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Care@Home

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Summary  

The pandemic has created an opportunity for change in healthcare whereby $265 billion worth of care services for Medicare fee-for-service and Medicare Advantage beneficiaries could shift to home care by 2025. The shift would represent a three- to four-fold increase in the cost of care being delivered at home today for this population. Pandemic-related factors, such as the growth in virtual care and new technologies, including remote patient-monitoring devices, have made home care possible. Venture funding for digital health companies reached a record-breaking $29.1 billion in 2021.  

Home care could improve the quality of care and patient experience by providing comprehensive care in the comfort of patients' homes and potentially reducing preventable adverse health events. Stakeholders, including payers, healthcare facilities, physician groups, care-at-home providers, technology companies, and investors, could see substantial value, although the types of benefits and costs would vary by stakeholder. The three categorized groups of services that could be delivered at home are services with capabilities in place that may benefit from scaling, services where capabilities exist that could be stitched together into a comprehensive offering, and services where existing capabilities will need to be enhanced or extended.  

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Chart from McKinsey & Co. Click on the image for the complete article.

Predictions & Opportunities  

Care at Home could provide better care for patients in the US, especially for high-risk patients with chronic conditions, the elderly, and those at low risk. The benefits and challenges associated with Care at Home are delineated into three categories of services that could be delivered at home: services with capabilities in place, services where capabilities exist that could be adapted for a comprehensive offering, and services with some capabilities but others that require further transformation. The continuum of opportunity for Care at Home services will depend on several factors such as evaluation of which services can be delivered at home, economic viability, physician awareness, perceptions and capabilities, and patient preferences. With regards to CMS, payers, providers and other stakeholders all could play a crucial role in accelerating the growth of Care at Home services and fulfilling CMS’s strategic pillars; by advancing equity, and naturally expanding access to affordable healthcare, while driving person-centered care innovation.   

Care at Home could influence CMS, policymakers and stakeholders in several ways. Here are a few possible examples:  

• Cost savings: The potential cost savings associated with Care at Home could be an attractive proposition for policymakers. Home-based healthcare services can be more cost-effective than inpatient care or nursing home care. Medicare and Medicaid may benefit from incentivizing the use of home-based healthcare services to reduce costs while still providing high-quality care.  
• Improved patient outcomes: Care at Home could improve the quality of care and patient experience outcomes due to increased convenience and personalized care, potentially reducing preventable adverse health events for diagnosis, treatment, or self-care. This could be appealing to policymakers who are focused on improving healthcare outcomes for their constituents and reduction in healthcare costs over the long term.  
• Increased access to care: Care at Home could increase access to care for patients who may have difficulty traveling to a healthcare facility or who live in remote areas and the advancements in technology and the aging population, there is a growing demand. This could be an important consideration for Medicare and Medicaid policymakers who are focused on improving healthcare access and equity.  
• Technology and innovation: The growth in virtual telehealth care, the emergence of new technologies and capabilities, cultivating investment in the digital health market and more patients with post-acute and long-term care needs evaluating their options are all factors that could be seen as opportunities for innovation and technology adoption. Policymakers who are interested in promoting innovation and technology adoption in healthcare may be interested in exploring and expanding the need for Care at Home services to ensure that patients have access to necessary care.  
• Need for improved data sharing: Improved data sharing among healthcare providers and payers can help ensure that patients receive appropriate care and prevent unnecessary hospitalizations or readmissions. Medicare and Medicaid may need to invest in data-sharing infrastructure to support home-based healthcare services. 

For the complete McKinsey article: https://www.mckinsey.com/industries/healthcare/our-insights/from-facility-to-home-how-healthcare-could-shift-by-2025 

Topics to Explore 

In collaboration with relevant stakeholders and colleagues explore these short to long-term questions such as: 

• How might you educate and train healthcare facilities, physicians & stakeholder groups on the benefit of Care@Home?
• How might you comprehensively structure more viable payment innovations or policies to cater for the rapidly expanding Care@home market?
• How might you create new customer journey maps (HCD methods) to explore new payment or reimbursement opportunities?
• How might you strategize a pipeline of Care@Home policy plans and services for acute and long-term care that supports more extensive services?

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