The future of healthcare takes place at home

“There has always been a desire for home healthcare, but we never really saw a total push for the execution. I think the pandemic has accelerated that actionable piece,” says Kris Srinivasan, senior manager of payor strategy at McKesson Medical-Surgical.

Though care in the home once felt like the future of healthcare, it already seems to be turning into reality, with home healthcare industry trends on the rise.

While a few hospital systems, like Johns Hopkins Medicine and Massachusetts General Hospital, had established in-home care prior to COVID-19, several large organizations took action to launch in-home care services during the pandemic, including Kaiser Permanente and Mayo Clinic.

“If you look at current trends in the marketplace, fewer large hospitals are being built. Outpatient settings are used more, along with more satellite campuses. The primary driver for this is that access to care needs to be increased for patients,” says Srinivasan.

Providing services in the home is one way to bring that access to patients, no matter where they are. Because of this and other factors, healthcare will continue to shift to the home, and home medical equipment (HME) providers need to be ready to do their part.

The elderly prefer to age at home

According to the United States Census Bureau, the number of people aged 65 and older grew by over a third during the past decade. By 2030, all baby boomers will be older than 65 years old.¹

As the population ages, the demands on healthcare will increase. However, most older adults prefer to age in place.

“The preferred site of care for the aging population is going to be the home. It’s where they’re most comfortable. It’s their known setting,” says Srinivasan.

In fact, a 2018 survey conducted by the American Association of Retired Persons (AARP) found that 3 out of 4 adults age 50 and older want to stay in their homes and communities as they age.²

It may be better to manage chronic illnesses at home

The Centers for Disease Control and Prevention (CDC) reports that 6 in 10 adults in the U.S. have a chronic disease, while 4 in 10 have two or more chronic diseases.³

One study found that the number of chronic conditions a person has and the number of affected body systems (like the endocrine system, circulatory system and/or others) increase their risk of hospital admissions for ambulatory care sensitive conditions. These are conditions for which ambulatory or primary care interventions could prevent hospital visits.⁴

Srinivasan says offering patients the ability to receive primary care services virtually, from the comfort of their homes, could result in better management of chronic conditions.

“Chronic care management is better done in a home setting where you’re preventing the hospitalizations rather than having to trigger the reactive methodology. [This includes] looking at remote patient monitoring tools and technologies, and other types of resources that are now being leveraged and developed,” he says.

Convenience & safety are benefits of home healthcare that are hard to beat

Today, many people want to shop from the comfort of their home and avoid in-store shopping unless they have to do it. The same goes for the future of healthcare.

“It’s ‘Amazonification.’ I don’t think healthcare is different. The pandemic demonstrated that,” says Srinivasan.

For instance, if a parent has a child with cold-like symptoms and they can access their pediatrician via a telemedicine appointment, the convenience is hard to deny – jump on a video call, talk to the doctor and have them send over any necessary prescriptions to the local pharmacy. Then, head over to the pharmacy drive-thru to pick these up and go home.

“It’s easier than pulling your child out of school or putting them in the car, getting to a facility and getting them home. All of those are time consuming, and because time is of the essence, I think this will also drive more care to the home,” adds Srinivasan.

The protection this process offers a parent and their child is also enticing. By staying out of the waiting room, parents are avoiding the risk of passing along the infection to others or picking up a different one. 

Patient preferences for home care drive demand

Most home healthcare companies provide a range of medical services, such as nursing care, physical and occupational therapy, social work and more. According to a report by Precedence Research, the global home healthcare market size will increase from $264.87 billion in 2020 to $662.67 billion by 2027. Blood pressure monitoring devices, glucose monitoring devices and other therapeutic and diagnostic devices are often used for in-home services.⁵

During the pandemic, as patients adopted home healthcare options, many adapted to telehealth and even came to rely on it. In fact, according to the “COVID-19 Telehealth Impact Study,” conducted by the American Medical Association (AMA) in collaboration with the COVID-19 Healthcare Coalition, patients were happy with the telehealth services they received during the pandemic and want to see this modality stay. Of the 2,000 patients surveyed:⁶

• 79% stated being very satisfied with the care provided during their last telemedicine appointment
• 73% plan to use telehealth services going forward
• 41% would have preferred a telehealth visit rather than an in-person one for their last visit, even if both required a copay

“HME providers are well positioned to deliver care in the home through existing technology as well as new technology being developed. And with patient consumerism, patients are shopping for their physicians and health systems that they want to go to,” says Srinivasan.

He adds that patients like the ease of being in their natural setting while they access care in a timely manner. Another benefit of home healthcare is that patients can also connect with physicians who are further away from them, thanks to telehealth platforms.

“Telehealth allows better access to professionals in the more rural settings and suburban areas […] Patients don’t want to travel to a metropolitan area to get good care. All of those components are driving healthcare away from traditional healthcare environments,” says Srinivasan.

Telehealth can help keep patients compliant

Telemedicine makes it easier for people to stick to their appointments. In one study of patients at a primary and specialty care clinic, of over 155 scheduled in-office visits, 36.1% were no-shows. However, patients only missed 7.5% of telemedicine visits.⁷

“If you look at behavioral health especially, the number of missed appointments over the last year dropped dramatically because of telehealth platforms, so that’s a huge advantage,” says Srinivasan.

HME providers should consider integrating telehealth services as part of the way they do business to help keep patients compliant – and free up staff to take on more patients.

Changing regulations have broadened access to virtual care

Until March 2020, Medicare recipients weren’t able to use telehealth, unless they wanted to pay out of pocket for their care. On March 6, 2020, under an emergency declaration, the Centers for Medicare & Medicaid Services (CMS) broadened access to Medicare telehealth services. Now, beneficiaries can receive a wider range of covered services from their doctors virtually.⁸

CMS stated that the change was part of a broader effort to give better access to care to all Americans, including those who are at a high risk for complications from COVID-19, and contain community spread of the virus. The adjustment sparked more changes in regards to telehealth legislation, with a focus on extending some policies beyond the pandemic.

What does more in-home care mean for HME providers?

As the future of healthcare demands more care in the home, the demand for HME providers will also increase. “HME providers are the ones best equipped to provide deliver care in the home,” says Srinivasan.

As a number of different hospital at home programs popped up over the last year, he says that many health systems have turned to HME providers to help set up equipment in the home, train patients on how to use the equipment and maintain intervention thresholds and measures.

“HME providers have had that infrastructure in place for 30 to 40 years. I think the time is now for them to be better leveraged in this space because they are best equipped to deliver care in the home – and have the experience to back it up,” Srinivasan says.

To prove their place in the future of healthcare, he believes HME providers need to act on two fronts.

1 | Provide technical solutions for care

Along with demand for home-based medical equipment, Srinivasan believes that the need for software and patient engagement solutions will grow as well. “This is the future, and HME providers should find ways to engage with their patients electronically,” he says.

“There are a few patient engagement technology applications that already exist in the market. Here at McKesson Medical-Surgical, we have McKesson VerbalCare®, which is a patient engagement app that can help automate personalized patient communications, send patient reminders of follow-ups and product resupply and even access videos and other patient resources,” said Srinivasan. “Tools like VerbalCare are designed to support improvements in patient response times with two-way messaging and help improve therapy adherence for better patient outcomes.”

To meet the future head-on, HME providers can be proactive in adopting tools like VerbalCare to prepare for patient demand.

2 | Advocate your services

Spreading the word about the value HME providers bring to the healthcare continuum is essential. “There are a number of health systems that don’t know what HMEs do, or what they provide, and getting the word out that we in the HME industry can deliver outstanding patient care to help drive better outcomes is critical,” Srinivasan says.

While providers wonder how they will receive payment for in-home services, Srinivasan says he believes payers are shifting their policies for the better. This is why it’s important for payers to understand the value providers bring as well.

“They don’t know how to do it yet in terms of what the payment model and structure looks like, but as long as we’re delivering that value-based care in the home setting, payment is going to follow. It’s not as far behind as many think,” he predicts.

According to a 2020 report by CareCentrix, of 75 health plan executives surveyed, 97% said they believed more care needs to take place in the home.⁹

“I think HMEs have already proven they can deliver and execute home care services and products in the home, but being able to innovatively demonstrate the value of what they do day-in and day-out is going to be critical for this industry in the future,” Srinivasan says.