Insights
KATHERINE DAVIS-YOUNG
The Biden administration massively expanded hospital-level care at home as part of its strategy to enhance hospital capacity. The Mayo Clinic says it's having an impact.
[RACHEL MARTIN, HOST:] Arizona is still dealing with the worst of omicron. Hospitals there have been near capacity for months. Lately, a number of them have been working to free up patient beds by treating people with serious conditions in their own homes. From member station KJZZ in Phoenix, Katherine Davis-Young reports.
[KATHERINE DAVIS-YOUNG, BYLINE:] In late 2020, the federal government announced strategies to ease stress on health care facilities, including more flexibility for hospital-level care at home.
[DAVID LEVINE:] "We went from zero approved hospitals to, a year later, over 185 hospitals all throughout the country have been approved for this care model."
DAVIS-YOUNG: Dr. David Levine with Brigham and Women's Hospital in Boston has led research into the effectiveness of acute care at home. Providers can't offer surgery or ICU-level care outside of hospitals, but technology is now good enough that a growing number of hospitals are offering X-rays, bloodwork and many treatments for non-life-threatening conditions on the go. And Levine's research shows patients who get treated at their kitchen table or on their couch have better health outcomes than those in brick-and-mortar medical facilities.
[LEVINE:] "You end up getting readmitted much less often, and you end up lying down much less often and moving around much more when you're at home versus in the hospital."
[DOLORES WIESE:] "Oh, I tell you."
DAVIS-YOUNG: Patient Dolores Wiese says getting to eat home-cooked meals, see her family and sleep in her own bed makes recovery a lot more comfortable.
[WIESE:] "I like to be active. And to be tied down in bed in a hospital? No. I'll take this any day."
[UNIDENTIFIED PERSON:] "Thirty-four?"
[TAMI HAMPSON:] "One-thirty-four."
[WIESE:] "Oh."
[HAMPSON:] "So that's good."
DAVIS-YOUNG: I met Wiese in her apartment in a retirement community in Phoenix. She was being treated for a skin infection that typically might have kept her in the hospital for a few nights. Nurse Tami Hampson with DispatchHealth rolls in a few suitcases full of medical gear.
[HAMPSON:] "We have all of our equipment here to do all of our exams or draw blood. We could put IVs in. We can…"
DAVIS-YOUNG: Another hospital system that began offering at-home care during the pandemic is Mayo Clinic. Mayo's Dr. Michael Maniaci says patients respond really well to virtual doctor visits and regular follow-up calls. But he says for now, the federal government is only paying a lump sum for the custom-tailored care.
[MICHAEL MANIACI:] "There's really no true reimbursement for that that's built yet in the system."
DAVIS-YOUNG: But Maniaci says everyone will save money in the long run if patients stay healthier. And then there's the issue of space.
[MANIACI:] "Even if we're losing money because we're giving extra services, what's the cost of opening up that hospital bed for a cancer patient or surgical patient that needs it more?"
DAVIS-YOUNG: Across three states, Mayo says it's been able to free up 3,300 hospital bed days by treating patients at home. The challenge, Maniaci says, will be scaling up. But a few private insurers have started joining the government and are paying for in-home care now, too. Humana is one. The company's Dr. Amal Agarwal says Humana is also growing its own in-home care service. The numbers, he says, just makes sense.
[AMAL AGARWAL:] "It can provide good clinical care in the right scenario, and it can be done at a lower cost. So I think that there's value there. And it's a lower cost for the member, as well."
DAVIS-YOUNG: The federal permission for hospitals to expand in-home care was meant to be temporary, but providers and now some insurers really want lawmakers to allow it to continue permanently.
[HAMPSON:] "We'll put another Band-Aid on top of it, but it looks pretty good."
DAVIS-YOUNG: That would be fine with Dolores Wiese back in Phoenix. Her medical visit ends with laughs and hugs.
DAVIS-YOUNG: For someone who's technically hospitalized, it's clear she's having a great time.
[WIESE:] "The best thing that's happened since running water."
DAVIS-YOUNG: She'd prefer not to be hospitalized again, but if she is, she really hopes it will be in her living room.
For NPR News, I'm Katherine Davis-Young.
