Health care goes remote with hospital-at-home trend : Shots

Health care goes remote with hospital-at-home trend : Shots

Since the pandemic, some hospitals have started offering to let patients with acute illness recuperate at-home, with 24-hour remote access to medical professionals and daily home visits.

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Since the pandemic, some hospitals have started offering to let patients with acute illness recuperate at-home, with 24-hour remote access to medical professionals and daily home visits.

FG Trade/Getty Images

David and Marcia Elder packed their bags anticipating a month-long stay at the Mayo Clinic in Jacksonville, Fla., when David went in for a bone-marrow transplant in late February, as part of his treatment for multiple myeloma, a blood cancer.

A few hours after surgery, the couple were amazed when staff offered them the option of returning home that day. “They came to us and said, ‘We have this hospital-at-home program’ and I was like, ‘What? I’d never even heard of it,'” Marcia Elder says.

By dinnertime that day, paramedics had set up a make-shift recovery room in their living space and they returned to convalesce at home.

Such a thing was unimaginable, just a few years ago. The Mayo Clinic was among the first hospitals in the country to experiment with sending acute patients home for remote care four years ago. Now, some 250 similar programs exist throughout the country.

That’s largely because during the pandemic, the federal agency that runs Medicare and Medicaid relaxed normal rules requiring around-the-clock, on-site nurses for hospitals requesting the exception. This allowed at-home hospital care programs to rapidly expand. Those pandemic-era waivers will remain in place until at least the end of 2024, although some experts anticipate policy changes allowing such programs to remain in place permanently.

David Elder flashes his hospital bracelet from the comfort of an easy chair in his own home, which he was sent back to just a few hours after his bone marrow transplant surgery. He said it was a lot more restful to be home.

Marcia Elder


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Marcia Elder

As a result, at-home hospital care is fast becoming an option for acute care for many conditions, even for treatment of cancer, or for patients like Elder, recovering from complex procedures. Such shifts could potentially reshape the future of hospital care, affecting many more patients.

The practice has been enabled by other recent trends as well – for instance the increase in traveling medical staff and the prevalence of portable Internet-enabled devices to connect with medical help remotely. The crisis of the pandemic also normalized remote care. And dealing with COVID surges made hospitals — as well as regulators and health insurers — more receptive to the notion that at-home care might be healthier, cheaper, and generally more pleasant than at a hospital.

“People do better; they’re more mobile, they recover faster,” says Michael Maniaci, an internist who directs virtual care for the Mayo Clinic. “They use physical therapy or skilled nursing care less. You ask: Why is that? Because there’s something magical about being at home.”

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Pandemic accelerates trend towards more outpatient health treatment, report finds | Area

Pandemic accelerates trend towards more outpatient health treatment, report finds | Area

The change toward emphasizing outpatient and in-household professional medical treatment is likely to adhere even as the COVID-19 pandemic is waning locally and nationally, in accordance to a countrywide bond-rating agency.

Moody’s Traders Services explained in a report produced Friday that healthcare units and hospitals’ earnings advancement and margins will “continue to be strained” by the change in treatment shipping to lower-value outpatient or in-dwelling configurations.

“The pandemic has fueled a shift in healthcare shipping, with much more clients not able or unwilling to seek care in clinic settings,” Moody’s analyst Diana Lee mentioned.

“Even as the pandemic ebbs, its impact on how people obtain healthcare will persist, with much less crisis-home visits.”

“Changes in reimbursement designs, new medicine, equipment and expanding expenditure in outpatient providers, together with ambulatory operation facilities (ASC), will push down inpatient care, the classic evaluate of current market share and presence,” Lee explained.

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Yet another factor contains escalating acceptance and use of telehealth, ensuing in much less non-COVID emergency-home visits. Some companies are increasing dwelling-care services to incorporate in-dwelling acute-care admissions.

“An getting older populace, greater acuity conditions and solid inhabitants progress in some marketplaces will reduce this change,” Lee mentioned.

Wake Forest Baptist Clinical Heart described Feb. 25 that it had a 24.3% boost 12 months more than year in outpatient functioning-area circumstances to 41,301 for the duration of the quarter that finished Dec. 31. It also experienced a 13.6% jump in crisis-office visits to 197,101 and a .2% minimize in inpatient admissions to 60,133.

Cone Health and fitness noted March 1 in its very first quarter 2022 report possessing outpatient visits raise 12.2% to 249,952, while emergency-division visits had been up 10.9% to 81,074. The method described conducting 11,870 telehealth visits, down 24.5%.

Lee explained the federal Facilities for Medicare and Medicaid Services’ final decision to remove specified orthopedic and cardiac techniques from its inpatient-only list will shift extra treatment method to medical center-dependent outpatient departments or ambulatory surgical centers.

“Hospitals will also proceed to transition to hazard-using versions of reimbursement, retaining clients out of extra expensive, acute-treatment medical center options,” Lee explained.

“Not-for-gain hospitals will increase partnerships with primary marketplace gamers in telehealth and urgent care, as very well as with ASCs. Due to the fact most ASCs are owned or jointly owned by doctors, hospitals will typically share income and income.”

Breakthroughs in medicine and healthcare units also are enjoying a role in decreased inpatient care.

Lee cited as an illustration that in cardiology, new medicines and at-home heart screens “will cut down the risk of hospitalizations for coronary heart failure, a crucial purpose that people in excess of 65 are admitted.”

“In orthopedics, new systems that assist reduce surgical time or create client-specific implants will help the change to outpatient processes.”

A counterpoint to the pattern, Lee explained, is the projection of improves in very intricate instances necessitating higher concentrations of specialty treatment

“Hospitals with a powerful emphasis on quaternary and tertiary treatment will be

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