The underestimated value proposition of serving high-acuity patients at home

The underestimated value proposition of serving high-acuity patients at home. Is your health system leaving money on the table?

Meeting new demands with an innovative partnership approach that brings the power of the hospital to patients at home.

As many in healthcare are keenly aware, the potential for a national hospital capacity crisis has long preceded the global pandemic. With nearly a million hospitalizations, the 2017-2018 flu season offered a precursor to the level of provider fatigue and bed shortages healthcare would face with the onslaught of COVID-19 patients. The pandemic did, however, illuminate and time stamp the need for solutions to transform the dated industry mindset. Moreover, the abruptness of adapting to pandemic life at home sparked a culture shift in America. From how we feed our families to where we exercise and get our entertainment, how we communicate on the job, and manage our health and wellbeing, pandemic life has forced a shift in the consumer mindset. As a result, today’s patients are looking more closely at the cost, quality, and convenience of care with on-demand expectations.

Tailwinds from innovation in new care delivery models, streamlined technology, and a commitment to right-sizing healthcare spending have helped make a case for serving high-acuity patients at home. In-home care models complement facilitybased care delivery by extending their reach to underserved or hard-to-reach populations in their communities. And as several forward-thinking health system leaders have found, partnering to provide high acuity care to patients in their homes has fast-tracked the ability to meet evolving consumer expectations. Additionally, it helps manage workforce challenges and capacity issues, while protecting profit margins.

FOCUS POINT 1 Serving High-Acuity Patients at Home: Appealing to Today’s Consumer Minded Patient A recent national survey looked at the importance of a lower-stress, higher-value care site and offered overwhelming support for at-home treatment.

For example, 70% of respondents to the study cited a reduction in anxiety as a key reason they’re comfortable receiving care at home, and 85% who received such care said they’d recommend it to family and friends.

To meet the needs of post-COVID-19 consumers, one of the nation’s largest health systems, AdventHealth, partnered with DispatchHealth in April 2021 to deliver high acuity healthcare to its patients at home. Nick Archer, Vice President of Venture Operations, said, “Choice of setting impacts consumers’ perception of care. So, our attention is on providing options across multiple channels - we’re focused on things that provide a better healthcare experience and choosing where you want it ladders up and leads to better outcomes.”

With the shift to consumerism in healthcare, health systems must focus on cost-effective options to expand their reach where and when patients need care. Because of the traditional health system model, systems are not always able to meet those needs for various reasons—panels could be full for the day, or the need for care might be after hours, on weekends, or holidays. However, because of the DispatchHealth model, patients and partners alike have extended access to care, particularly after hours and on weekends. Specifically, for AdventHealth, DispatchHealth cares for an average of 44% of the system’s patients outside traditional clinic hours.

“ Choice of setting impacts consumers’ perception of care. So, our attention is on providing options across multiple channels - we’re focused on things that provide a better healthcare experience and choosing where you want it ladders up and leads to better outcomes. ick Archer N Vice President, Ventures Operations, AdventHealth

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Streamlining and maximizing the technology that is now portable is where we can start meeting consumer expectations of care on demand. Another premier institution partnered with DispatchHealth to integrate care in the home is the University of California Irvine Orange County’s only academic health system serving more than one million patients annually. Susanna Rustad, Chief Procurement Officer and executive director of virtual care, says their patients are looking for digital-first options. “They’re seeing it in finance and retail; they’re very comfortable with the integration, so healthcare is that next natural step for them. And as healthcare leaders, it’s imperative we help guide our patients and members through the journey.”

Finally, when combining the healthcare focus of patient experience as part of The Quadruple Aim and the driving change from consumer-patients, meeting expectations of this shifting tide is critical to success.

In the traditional health system model, many patients feel misunderstood and, at times, mistreated. But the ability to treat a patient on their terms is a gamechanger for satisfaction rates and clinical outcomes.

As a result, DispatchHealth boasts a Net Promoter Score (NPS) of 95+, an unprecedented industryagnostic customer experience metric.

“ ...patients are looking for digital-first options. “They’re seeing it in finance and retail; they’re very comfortable with the integration, so healthcare is that next natural step for them. And as healthcare leaders, it’s imperative we help guide our patients and members through the journey.”

Susanna Rustad Chief Procurement Officer and ED of Virtual Care, UCI Health

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FOCUS POINT 2 Serving High-Acuity Patients at Home: A Hedge Against Workforce Challenges, Margin Compression “ People join the medical field to make a difference in patients’ lives. And patients’ health extends beyond the traditional four walls of a health system,” says DispatchHealth Chief of Staff Dave Dookeeram.

“ During my healthcare career, I’ve seen some of the best providers burn out with root causes of patient readmission, the inability to focus on chronic care management, and only having a limited view of the patient in the hospital. The DispatchHealth business model enables providers and partners a unique, usually unknown, holistic view of patients, including social determinants of health, by bringing the care into the home.

With healthcare delivery becoming increasingly demanding, some health systems have realized that expanding care delivery outside of their traditional brick-and-mortar setting has made them more attractive as an employer of choice. It also has increased options for existing employees who might feel burned out or desire a different role.

Dookeeram adds, “During my healthcare career, I’ve seen some of the best providers burn out with root causes of patient readmission, the inability to focus on chronic care management, and only having a limited view of the patient in the hospital. The DispatchHealth business model enables providers and partners a unique, usually unknown, holistic view of patients, including social determinants of health, by bringing the care into the home.”

Dave Dookeeram Chief of Staff, DispatchHealth

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FOCUS POINT 3 Serving High-Acuity Patients at Home: A More Cost-Effective Pathway Building healthcare facilities requires enormous amounts of time and capital, which presents challenges during an influx of patients brought on by a pandemic and in periods of rapid growth. To meet demand, the University of California Irvine is embarking on a $1.3 billion multi-year construction project to build a new 144-bed complex. “But traditional takes time,” commented UCI’s Susanna Rustad. “It’s rigid; how do we solve for what patients and caregivers need now?” At roughly $4 million per bed, it is an eye-catching amount that bolsters the case for home care. Partnering to deliver healthcare at home offers a quick, more cost-effective pathway for health systems to provide care, extend their brand, and drive growth with a lower investment. Rustad adds, “Sometimes when you privilege speed, you lose quality, but when we have proven quality partners, and they already have broad coverage and abilities, we can have our cake and eat it too.”

AdventHealth’s Nick Archer adds, “There is expertise at DispatchHealth that they’ve brought to the table as it relates to care model logistics and technology that we don’t have and is not something we think we can scale fast enough.”

“ Traditional (facility planning) takes time. It’s rigid; how do we solve for what patients and caregivers need now?

Susanna Rustad Chief Procurement Officer and ED of Virtual Care, UCI Health

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In addition, AdventHealth capitalizes on the easy and financial feasibility of DispatchHealth’s in-home acute care services to extend the health systems’ mission and touch patients in underserved markets.

Archer also points out the added value of a constantly evolving payer landscape, “DispatchHealth is driving contracts at a national level; from a geographic standpoint, we might not be able to drive the same level of success.”

Finally, partnerships allow hospitals or health systems to ease into new channels of care in the same way that hospitals grapple with low-acuity surgeries and the resulting emergence of ambulatory surgery centers.

“ There is expertise at DispatchHealth that they’ve brought to the table as it relates to care model logistics and technology that we don’t have and is not something we think we can scale fast enough.

Nick Archer Vice President, Ventures Operations, AdventHealth

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Reduced Readmissions

41% reduction in 30-day readmission for patients that receive transitional care services1

Medical Cost Savings

An estimated $1,200 in medical cost savings for every visit that avoided an unnecessary trip to the emergency room.2

Medical Cost Savings

Ranges from $5,000-$7,000 for every patient admitted with hospital level care in the home.3 1 - Health System Partner Bridge Care Case Study, March 2021 2. Medical Cost Savings – 2021, All Markets; Acute Care 3. M edical Cost Savings – 2021, All Markets; Advanced Care

FOCUS POINT 4 Serving High-Acuity Patients at Home: Good for Patients and Solving for Repetitive Readmissions Ultimately, deep clinical integration into service lines allows hospital operators to safely treat some patients at home, more rapidly discharge patients and prevent those patients from being readmitted.

AdventHealth utilizes DispatchHealth’s hospital-tohome transition program, Bridge Care. Health system executive Nick Archer adds, “As with many hospitals, there are sometimes challenges with getting our Medicare patients out promptly and placing them appropriately. By partnering with DispatchHealth, we can offer in-home care to individuals and get them where they want to be, in a safe environment.”

In a 30-day window, avoidable hospital visits plunge by 41% when patients receive transitional care from DispatchHealth. This data point makes sense when partners see how well patients respond to difficult days in transition when an at-home provider is there to translate the sometimes-confusing set of discharge instructions that accompany patients upon their return home. With the support of convenient alternatives to patients spending an extended time in an inpatient setting, health systems can operate more efficiently and profitably.

And finally, moving care into the home also offers cost savings for patients. For example, DispatchHealth’s on-demand, high-acuity care provides savings averaging between $1,000 to $1,500 for every patient who doesn’t need a trip to the emergency room. And when it comes to in-home hospitalizations, the cost savings increase by a factor of five: by rerouting care to the home, partners save an average of $5,000 to $7,000 per patient.

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OUR CAPABILITIES We’ve brought the power of the hospital to the comfort of home by building a complete system of care, refined over 8 years and hundreds of thousands of patients. ​ Our system of care is built to deliver care across the healthcare continuum, to keep patients healthy at home – from caring for the highest acuity patients with urgent or hospital-level needs, to supporting transitions of care and ongoing management of chronic conditions. Starting at the center of this graphic is our: Core System

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Post-Hospital: Transitional Care & SNF at Home are aimed at readmission reduction to support the management of patients following a visit to the emergency room, hospital or skilled nursing facility

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Outpatient Support: Last Mile Care & Population Health is uniquely positioned to extend a partner’s reach into the home in a variety of ways to identify and address social determinants of health. Further services like portable imaging, point of care lab testing, utilization management, assisted virtual visits, or other health and wellness assessments are built here.

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OUR CAPABILITIES CONT. The final outer ring, circling the other two

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CONCLUSION Serving high-acuity patients at home: appealing to the new consumer-patient DispatchHealth has built a complete system of care, refined over eight years by delivering care for hundreds of thousands of patients. Built to deliver across the healthcare continuum, it has four components: a proprietary technology platform, connectivity, and flexible 24/7 care built around the patient and clinical capabilities.

Changing consumer expectations, an increasingly complex and challenging financial outlook, and the difficulties in longer-term master facility planning contribute to making in-home care more attractive for patients, providers, and health systems. Clinically stellar outcomes at a lower cost won’t come easy.

Still, it appears that, for any hospital or health system serious about accomplishing all these goals, expanded care delivery access points must be an integrated part of health systems networks.

To learn more about how your health system could benefit from expanding access to care for your patients, visit: DispatchHealth.com/partners

“ Bringing the power of the hospital to the comfort of the home is our anchor.

Dave Dookeeram Chief of Staff, DispatchHealth

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