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Opinion: We Need To Expand How We Think About Home-Based Health Care. SNF at Home Is a Step in the Right Direction

Patients no longer need to be tied to traditional care delivery models to receive exceptional care. Providers, payers and policymakers must continue working together to expand home-based health care and meet the preferences and needs of our aging population.

It’s no surprise that when given the choice, most people would prefer to receive care at home rather than a hospital or skilled nursing facility if they could receive the same level and quality of care. A recent study revealed 70% of seniors would prefer in-home care, but most are not aware of their options.

The number of Americans age 65 and older is projected to reach 95 million by 2060, fueling an estimated increase of more than 50% of adults requiring nursing home-level care. As we prepare to meet the needs of this growing population segment, providers, payers and policymakers should consider the vast scope of health care services that can be tailored for home environments. Skilled nursing at home, often called SNF at home, is an example of how providers are delivering enhanced clinical care in the home with success in improving patient experience, reducing rehospitalizations and increasing total cost of care savings.

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SNF at home provides home-based clinical support, medication management, medical supplies, durable medical equipment, personal care assistance, remote patient monitoring, telehealth nurse triage and patient and family education – many of the services offered through traditional home health. SNF at home also includes non-medical services that can impact health outcomes such as meals and nutritional support, non-emergency transportation, respite care and caregiver support and enhanced training to support activities of daily living. To access this level of support, patients have typically been required to stay in skilled nursing facilities, but SNF at home programs are allowing appropriate patients the option to receive this care safely where they live. This shift in the point of care satisfies patient preference for home-based care while reducing the overall cost of care.

Hospitals and health systems partner with SNF at home providers to identify eligible patients. The SNF at home provider communicates with patients and families, coordinates transitions in care, and offers education and training to ensure the appropriate level of support can be provided within the home environment.

A study recently found the median cost of care for patients receiving home-based skilled nursing services was almost 10% less than those receiving care in a facility. Additionally, patients receiving at-home care saw greater improvement in their ability to conduct daily living activities. These results show promising potential for the impact home-based post-acute care services can make on patient lives.

Policymakers can support payers and providers in meeting increasingly focused value-based care objectives by supporting legislation to expand home-based services and bridge gaps in care while achieving improved patient satisfaction and reducing per capita costs of care. Many providers are currently limited in their ability to offer expanded home-based care services due to reimbursement structures that don’t consider the nuances of providing enhanced care in a home setting.

At the onset of the Covid-19 pandemic, home health agencies were granted exceptions that supported innovative care delivery, including enhanced flexibility to provide telehealth services and expedite discharge among care settings. Many of these exceptions expired with the end of the public health emergency. Without a continued focus on broadening reimbursement to encourage flexibility in home-based care delivery, we could see innovations like SNF at home struggle to gain traction.

Patients no longer need to be tied to traditional care delivery models to receive exceptional care. Providers, payers and policymakers must continue working together to expand home-based health care and meet the preferences and needs of our aging population. Together, they have the power to make home where the heart – and the health – is.

Photo: Kiwis, Getty Images

Jordan Holland is vice president of value-based contracting for Compassus.

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