The global home healthcare market is expected to reach nearly $300 billion by 2026, and little wonder. The world’s population continues to age rapidly, patients are increasingly digitally literate, and the technology that supports at-home care grows more effective every day.
CVS’s recent $8 billion buyout of Signify Health—a platform that helps coordinate home-based care between patients and caregivers, and enables value-based care by working with both health plans and health systems to deliver appropriate care—demonstrates how active the sector is.
Care delivery at home includes post-acute care (also called “hospital at home”), outpatient care, personal care (including private nurses, non-medical care, etc.), telehealth and end-of-life, or hospice, care. The field is seeing a surge of investment by governments and venture capitalists.
To stay relevant in the care-at-home age, payers and providers would do well to begin designing robust home-care strategies that offer a differentiated care-at-home experience.
The Cognizant take
Sashi Padarthy, Partner in Healthcare Consulting at Cognizant, says the industry is poised to “go beyond video visits, offering multi-disciplinary virtual and in-person care.” Health organizations will increasingly use artificial intelligence/machine learning models to offer real-time insights—which is the core premise of care at home.
“Next-generation models of telehealth and remote patient monitoring are here but require extensive integration with clinical workflows,” Padarthy adds.
Value-based care and innovative payment models from the Centers for Medicare & Medicaid Services and other payers have begun providing reimbursement for patient care at home, as patients increasingly prefer the home environment over the hospital. Health tech firms like Medically Home, Heal, Cera and Signify are creating intelligent care delivery platforms that connect patients with their doctors and coordinate care across the system. Many major health systems and health plans, including Kaiser, Mayo and Humana, have partnered with these firms.
Here are actions payers and providers can take to stay relevant in this evolving healthcare landscape, according to both Padarthy and Kiran Kowshik, Senior Healthcare Consulting Manager at Cognizant:
- Accelerate health-tech partnerships. Developing and testing the technology to support home care is both expensive and time-consuming. Hospitals should partner with health-tech companies to combine these firms’ expertise in technology with health systems’ care-delivery know-how to pilot and rapidly scale home-care models.
- Partner with payers. Collaborate with payers to negotiate contracts for effective reimbursement of home healthcare services. Value-based care models would be an ideal starting point for such partnerships.
- Train clinicians and nurses. Clinicians, nurses and home-care providers need training to serve patients effectively at home.
- Drive value-based care arrangements. Partner with providers to develop value-based care arrangements that promote and reimburse home care and align incentives. This will not only reduce costs but also improve the member experience and stickiness.
- Benefit design for home-care reimbursement. Offer benefits and reimbursement for various home healthcare services.
- Create focused networks of providers. Identify and create specialized, multi-disciplinary networks of providers that can provide home healthcare services for a variety of specific conditions.