As you can imagine, the emergence of COVID-19 has changed and will continue to change the healthcare landscape in the United States and throughout the world. Additionally, home health has been and will continue to be impacted by this novel coronavirus.  Already COVID-19 has profoundly impacted the home care industry due to the risk of transmission and over-capacity of the healthcare system. Our thesis is that even after the COVID surge has passed and treatment or vaccine has been found, home care will continue to increase and the management of care at home will become ever more important. Furthermore, the emergence of COVID-19 and its strain on emergency care locations has led to more care being delivered virtually in the home through telehealth.

Telehealth during COVID-19

Since February, the Centers for Medicare & Medicaid Services (CMS) has encouraged home care providers to use telehealth during the pandemic.

• Ordering providers of home health care have requested telehealth
• Home health agencies have requested that care be delivered via telehealth

How long will this last?

COVID-19 is likely to be with us into 2021 at least. With the threat of infection and the strain on resources, at-home care makes sense not only for those who are homebound but also for those who are not homebound, such as those who are aging in place. Due to the strain on emergency services, health care plans are attempting to move patients to less intense and lower-cost sites of care where high-quality outcomes can still be achieved. This means that those health plans will continue to attempt to divert patients from inpatient facilities (IF) and skilled nursing facilities (SNF) to home. Consistent with this, we know that most patients prefer to be cared for at home.

What does this mean?

Moving forward, management and clinical oversight of home care will be a crucial component of the health plan toolkit for managing members at home as the home health care industry remains fragmented and the quality of care is variable. While aligned provider financial incentives tied to quality improve care, these incentives are insufficient to ensure an optimal outcome for the patient. Additional clinical oversight and innovation are necessary and appropriate.  For example, one major change that has already been reflected in-home care since the advent of this pandemic is the increased ability of home healthcare agencies to deliver more complex care in the home ( e.g. COVID-19 patients with mild to moderate respiratory distress). To ensure the success of care at home it will also be vital that all in-home services are well coordinated.  For example, those managing post-acute care in the home will need to ensure that proper durable medical equipment is available to the patient and that the patient knows how to correctly use it. Please continue to follow us for on-going discussions about the future of home healthcare after COVID-19 and how the home healthcare system will need to continue to adapt and grow.