SSM Health hopes to expand home-based skilled nursing to other hospitals in its system after achieving good results from a program it launched last spring in Madison, Wisconsin.
The St. Louis, Missouri-based health system launched the Recovery Care at Home program with technology company Inbound Health at St. Mary’s Hospital. The program provides nurse visits, therapy, durable medical equipment, infusion services, imaging and telehealth support to certain patients in their homes following a hospitalization.
Related: SSM Health expands home-based care programs with hospital at home
Approximately 50 patients who received skilled nursing at home had about a 45% reduction in hospital readmissions compared with similar patients who received facility-based care, Kyle Nondorf, regional vice president of acute care operations for SSM Health Wisconsin, said. He also said patients who received home-based care spent an average of about five fewer days in the hospital than their counterparts who received post-acute care in a skilled nursing facility.
SSM Health hasn’t tracked cost savings yet, but Nondorf said treating patients at home allowed St. Mary’s to free up capacity for sicker patients. He said the hospital plans to double the number of patients it enrolls in Recovery Care at Home this year and the health system hopes to replicate the program across its 23 other hospitals in Wisconsin, Illinois, Missouri and Oklahoma.
“Each market is different and unique. Where we see value is when we have bed capacity constraints with patients not being able to access acute care. That seems like the logical place for us to expand to help decompress those facilities,” Nondorf said.
Health systems including Cleveland Clinic and Minneapolis-based Allina Health have started home-based skilled nursing programs over the past few years. Mass General Brigham is also studying the potential of such a program.
But reimbursement remains a challenge. Fee-for-service Medicare does not pay for skilled nursing at home. Only a few Medicare Advantage plans cover the programs through value-based care contracts, which reimburse hospitals at a fixed rate that is lower than a 30-day episode of care at a skilled nursing facility.
Inbound Health CEO Dave Kerwar said Medicare reimbursement that pays the same rate for home-based skilled nursing as facility-based care could be a boon to the model.
“Medicare reimbursement would really advance this care model because other payers will follow what the government does in this area,” Kerwar said.
Moving Health Home, an advocacy group that promotes home-based care, said in an email it is lobbying Congress for Medicare reimbursement of skilled nursing at home.
