Hospital at home might be more convenient for patients but the patients experience is so irrelevant to American healthcare that I chuckle to even mention it. Hospital at home achieves the same outcome for a lower cost but doesn’t get reimbursed at the same rate. It’s cheaper and better for patients and the insurance companies but The hospital/health system is the gatekeeper here. Therefore the concept will never get off the ground. Risk based contracts are Not coming to save hospital at home. There will be no innovation, only decay.
RPM & CCM are good models with flawed implementation to much focus on the COT code reimbursement criteria and not on outcomes. When patient realize the lack of value they unenroll. Examples: For RPM, great the patient took their blood pressure on 16 day within a 30 day period, they paid their co-pay but what was their value? For CCM, the patient gets a call once a month but did they really get the true experience of a care coordinator in the other 29 days of the month? For RTM, medication adherence, study show one has to be 80% compliant with therapy to realize therapy benefit(s); however they only had to demonstrate compliance for 16 of 30 days? For tech companies these program aren’t about CPT code compliance - it’s about true patient guidance along the clinical pathway - relationships and experiences matter; let’s give the patient what they want - tools to provide self-management and trusted resources to guide them vs always having to call the doctor or rely on the things found on the internet. Those focused on providing health assistance through education, engagement and outcomes (all with physician oversight) will be transformation leaders.
Hospital at home might be more convenient for patients but the patients experience is so irrelevant to American healthcare that I chuckle to even mention it. Hospital at home achieves the same outcome for a lower cost but doesn’t get reimbursed at the same rate. It’s cheaper and better for patients and the insurance companies but The hospital/health system is the gatekeeper here. Therefore the concept will never get off the ground. Risk based contracts are Not coming to save hospital at home. There will be no innovation, only decay.
RPM & CCM are good models with flawed implementation to much focus on the COT code reimbursement criteria and not on outcomes. When patient realize the lack of value they unenroll. Examples: For RPM, great the patient took their blood pressure on 16 day within a 30 day period, they paid their co-pay but what was their value? For CCM, the patient gets a call once a month but did they really get the true experience of a care coordinator in the other 29 days of the month? For RTM, medication adherence, study show one has to be 80% compliant with therapy to realize therapy benefit(s); however they only had to demonstrate compliance for 16 of 30 days? For tech companies these program aren’t about CPT code compliance - it’s about true patient guidance along the clinical pathway - relationships and experiences matter; let’s give the patient what they want - tools to provide self-management and trusted resources to guide them vs always having to call the doctor or rely on the things found on the internet. Those focused on providing health assistance through education, engagement and outcomes (all with physician oversight) will be transformation leaders.