows that interest elsewhere is increasing.
“COVID hasn’t necessarily been an accelerant to utilization,” Prather said. “However, what it has done is really bring visibility into what we’re doing. It’s much more obvious to people today why somebody would come to your home or that that is even an option. For us, I think it sparked awareness within the industry.”
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