How COVID-19 Will Impact Home Health Demand
Nearly all healthcare settings in this country have been changed by the COVID-19 pandemic, including home healthcare.
“COVID-19 has raised a level of awareness about home care,” said Merryl Siegel, senior vice president and regional executive director of Post-Acute Services at Northwell Health and executive director of Northwell Health At Home in New Hyde Park, New York. Northwell has about 800 home healthcare personnel in the field.
“Our staff members have stayed with us, very few people leaving,” Siegel added.
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How COVID is changing Home Health Nursing
Caring for more acutely ill patients
Norwell Health has traditionally cared for acutely ill patients, but during the peak of the COVID-19 pandemic in New York, it developed a program to care for acutely ill patients with the novel coronavirus.
“Some were discharged and some were very sick at home but did not need hospitalization,” Siegel said. “We take care of very acute patients in the home. We take care of open-heart patients, heart transplant patients at home.”
Personal protective equipment (PPE) was a challenge, as was the fear of strangers coming into one’s home, Siegel said. Northwell Health expanded telemedicine in the home and then as patients became more comfortable, clinicians went into homes.
“Our success was due to being part of a large health system,” said Siegel said, explaining that helped with PPE and collaboration with pulmonary physicians.
Northwell Health’s home health patient satisfaction scores increased dramatically during the COVID-19 pandemic, something Siegel thinks is related to how the clinicians helped the patients.
Mayo Clinic in Jacksonville, Florida, has launched a program with Medically Home of Boston to offer comprehensive and complex care to patients at home through a technology platform in response to consumer demand, regulatory flexibility and innovations in technology.
“During COVID-19, we’ve learned that patients expect more virtual and remote care than ever,” said John Halamka, MD, president of Mayo Clinic Platform, in a statement he program debuted in Jacksonville and Eau Claire, Wisconsin, with services including infusions, skilled nursing, medication delivery, laboratory and imaging services, behavioral health and rehabilitation services.
More chronically ill receiving care at home
With COVID-19 taking a heavy toll on nursing home residents, many people would like to remain in a home or community-based setting. Bud Langham, chief strategy and innovation officer at Encompass Health, told Forbes that the company has received more referrals from physicians for patients. The company specializes in post-acute care, and many of these new patients have acute and complex conditions.
Keeping people home saves health systems money. It’s far less expensive than inpatient care.
“The goal is always to keep patients out of the hospital,” Siegel said.
Siegel reported good communication with providers is paramount to the success of caring for patients at home.
“We saw a huge increase in communication with our physicians and community physicians,” Siegel said.
Palliative care, for seriously ill patients, also offers opportunities for home health agencies. Northwell Health’s palliative care program received the Joint Commission’s Community-Based Palliative Care Certification for its Advanced Illness Program. Siegel reported that Northwell’s clinicians recognized that patients receiving home care needed more support. Therefore, the home health agency expanded, bringing on geriatric, palliative and advanced illness specialists.
Challenges for home health
Challenges for home health include people remaining fearful of obtaining health services, including elective surgeries, as well as the staffing and retention issues that are affecting other areas of healthcare delivery.
A June 2020 study from KaufmanHall found 55 percent of consumers had skipped medical care since the start of the coronavirus epidemic, and 54 percent of patients reported delaying care due to fear of becoming infected with COVID-19.
While some services and elective procedures have rebounded, virus surges continue to plague the country, and some health systems are once again advising patients to postpone non-urgent services. Therefore, fewer patients are currently in need of rehabilitation and nursing services as they recover, which can affect revenues.
The National Association for Home Care & Hospice, AARP, and a number of other groups are also championing the Choose Home Care Act of 2021 which was introduced in both the U.S. House of Representatives and the Senate last year. The bipartisan legislation is designed to increase access to home health care following hospitalization for eligible Medicare beneficiaries by offering a safe, high-quality post-acute option for nursing home level services in the home.
While Northwell and other home health providers have embraced telehealth – both virtual visits and remote patient monitoring — reimbursement is lacking. Additionally, some older adults are still hesitant about the technology.
Home health agencies are ready to care for people with COVID-19 and other illnesses going forward.
“We are more prepared for a surge,,” Siegel said.
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