Adaptive strategy for high-acuity home-based healthcare delivery

Patient care is rapidly shifting into the home. Based on a survey of physicians who serve predominantly Medicare fee-for-service (FFS) and Medicare Advantage (MA) patients, the global management consulting firm McKinsey and Company estimates that approximately 25 per cent (or US$265 billion) [Bestsennyy, O., Chmielewski, M., Koffel, A., Shah, A. and McKinsey and Company, (2022), ‘From facility to home: How healthcare could shift by 2025’, 1st February, available at: https://www.mckinsey.com/industries/ healthcare-systems-and-services/our-insights/from-facility-to-home-how-healthcarecould- shift-by-2025 (accessed 5th August, 2022)] of the total cost of patient care could shift to the home. This shift is being propelled by payers, an ageing population, consumer preference and technological innovation. Payers have realised the cost savings opportunity of treating patients in the home. This is evidenced by large payer organisations investing in resources internally and externally in organisations that are elevating the acuity of care in the home. With approximately 10,000 Americans [United States Census Bureau, (2019), ‘By 2030, all Baby Boomers will be age 65 or older’, 10th December, available at: https://www .census.gov/library/stories/2019/12/by-2030-all-baby-boomers-will-be-age-65-or-older.html (accessed 5th August, 2022)] ageing into Medicare every day and seniors preferring to receive care in the home, the market will continue to grow for years to come. Improvements in both the capability and cost of technology are helping to enable higher acuity care to be performed in the home. The pandemic accelerated the movement by compelling CMS to institute the hospital at home waiver, spurring significant investment in high-acuity home care platforms, increasing payer openness to reimburse for high-acuity home care services, and increasing provider and patient comfort with these care options and associated technology, as patients avoided traditional healthcare facilities early in the pandemic. This paper discusses how healthcare systems such as MultiCare are looking to innovate and improve health outcomes for patients in the location where they want it most.