Why 2023 Was a Milestone Year for Comprehensive Healthcare at Home

If 2023 taught us anything, it’s that the culture of healthcare is shifting — home. In the past twelve months, Contessa has witnessed this shift across all our service lines, with both new and existing partnerships. Our innovative approach to healthcare at home has evolved from offering a singular hospital-at-home program to delivering the full continuum of care through our Comprehensive Care at Home model, which has quickly become integral to health systems and payers’ strategies. 

A strategy to scale and grow became the focus of 2023 

As we approached 2023, it was clear that hospital-at-home and the continuum of care at home was becoming a permanent part of healthcare strategy. 2022 came to a close with an extension of the Centers for Medicare and Medicaid (CMS) Hospitals Without Walls waiver, indicating the continued national interest around the longevity of these programs. 

This extension was met by a shift from hospital leaders asking, “Should we consider adding a hospital-at-home program to our strategy?” to a longer-term question: “How can we grow a hospital-at-home program to an average daily census (ADC) of 50-100 beds?” 

With or without the waiver, Contessa has always been poised to answer this question with scalable, reimbursable models of care. By joining forces with Amedisys, Inc. and expanding beyond our hospital-at-home program, Recovery Care at Home, to also delivering Rehabilitation Care at Home and Palliative Care at Home, we entered 2023 with a comprehensive model of healthcare in the home. This resulted in a vote of confidence from our existing partners, as well as new partners. 

New health system partnerships went live in 2023 

As 2023 unfolded, we launched care at home services with three new partners, Baylor Scott & White Health (BSWH), Virginia Mason Franciscan Health (VMFH) and the University of Arkansas for Medical Science (UAMS). Both UAMS and BSWH have opted to expand beyond adoption of just the hospital-at-home component and have chosen to incorporate additional service lines through Contessa as well.  

In all three cases, these programs were well-received in their first few months of operation. The launch of BSWH’s hospital-at-home program saw an immediate surge in patient admission, as did VMFH’s program, and UAMS’ Comprehensive Care at Home program is also quickly gaining ground. 

These successes speak to the growing enthusiasm around these models of care, especially when they are effectively built and managed with the help of an experienced partner like Contessa. 

Rapid growth of existing partners 

Along with our new hospital system partnerships in 2023, our existing health system partners added on to their foundation of success with Contessa’s Recovery Care at Home and rolled out new lines of care. This includes Mount Sinai Health and Penn State Health’s adoption of Rehabilitation Care at Home, Prisma Health and the new BSWH partnership expanding their footprint to new locations and Henry Ford Health rolling out Palliative Care at Home. 

Each of these expansions further affirms the scalable and sustainable approach to advanced healthcare in the home that forward-thinking health systems are seeking to build. And the numbers support that narrative: in 2023, both Prisma Health and Mount Sinai hit the milestone of serving more than 1,000 patients through their hospital-at-home programs. 

Palliative Care at Home is also expanding rapidly 

The strategy to expand healthcare services in the home wouldn’t be complete without the addition of palliative care in the home. With hospital-at-home and other episodic care models operating at “full speed ahead”, palliative care is disrupting the status quo by providing a longitudinal model of care that maintains the fabric of care in the home across patients’ healthcare journeys.  

It’s this innovative approach to better outcomes with value-based care in the home that has driven our wins with Palliative Care at Home in 2023. Working together in a new partnership with a large national payer, we’ve supported more than 600 patients this year with complex and chronic diseases.  

With Palliative Care at Home, we’re able to reduce healthcare fragmentation with coordinated transitions of care, relieve burdensome symptoms, educate patients on their disease processes and establish individualized goals of care with advance care planning (ACP) that exceeds national benchmarks. In our value-based program, approximately 90% of palliative care patients have a documented ACP within 60 days of admission, reducing unnecessary care utilization and hospital readmissions for this vulnerable patient population.  

These benefits of palliative care are why we’ve seen a massive surge in the growth of community-based palliative care programs in the past few years, a phenomenon that will continue to expand to bring this specialized medical care directly to patients’ homes. 

Looking to the future 

The growth of the continuum of care over the course of 2023 illustrates the shift away from hospital-at-home programs as one small branch of healthcare strategy to a core offering, which will only continue to strengthen as we see the overlap between the models of care expand.  

Going forward, we can expect to see patients seamlessly transition between hospital-level care at home to rehabilitation services and even primary care, in many cases with palliative care as a core support across all service lines for patients with advanced illness. 

As this approach continues to evolve and expand, it’s reasonable to infer that today’s improved outcomes and high patient satisfaction will translate into even greater growth as more and more stakeholders recognize the value of this modality of care. These are exciting times, and Contessa is proud to be a leader at the forefront of bringing comprehensive healthcare home. 

Meet Our Expert

Robert Moskowitz, MD, MBA, Chief Medical Officer

Rob Moskowitz, MD, MBA, is dedicated to ensuring that patients receive high-quality care that is timely, accessible and comprehensive. As the Chief Medical Officer at Contessa, he leads all clinical and quality aspects of Contessa’s home-based care continuum. Dr. Moskowitz brings his experience as a practicing emergency physician to all aspects of his role at Contessa, seamlessly partnering with health system leaders to develop, implement and monitor industry-leading hospital care at home programs.