A big part of the evolution of health systems has been more meaningful engagement with the home as an extension of brick-and-mortar operations. In recent years, organizations like Advocate Health and Mass General Brigham have exemplified this shift.

These major health systems are reevaluating their home-based care capabilities and partnerships, and leveraging technology and innovative care models–including hospital-at-home–to enable more integrated and cost-efficient services.

These health systems are on the leading edge of this trend and could play a significant role in shaping the role that the home plays as a site of care, particularly in light of research efforts tied to their efforts.

These were among the key points that leaders with both Advocate and Mass General Brigham recently made during a panel discussion at the WTWH Media CONTINUUM Conference in Arlington, Virginia.

Advocate leverages scale

Since combining with Atrium Health in 2022, building out a care-at-home platform has been a major area of focus for Advocate Health. The combination of Advocate Aurora Health and Atrium Health created the third-largest U.S. nonprofit health system, serving nearly 5.4 million unique patients across Alabama, Georgia, Illinois, North Carolina, South Carolina and Wisconsin, according to the organization’s website.

“Right now, [we’re] looking at every single one of our markets, identifying all of the home-based programs and services, inventorying them, and then making decisions about where the gaps are, and then what programs need to be scaled,” Denise Keefe, the senior vice president of continuing health at Advocate Health, said during a panel discussion at the recent WTWH Media CONTINUUM conference.

Indeed, Advocate Health is in the process of scaling its hospital at home program to Wake Forest. The program already has a robust presence in the Charlotte market.

Plus, the health system is looking at the Chicago market to identify opportunities there as well.

From a technology perspective, Advocate Health is also moving to develop care navigation capabilities.

“The ideal is that you have these longitudinal plans of care for patients, and you can move them between and among all of our care-at-home platforms to prevent that patient from going back to the hospital,” Keefe said. “That’s the work that we’re doing. Historically, we have been able to connect one or two nodes, if you will, so from home health to hospice, or from the skilled nursing facility to home health. Maybe we can do three. But to look at the patient holistically, and then guide them through that path in a seamless way, is the future state.”

On the operations side, Advocate Health has been able to place all of its care-at-home programs and services under a single leadership structure. The organization is also standardizing all of its processes.

Another aspect of combining with Atrium Health is figuring out financial synergies, according to Keefe.

“Whenever you bring organizations together you look for synergies, and we’ve identified and quantified some really great financial synergies as we continue to invest deeper into the integration work,” she said. “I’m excited about what’s to come because I think when you have that kind of scale, it does enable you to make investments.”

Studying short-term rehab care at home

On its end, Mass General Brigham is centering the home through a recent grant award.

In August, the organization was awarded $4.6 million from the Massachusetts Executive Office of Health and Human Services to study short-term rehab at home. The study is a randomized controlled trial that examines the impact of delivering short-term rehab care at home compared to a traditional post-acute care setting.

“We have five different hospitals that we are running it through, so it’s not just our system,” Danny Metzger-Traber, vice president of strategic business operations at Mass General Brigham Healthcare at Home, said during the panel discussion. “We’re working with some other peers in the area. The idea is that this is providing an alternative to a SNF. I know a lot of folks do SNF type care at home. This is a bundle rehab at home program we’re doing for those patients who otherwise would be in a brick and mortar SNF. Our hope is that this follows a similar trajectory to home hospital for us.”

Merz Photography for HHCN | CC0

For context, Mass General Brigham’s home hospital program was also preceded by a randomized control trial.

“That gave us the confidence between the quality outcomes, and just the ability to really deliver this program to the right set of patients, that we have so much conviction and have scaled up the program to the extent that we have,” Metzger-Traber said. “The optimistic dream of dreams is that the state of Massachusetts sees how well this program is run.”

Ultimately, when engaging in these various care models, Metzger-Traber believes that innovation breeds innovation.

“The fact that we’re doing this means we’re using medication dispensers that are different from the ones we use for other patients, because this is a different length of care, it’s a different intensity of care than our other home-based populations,” he said. “We’re doing virtual physical therapy for these folks. It’s just we’re layering on a lot of other cool things and knitting that together. That’s all enabled by this randomized control trial of research in this space. I love that aspect of something innovative and new that we get to do. I’m very excited to see the outcomes over the next year of the trial.”