The Biden administration massively expanded hospital-level care at home as part of its strategy to enhance hospital capacity. The Mayo Clinic says it’s having an impact.
RACHEL MARTIN, HOST:
Arizona is still dealing with the worst of omicron. Hospitals there have been near capacity for months. Lately, a number of them have been working to free up patient beds by treating people with serious conditions in their own homes. From member station KJZZ in Phoenix, Katherine Davis-Young reports.
KATHERINE DAVIS-YOUNG, BYLINE: In late 2020, the federal government announced strategies to ease stress on health care facilities, including more flexibility for hospital-level care at home.
DAVID LEVINE: We went from zero approved hospitals to, a year later, over 185 hospitals all throughout the country have been approved for this care model.
DAVIS-YOUNG: Dr. David Levine with Brigham and Women’s Hospital in Boston has led research into the effectiveness of acute care at home. Providers can’t offer surgery or ICU-level care outside of hospitals, but technology is now good enough that a growing number of hospitals are offering X-rays, bloodwork and many treatments for non-life-threatening conditions on the go. And Levine’s research shows patients who get treated at their kitchen table or on their couch have better health outcomes than those in brick-and-mortar medical facilities.
LEVINE: You end up getting readmitted much less often, and you end up lying down much less often and moving around much more when you’re at home versus in the hospital.
DOLORES WIESE: Oh, I tell you.
DAVIS-YOUNG: Patient Dolores Wiese says getting to eat home-cooked meals, see her family and sleep in her own bed makes recovery a lot more comfortable.
WIESE: I like to be active. And to be tied down in bed in a hospital? No. I’ll take this any day.
UNIDENTIFIED PERSON: Thirty-four?
TAMI HAMPSON: One-thirty-four.
HAMPSON: So that’s good.
DAVIS-YOUNG: I met Wiese in her apartment in a retirement community in Phoenix. She was being treated for a skin infection that typically might have kept her in the hospital for a few nights. Nurse Tami Hampson with DispatchHealth rolls in a few suitcases full of medical gear.
HAMPSON: We have all of our equipment here to do all of our exams or draw blood. We could put IVs in. We can…
DAVIS-YOUNG: Another hospital system that began offering at-home care during the pandemic is Mayo Clinic. Mayo’s Dr. Michael Maniaci says patients respond really well to virtual doctor visits and regular follow-up calls. But he says for now, the federal government is only paying a lump sum for the custom-tailored care.
MICHAEL MANIACI: There’s really no true reimbursement for that that’s built yet in the system.
DAVIS-YOUNG: But Maniaci says everyone will save money in the long run if patients stay healthier. And then there’s the issue of space.
MANIACI: Even if we’re losing money because we’re giving extra services, what’s the cost of opening up that hospital bed for a cancer patient or surgical patient that needs it more?
DAVIS-YOUNG: Across three states, Mayo says it’s been able to free up 3,300 hospital bed days by treating patients at home. The challenge, Maniaci says, will be scaling up. But a few private insurers have started joining the government and are paying for in-home care now, too. Humana is one. The company’s Dr. Amal Agarwal says Humana is also growing its own in-home care service. The numbers, he says, just makes sense.
AMAL AGARWAL: It can provide good clinical care in the right scenario, and it can be done at a lower cost. So I think that there’s value there. And it’s a lower cost for the member, as well.
DAVIS-YOUNG: The federal permission for hospitals to expand in-home care was meant to be temporary, but providers and now some insurers really want lawmakers to allow it to continue permanently.
HAMPSON: We’ll put another Band-Aid on top of it, but it looks pretty good.
DAVIS-YOUNG: That would be fine with Dolores Wiese back in Phoenix. Her medical visit ends with laughs and hugs.
DAVIS-YOUNG: For someone who’s technically hospitalized, it’s clear she’s having a great time.
WIESE: The best thing that’s happened since running water.
DAVIS-YOUNG: She’d prefer not to be hospitalized again, but if she is, she really hopes it will be in her living room.
For NPR News, I’m Katherine Davis-Young.
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