Hospital systems are now making a greater effort to collaborate with senior care providers – including those in home-based care – in an effort to elevate care delivery.
Key players in this larger move to work more closely with senior care providers, or to integrate that care directly, are Kaiser Permanente and Trinity Health.
While home-based care always played a role in care delivery at Kaiser Permanente — one of the largest health systems and health plans in the U.S. — last year the company leaned in further by building a designated Care at Home arm.
The health system tapped Angel Vargas, vice president of Care at Home at Kaiser Permanente, to help lead the segment.
“We’ve always had a home health, hospice, home palliative, DME and medical transportation portfolio, but it was a little fragmented and decentralized,” he said earlier this month during a panel discussion at Aging Media Network’s CONTINUUM event. “What we did last year was centralize it as a service within the delivery model. Now, we’re one unified operation for all care at home. Anything in the home is under this portfolio of services.”
The idea behind this move was having “one cohesive message, one experience” for all patients, according to Vargas.
Kaiser Permanente’s Care at Home services line includes home health care, home-based palliative care, hospice care, hospital at home, lab at home, a virtual nursing center, DME and medical transportation services.
Reiterating a point he made to Home Health Care News last year, Vargas stressed that home-based care will be a major distinguisher at Kaiser Permanente.
“We acknowledge that the hospital can no longer be the future of the health care system,” he said.
Vargas also noted the shifting demographics of the U.S.
“88 million people will be over the age of 65 by 2050 … well, 90% of them want to age in place, at home,” he said. “In order to do that, you have to build a robust setting of care in the home space.”
Kaiser Permanente is especially excited about offering high-acuity care in the home setting.
“Right now, traditional home care, in particular, is the Flintstones, and we need to become the Jetsons,” Vargas said. “You put $32 million into a hospital, you get a boiler room upgrade, but you put $32 million into home care, you get 70,000 visits per year. If you look at that context, that’s the future we’re trying to build. I would say that Kaiser Permanente takes that portion of the continuum very seriously.”
However, there are limits to what can be done in the home setting.
“We can’t do intensive surgeries in the home, we can’t do certain things in the home — that’s fine,” Vargas said. “We’ll keep that in the appropriate setting, but we can do a lot of IV infusions, we did remdesivir successfully. We can do hospital-level care for patients that would be admitted. Let’s go as far as we can, safely, and then leave the rest to the appropriate setting.”
Still, in order for hospital systems to truly be successful, the technology will have to keep up. Vargas said that the technology right now is not “advanced as it could be,” and that’s an area that could help home-based care delivery improve in the coming years.
On its end, Trinity Health Senior Communities is part of the larger Trinity Health umbrella.
The organization has a large spectrum of care modalities. Trinity has a large home health footprint, a big senior housing footprint, skilled nursing and more.
The most important thing is making sure patients are in the right setting, wherever that is, according to Jan Hamilton-Crawford, CEO and president at Trinity Health Senior Communities.
“I think about making senior living, making PACE, making home care, whatever the needs of the individual, making that available,” she said during the panel discussion. “We, as the health care providers, need to be able to make sure that we reach those people and get to those people, so they can make those choices early on.”
Hamilton-Crawford believes that it’s crucial for providers to step in and educate seniors on what choices are available to them, and what each clinical setting entails.
“People really don’t understand what they need, or don’t know what their choices are, until they’re probably 80 years old and they have an episode,” she said.
Looking ahead, it’s going to be important for providers across the country to gain a “unified perspective,” according to Vargas.
“We could solve these continuum issues as a system, as opposed to a fragmented reaction to hospital needs,” he said. “We are reacting to hospital needs, we are reacting to ambulatory access gaps. We’re not a system yet.”
