Utah-based health system Intermountain Healthcare is now providing hospital-level services in patient homes. Intermountain is a provider of hospice, palliative care and home health care as well as an operator of 24 hospitals.
Though development of this program has been underway for several years, the company accelerated its implementation timeline to help address the needs of surging numbers of COVID-19 patients who need services traditionally offered only in hospitals. Patients who participate in the program will have access to home-based palliative care.
Intermountain is working with Castell, one of the health system’s portfolio companies, which provides a comprehensive technology platform designed to help organizations transition to value-based care, improve patient outcomes and cut costs.
“The hospitals of the future will expand virtually into homes to provide appropriate acute-level care. This new service supports patients who are at risk for hospitalization or complications, along with their families,” said Rajesh Shrestha, Castell president and CEO and Intermountain vice president and chief operations officer for community-based care. “Many patients find they feel more calm and comfortable at home than in a hospital, and that in itself can be conducive to healing. It also allows people to be more independent.”
The move is expected to result in significant cost savings realized through reduced hospitalizations, reduced hospital lengths of stay, fewer emergency department visits and fewer intensive care unit admissions.
“Value based payment models have been a major factor. We believe that bearing both the financial and clinical risk for a patient is the platform for innovation and care transformation. The emergence of this program is striking evidence of that reality,” Nick Bassett, vice president for population health services for Castell, told Hospice News.
The program is focused on patients who suffer from serious or chronic illnesses such as heart failure, diseases of the kidneys, some vein and intestinal conditions, some types of cancer and some infectious diseases, such as cellulitis. Some imaging and laboratory services will be available, according to Bassett. Patients who have an insurance plan or payor in a value-based contract with Intermountain are eligible to receive these home-hospital services.
“When caregivers are able to actually see and treat a patient in their home environment, they gain a better understanding of ways to help the patient make their daily tasks safer, healthier, or easier,” said Josh Romney, M.D., Castell population health medical director and an internal medicine physician with Intermountain Medical Group. “Enabling hospital-level care in patients’ homes will help advance Intermountain Healthcare’s transition to value-based care, where the goal is to keep patients healthy, improve outcomes and reduce overall costs.”
Patients would initially undergo an orientation in a hospital, followed by in-person and virtual check-in visits from an interdisciplinary team. Telehealth will be a key aspect of the program, including the use of remote patient monitoring systems.
Standard equipment for patients in the program includes a blood pressure monitor, pulse oximeter, cellular-enabled digital tablet, and a digital scale. Additional equipment such as a continuous heart rate and oxygen sensor will be added, based on a patient’s diagnosis. All the devices connect to the tablet through Bluetooth and transmit vital signs to a remote monitoring center.
“Receiving hospital-level care at home typically costs less than overnight hospital stays, which ultimately leads to lower out of pocket costs – not only for patients – but health systems as well,” Bassett said.