The New York City area’s largest academic medical center, the Mount Sinai Health System, is expanding its community-based palliative care service in partnership with Contessa. The initiative is called Palliative Care at Home.
The program is born out of needs that arose during the COVID-19 pandemic. With many patients anxious about entering facilities due to fears of the virus, more health care has trended towards the home setting. The cancellation of elective procedures and the need to free up beds for COVID patients are also contributing factors. In response to these pressures, Mt, Sinai, with aid from Contessa, is building scale for their home-based services.
The organizations began offering palliative care at home strictly to COVID patients as the pandemic ramped up, but the program is now available to the larger patient population.
“Palliative Care at Home, which launched this past Spring to help care for seriously ill COVID-19 patients in their homes, will now be available to all of our seriously ill patients and their families,” said R. Sean Morrison, M.D., the Ellen and Howard C. Katz Professor and Chair of the Brookdale Department of Geriatrics and Palliative Medicine at Mount Sinai.
Nashville-based Contessa, Mt. Sinai’s partner in community-based services, works with hospital systems to bring more care into the home. The organization will work with Mount Sinai to operationalize the program, lend expertise in staffing, negotiate with payers, and help implement Mount Sinai’s care model at locations nationwide.
This move builds on two previous home-based programs for these organizations, Rehabilitation at Home and Hospital at Home. Demand for these programs rose during the pandemic. The Hospital at Home program has treated more than 1,000 patients since it launched in 2017.
A rising number of hospitals are starting to integrate home-based palliative programs into their service lines.
North Dakota-based CHI-St. Alexius Health System has extended its palliative care program to include outpatient and home-based services. The hospital’s inpatient palliative care team in 2013 became distinguished from its hospice services.
St. Mary’s Health System is also expanding their hospital-based palliative care program outside of their walls and into patients’ homes in three Georgia counties. SSM Health and Allina Health have made similar announcements.
St. Louis, Mo.-based SSM Health is a health system operating in Missouri, Wisconsin, Oklahoma and Illinois, that offers hospice and home health care through its SSM Health at Home division.
This trend could mean increased competition for hospices, who currently provide about 50% of the home-based palliative care in the United States, according to the Center to Advance Palliative Care.
Community-based palliative care can reduce health care costs by more than $4,000 per patient, according to a July 2017 study in Health Affairs.
“Hospital at Home provides a discrete episode of care, designed as a mechanism to replace hospitalization,:” Morrison said. “Palliative Care at Home provides ongoing care and support day after day, month after month, for seriously ill patients and their families in their own homes, thus avoiding unnecessary and burdensome emergency department visits and hospital admissions.”