The experience during the COVID-19 pandemic has accelerated reaching the day when care in the home is a common and widely available option for patients. The advent of the widespread use of telehealth, remote patient monitoring, virtual disease prevention and disease management, caregiver support, medical record sharing, and new practices by providers and patients can make this possible. A massive growth of home-based care models has erupted, spotlighting new models and those that existed before the pandemic. Care in the home also contributes to health equity by giving historically disenfranchised communities the option to receive care on their terms. It promotes trust and communication by removing institutional barriers and placing the interaction in a familiar setting. A recent national poll confirms this, finding that 70 percent of those surveyed are comfortable receiving care in the home citing that a familiar environment helps alleviate anxiety.

In this report, Moving Health Home (MHH), a coalition of health care organizations with a bold vision to make the home a site of clinical services, explores the transformation that home-based care has undergone during the pandemic. Insights and findings from this report are based in part on in-depth interviews conducted by Avalere Health with leaders from organizations that have either based or adapted their clinical and business models to serve patients in their homes.

Based on the interviews with Landmark Health, DispatchHealth, Contessa Health, Ascension, and Advocate Aurora Health, MHH identified four lessons learned from the pandemic experience, including:

1. Home-Based Care Encompasses a lot More than Home Health – Care in the home is no longer limited to traditional home health services and exists on a spectrum of intensity and type of services offered.
2. Organizations with Experience Providing Home-Based Care Were Well-Positioned to Respond to the COVID-19 Public Health Emergency (PHE) – While many organizations quickly adopted to the pandemic, models that succeeded most rapidly typically leveraged existing home-based care programs and infrastructure.
3. Home-Based Care Models Boost Patient Satisfaction, Improve Quality, and Reduce Costs – Beyond addressing capacity and caregiver fatigue issues, home-based care models have demonstrated the ability to improve quality, boost patient satisfaction, and reduce costs.
4. Regulatory Flexibility is Essential to Success – The pandemic demonstrated that regulatory flexibilities are critical to fully enable care delivery in the home.

To fully realize the benefits of home-based care, including improved clinical outcomes, patient experience, and reduced caregiver burden, state and federal policymakers will need to implement permanent flexibilities and programs that build on the lessons learned from the temporary PHE waivers. The pandemic has gifted the opportunity to transform how health care is delivered, and this report is an important step in ensuring home-based care is part of our health care future.

Background: On December 2, Moving Health Home (MHH), a coalition of health care organizations advocating for improved access to home-based care, released a consumer survey sponsored by industry leaders BrightStar Care, Home Instead, Intermountain Healthcare, and Vituity. During the pandemic, holidays have looked different. People have been separated from their loved ones by distance and the walls of health care facilities. This has been alleviated, in part, by federal flexibilities such as the Hospitals Without Walls (HWW) and Acute Hospital Care at Home (AHCAH) waivers, that allowed hospitals to treat Medicare beneficiaries in their homes. However, these waivers are set to expire at the end of the public health emergency (PHE) unless Congress acts.

Survey Results: The new national survey, conducted by Morning Consult, speaks to the widespread support by adults for receiving care in their homes across the care continuum, including Hospital at Home.

• Americans Are Comfortable Receiving Care in the Home
  • 70 percent of those surveyed are comfortable with care in the home citing that familiarity helps alleviate anxiety and improve communication. This is especially important for those from underserved and minority communities.
• Americans Are Confident in the Quality of Receiving Care in the Home
  • 73 percent of adults are confident in the quality of receiving care in the home.
  • 85 percent of caregivers are confident in the quality of receiving care in the home.
  • 88 percent of adults were satisfied with the clinical care services they received in the home.
• Americans Prefer and Would Recommend Care in the Home
  • 85 percent of people who have had experience with care in the home would recommend it to family and friends.
• Americans Support Expanded Care in the Home
  • A bipartisan majority of consumers say it should be a priority for the federal government to increase access to clinical care in the home (73 percent Democrats, 61 percent Republicans).

Action: Congress should act now to temporarily extend the HWW and AHCAH flexibilities for two years after the PHE while working to develop a permanent Acute Care in the Home Program. View the MHH policy fact sheet here for more information on why Congress should act.

What They Are Saying

Press Release

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Full Analysis of Results

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Infographic

Survey Sponsors