Health leaders from Humana Inc. (NYSE: HUM) and the Perelman School of Medicine and Health Care Management at the Wharton School of the University of Pennsylvania call for a simpler and more patient-centered home care experience for patients, which can be achieved through the creation of payment models that encourage innovation for enhancing personalized care. This will lead to lower cost, high quality approaches to areas ranging from home dialysis to chronic disease management.
The findings were published today in the Journal of the American Medical Association (JAMA) in a paper titled “Innovation in Home Care: Time for a New Payment Model” The paper is co-authored by Kevin Volpp, M.D., Ph.D, Founders President’s Distinguished Professor of Medicine and Medical Ethics and Policy at the Perelman School of Medicine and Health Care Management at the Wharton School; Susan Diamond, Segment President, Home Business, Humana; and William H. Shrank, M.D., M.S.H.S., Chief Medical Officer, Humana.
In the paper, the co-authors discuss how the “the idealized care delivery model of the future would use a combination of remote monitoring sensors, bidirectional communication modalities to facilitate provision of care, and clinicians, and non-medical personnel working together to deliver coordinated services to address unmet clinical, behavioral and social needs. Such a system could proactively keep patients healthy as opposed to reacting to disease events once they progress.”
Technology can enable a personalized, convenient home health service experience, which is especially important in today’s environment. “The home has become the place where people, especially older adults living with multiple chronic conditions and most at risk to COVID-19, want to receive care,” said Diamond. “Our home health care delivery system needs to catch up to that reality. By reforming the payment system, we can incentivize innovation that will ultimately deliver better care to our members where they increasingly want it – at home.”
In the paper, the authors also state that the needs of providers and patients must be front-and-center when constructing new home care payment models:
- Be specific on the desired outcomes. Providers need to be incented by a payment model that makes clear to front-line providers what outcomes their efforts need to influence, with a clear sense that their reimbursement is aligned with either improvement in or attainment of strong outcomes. Providers taking on full clinical and social risk can be the foundation for the care experience.
- Ensure the unhealthiest are included. For people living with multiple chronic conditions, “consideration should be given to carefully account for the most severely ill 5% of patients who require extensive home services so that clinicians and health care systems are not de-incentivized from taking care of such patients.”
- People want a simple experience built around them. “Care should be simpler and more patient-centered whereby patient preferences are factored into the site of care delivery when economically feasible.” This is an opportunity for health systems to achieve people-focused care.
- Precision medicine is essential. “Given the heterogeneity of patient clinical and social needs, preferences, and effectiveness of different interventions in different people, health systems need to continuously adjust what is offered to whom.” It is essential that the holistic approach to care is optimized by serving the specific needs of the patient.
- Good things take time. “Economic returns from better management of diabetes or by enhancing functional status for a patient with Parkinson disease” will not happen overnight, but must be prioritized. It must be about whether care improves health at a reasonable price as opposed to saving money in the short term.
- Leverage the transformational power of analytics. The use of analytics can help us “identify risk, anticipate clinical decline, measure biometrics wirelessly, and connect patients to appropriate clinicians virtually,” enabling health plans to systematically identify patients at elevated future risk to guide interventions that proactively lower risk.
“Humana has always taken a holistic, human approach to health care,” said Shrank. “Our recommended approach to channeling innovation to enhance home care that we have put forth in the Journal of the American Medical Association reflect that commitment and reflect our focus on reforming our home health care delivery systems.”
For more information about Humana’s efforts to help people improve their health, please visit https://populationhealth.humana.com/.