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04/13/2021

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Enabling high-quality health care at home

As a result of the COVID-19 pandemic, more people across the U.S. are eager to get their health care needs met at home. From telehealth and virtual care provider visits, to managing chronic conditions, recovering post-surgery, and aging in place, the demand for health care in the home has never been higher.

“Though there was a growing interest in health care at home prior to 2020, the pandemic forced the issue,” said Rob Schlissberg, president of Cardinal Health at-Home Solutions, a market-leading medical supplies provider serving people with chronic and serious health conditions in the United States. “Patients and providers alike wanted to do what they could to slow the spread of the virus.”

At the start of the pandemic, there was a dramatic increase in telehealth services alone: According to McKinsey & Company, telehealth use was 78 times higher in April 2020 than it had been two months earlier; more than 32% of total outpatient visits that month were via telehealth.

Today, if given the choice, patients are more likely to prefer to receive care for higher-acuity care needs at home, too, a trend that experts expect to accelerate. McKinsey & Company estimates that “up to $265 billion worth of care services for Medicare fee-for-service and Medicare Advantage beneficiaries could shift to the home by 2025 without a reduction in quality or access” – a figure that is three to four times higher than the cost of care at home for this same audience today. According to the Centers for Medicare & Medicaid Services [CMS], more than 60 different conditions, including asthma, congestive heart failure, pneumonia and COPD, can be treated safely in the home.

Drivers fueling more care in the home:

  • An aging population: There are about 56 million people over the age of 65 in U.S.; 10,000 more people turn 65 every day. About 85% of those 65 and older have at least one chronic health condition; 60% have at least two. And McKinsey reports that 16% of those 65 and older are more likely than they were pre-pandemic to receive home health services.
     
  • Regulatory changes to Medicare: Federal and state governments issued waiver flexibilities during the COVID-19 pandemic that allowed hospitals to provide advanced level care to patients in their homes with a reimbursement pathway through traditional Medicare services. Coalitions, such as The Advanced Care at Home Coalition, have formed to bring together industry stakeholders to advance federal strategy related to advanced care at home delivery models, coverage and flexibilities.
     
  • Technology innovations: Smartphones and laptops made virtual care possible throughout the pandemic; rapid advances in technology that continue to make care at home easier and safer include patient monitoring software, wearable devices that track and report health-related data (fitness trackers, smartwatches and blood pressure monitors, for example), and artificial intelligence (AI) that gives care providers greater insights through data to better predict and manage patient outcomes.

As more and more people experience the benefits, comfort and convenience of care at home, the demand will only grow, Schlissberg said, and at-Home Solutions is in a unique position to meet the demand. “We are very close to the patients here; we know them very well. We understand what’s important to them today, and what will be important to them tomorrow.”

Helping patients live their best life

Today, at-Home Solutions serves more than three million customers per year with a wide variety of medical supplies in categories such as diabetes, enteral, incontinence, ostomy, wound care and more. Two businesses are core to at-Home Solutions: Edgepark, a direct-to-consumer segment that serves health care professionals, manufacturers and patients in the home, and at-Home, a business-to-business distribution service that delivers medical supplies and over-the-counter products to home medical equipment providers, home health and hospice agencies and E-commerce providers.

It was Edgepark that, more than 90 years ago, launched the business. Beginning as a small corner pharmacy in Ohio, Schlissberg explained, Edgepark offered prescription and over-the-counter medication for customers to properly manage their health conditions at home.

Today, at-Home Solutions does the same. “Our goal is simple: we do everything we can to help our patients live their best life at home,” Schlissberg said. “We offer the products they need, and we have an entire customer support team that serves as patient advocates, helping our customers navigate all the complexities of health care, including insurance.”

At-Home Solutions works with more than 20,000 health care professionals across the country, offering nearly 50,000 products from more than 750 manufacturers. With nine distribution centers and more than 1.2 million square feet of warehouse capacity, the business can get products to patients, customers or care providers anywhere in the U.S. within one to two days.

Building capacity for hospital-level care at home

Throughout much of the past two years, hospitals have been filled to capacity and beyond with patients battling COVID-19. That left providers with little choice but to offer non-COVID patients home-based care for a range of treatments, including infusions, skilled nursing, medications, laboratory and imaging services, behavioral health and rehabilitation services. Those patients treated at home were also less likely to be exposed to the virus and were less likely to suffer from other preventable health events that can occur in the hospital setting.   

It turns out that such care can be more cost-effective. According to McKinsey, many stakeholders, from payers to health care facilities to providers and investors could see “substantial value” from care at home: savings from a reduced number of adverse events, more accurate risk coding, and from simply providing care in what is a lower-cost site of care. An Annals of Internal Medicine study found that hospital-level care at home costs 38% less than traditional hospital stays. The study also found that patients at home had fewer readmissions and experienced more physical activity – a key component of recovery.

The move toward hospital-level care at home is expected to grow exponentially. In fact, Healthcare Finance recently reported that health informatics company Philips predicts that 40% of health care providers will shift 20% of their hospital beds to the home over the next three years.

As a trusted industry leader in helping patients take care of their health conditions from the comfort of their homes, Cardinal Health engaged with and invested in Medically Home years ago. A technology company that enables health systems to safely care for their patients at home, with a focus on hospital-level care, Medically Home, provides health systems and hospitals with all the elements required to safely care for patients, including the clinical protocols, payer access support, platform technology and fulfillment of all the clinical services required in the home through partners.

Most recently, Cardinal Health joined several other health care leaders in a combined $110M strategic investment in the company. At-Home Solutions is now working to determine how its expertise in supply chain and logistics can contribute to scaling advanced care in the home.

“Ultimately,” Schlissberg remarked, “we believe that enabling hospital-level care at home can significantly advance health equity, lower costs, and, most importantly, improve patient outcomes.”

Ensuring a culture of innovation

Innovation is key to enabling successful hospital-level care at home, Schlissberg said, and he has a team focused on it. “But innovation is also critical to the day-to-day improvements of our core businesses of Edgepark and at-Home,” he added.

“For example, we’ve integrated our services with electronic medical records (EMRs), so that medical supplies become, seamlessly, a part of a patient’s plan of care. We help make the work of in-home care providers easier: We’ve created a Cardinal Health at-Home mobile app that allows providers to order products on the go, giving them more time for their in-home patients.” Mobile apps also are helping home care and hospice agency providers diagnose wounds and treat them appropriately – and remotely, he noted.

For the at-Home Solutions team, innovation comes to life in many ways. It may be in the creation of a comprehensive solution or technology to address an unmet patient or customer need. It could be changes to streamline work processes that increase efficiency and move the team more quickly to its goals. For Schlissberg, innovation – no matter where it happens – is likely to lead to better products and processes and improved patient and customer interactions.

“Innovation is also about how we work,” Schlissberg added. “How do we innovate in the everyday to become more efficient, to improve our services and offerings to our patients, providers and home health agencies? How do we make their experiences with us the best they can possibly be?

“We are driven by these questions, and by addressing patients’ and care providers’ unmet needs. What we do for them is critical, because care at home can mean both the very best care and the very lowest cost of care. That’s a win-win-win: for patients, providers – and for the future of health care.”

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