Why Sutter Health, CVS See the Home as a ‘Mainstream’ Site of Care

On the same day a CVS Health (NYSE: CVS) executive emphasized the company only invests time and resources in its most fervent business beliefs, another exec ambitiously spoke about its at-home care plans. 

Speaking at HLTH this week, executives from CVS and other health care organizations held a discussion about managing chronic conditions in the home. While each vied for more home-friendly payment systems, they also all waxed poetic about the future of health care in the home.  

“I would tell you that we are 1,000% more passionate than ever about [the home],” Lisa Rometty, the president of CVS Health’s kidney care division, said at the conference. “What I really am encouraged by is that we have got such great partners – health systems and all different kinds of companies. And I think that is how we’re going to make home a mainstream site of care well beyond COVID.”

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Getting into patients’ homes is one of the keys to managing chronic conditions, Rometty said, hinting that CVS Health may be open to more home-based care partnerships in the future.

At-home kidney care has become more popular in recent years, and CVS Health’s investments have reflected that. Nine out of 10 people with kidney disease do not even know that they have it, Rometty explained, which ends up costing the health care system a lot of money over time.

“It’s really about having the right education to help patients feel good about being home,” she said. “It’s about having the right technology and infrastructure in order to do that, and it really is about those payment systems. … And I think if anything, COVID has shown us that we can do a lot more things from home than we ever thought that we could.”

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It’s not just kidney care that can be advanced in the home over the coming years, however. Virtually any kind of disease management works better in the context of the home, Chris Waugh, the chief design and innovation officer at Sutter Health, said at HLTH.

“I don’t know that there’s a chronic disease that doesn’t benefit from home care,” Waugh said. “I think anyone, with the context of where someone lives and the context of what’s surrounding them, is going to be better off than if we’re isolating them and taking them out of their natural habitat.”

Based in Sacramento, Sutter Health is a nonprofit health system that serves 22 counties across California and 3 million people. Its network includes hospitals, medical foundations, ambulatory surgery centers, walk-in care centers, as well as home health and hospice services.

“In the home, you can walk in and go right into the pantry. So if you’re talking about food habits, let’s take a look at that pantry,” Waugh said. “Let’s look at if the home is safe to [avoid falls]. Let’s see what medical devices are necessary and whatnot. It’s being the eyes and ears of the home to me, and it raises the empathy quotient on the care team side, because you can see the context of what you’re dealing with.”

Driving payment solutions

Most health care players that are becoming involved in the home will say that they had plans to do so before COVID-19. While that may be true, the health care environment that COVID-19 brought with it allowed them to do things they likely would not have been able to otherwise.

In the end, it created what Waugh called a “migration.”

“We’ve seen this migration, and we’ll continue to see it,” he said. “From hospital, to ambulatory, to home. COVID has obviously driven the home because we’ve seen a lot of chronic disease patients where it was too difficult or dangerous for them to receive care elsewhere. And so those chronic disease patients needed that home care.”

Two things fueled the opportunity for more home-based care investment: waivers and more viable reimbursement provisions, such as the Centers for Medicare & Medicaid Services’ (CMS) hospital-at-home waiver and new telehealth flexibilities.

“All of this allowed us to go into homes, and it turns out, that’s just the right place to be,” Waugh said.

The next big step, though, will be vying for fair payment once the COVID-19 crisis is no longer.

Some health systems have described the impending end of the public health emergency as a “regulatory cliff.”

“Right now, it’s about proving it and bending the cost curve,” Waugh said. “One of the biggest payers of health care is the government. So proving right now that you can get better health outcomes at home is what’s urgent and pressing, in order to make sure that we continue to reinforce this from an economic perspective. That will be critical moving forward.”

Groups of home-based care providers such as the newly formed Advanced Care at Home Coalition, as well as the Moving Health Home Coalition, have already begun work in Washington, D.C., to try to persuade lawmakers into more favorable home-based legislation past the COVID-19 crisis.

Even without that, though, it’s clear CVS – among others, like Sutter Health – will continue to focus on home-based care solutions anyway.

“[It’s about] being able to treat chronic patients and give them dignity and be able to give them a quality of life that they could not otherwise have,” Rometty said. “But it really is all about those payment systems.”

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