Understanding Hospital Care at Home

The COVID-19 pandemic has highlighted the challenges of providing adequate resources to patients who need inpatient hospital admission. To meet these challenges, health systems and health plans are turning to alternative approaches that deliver high-quality care outside the four walls of the hospital, while at the same time ensuring it is safe and affordable. 

One solution at the forefront of this objective is hospital care at home. This care modality has evolved to meet the increasing demand for accessible acute care, by bringing hospital-level care to the home. Simply put, hospital care at home offers medical services in the home to patients who meet the criteria for admission to a general medicine floor at the hospital. This not only benefits patients by making high-quality healthcare more accessible, but it also provides significant value for health systems and payers, by decreasing costs and improving the patients’ experience.  

Contessa’s unique hospital care at home model, called Recovery Care at Home, was first launched in 2015. Although hospital care at home has been in use since the 1990s and successfully implemented both in the U.S. and abroad, the financial viability of Contessa’s model has allowed us to scale our programs where others have struggled. Since that time, we’ve partnered with industry-leading health plans and health systems across the United States to successfully implement hospital care at home in multiple contexts, with proven positive outcomes. 

How hospital care at home works

Contessa’s hospital care at home model, Recovery Care at home, helps health system partners bring acute care to the comfort of patients’ homes. To do so, we build a care team that is fully equipped to follow patients through the continuum of their care, from their initial hospital visit to their admission to the Recovery Care at Home program and throughout their episode.  

As part of this process, we strive to understand what is important to our health system partners as well. Our model is flexible to meet the unique needs of each health system partner and integrates their resources in a financially beneficial way. 

We utilize robust clinical protocols, built over time and through extensive experience, and careful patient selection to identify and treat patients that can receive hospital care in their homes safely. While patients can be admitted from any care setting, like primary care or urgent care clinics, there are two common points of entry for Recovery Care at Home:  

• Straight from the emergency department (ED)- Recovery Care Coordinators, registered nurses specially trained on this care model, identify eligible patients who would otherwise be admitted to the inpatient unit from the ED. If the admitting physician agrees they can be cared for at home, these patients are offered this option, with over 90% choosing to accept care at home. 

• After their admission to the hospital- this pathway is known as Completing Hospital at Home, allows patients who are already admitted to the general medicine floor of the hospital to complete their course of hospital treatment at home after stabilizing on the inpatient unit. 

Common diagnosis-related groups that are a part of our Recovery Care at Home program include congestive heart failure, COPD, cellulitis, and pneumonia. Patients who receive their care at home are given technology and instructions that facilitate their treatment and recovery. This includes tablets for telehealth visits with physicians who round on patients daily, virtual monitoring equipment, and any DME necessary. Treatment is administered through carefully designed clinical protocols developed in conjunction with the hospital system. 

Patients are also visited at home at least twice daily by nurses with acute care experience, who ensure adherence to the care plan and are proactively involved in any need to escalate or change the plan of care.  

The built-in value of hospital care at home

For hospital care at home to make sense, it needs to be both valuable and scalable. Contessa’s expertise shines in both contexts, and the outcomes speak for themselves.  

Along with a clinically proven, safe care experience for patients, one of the things that makes Contessa’s strategy unique is that we offer a joint venture model, enabling financial and strategic benefits to our partners. This structure is key to a robust, viable program that is scalable and effective. 

For patients:

With an average patient satisfaction rating of 90%, patients clearly enjoy Contessa’s Recovery Care at Home program. It’s easy to understand why—most patients who are given the option of receiving their hospital care at home instead of on the inpatient unit choose care at home. Home is familiar, comfortable, and without the disruptions to rest and healing that can happen in the hospital. 

For hospital systems:

Years of experience in negotiating value-based contracts with both national and regional payers means Contessa’s Recovery Care at Home minimizes costs to providers. COVID-19 illustrated the value of decanting hospital beds and expanding care delivery. Hospital care at home does both at a lower cost than brick-and-mortar solutions can offer. 

Additionally, readmission rates are reduced by 44% with our hospital care at home — a value that cannot be understated. 

For health plans:

Contessa’s proprietary technology platform, Care Convergence, helps us manage logistics and analyze data to help health plan partners realize per-episode savings compared to historical cost. In addition, risk is shared for episodes of care, further lowering costs. 

The bridge between hospital care at home and comprehensive care options

Looking to the future, hospital care at home is not limited to acute care. Contessa’s Recovery Care at Home has expanded to a comprehensive suite of care at home options that offer a full continuum of care. This structure not only brings accessibility to all phases of care to our patients, it also is the most scalable and financially viable model for our partners.  

Our post-acute model, Rehabilitation Care at Home, allows patients who are ready for discharge from Recovery Care at Home or from inpatient status at the hospital to move to skilled nursing at home. And Palliative Care at Home offers options to patients who need the additional layer of support that palliative care provides.  

These comprehensive care options are only the start of remarkable things that can happen when Contessa partners with care providers to bring our healthcare options to patients. The future holds exciting possibilities for bringing even more care options to our program. We have built our success on innovative solutions for delivering this kind of care and comfort where many patients can thrive and heal best– at home.