Nancy Gin, MD, FACP, leads a vibrant panel discussion for The Permanente Journal on the evolution, merits, and challenges of value-based care.
In a recent HealthLeaders opinion article, Steven Parodi, MD, associate executive director of The Permanente Medical Group, shared the lessons learned from 3 years spent developing and implementing advanced care-at-home programs at Kaiser Permanente.
As the effects of pandemic-related physician burnout, supply chain issues, and rising inflation continue to put pressure on the health care industry, hospitals must meet the challenge by reimagining traditional care delivery, wrote Dr. Parodi. One promising solution: bring hospital-level care directly into the patient’s home. In addition to meeting strong consumer demand, in-home hospital-level care has the potential to make care more cost-effective if sufficiently scaled.
However, building an advanced care-at-home program while maintaining the same high quality of care found at a brick-and-mortar hospital requires significant research, planning, investment, vision, and fortitude. Dr. Parodi, who also serves as executive vice president of External Affairs, Communications, and Brand for The Permanente Federation, advised that health care organizations should start by designing programs centered on patient needs. For example, Kaiser Permanente began with focus groups to determine what patients look for in this type of program.
Next, aligning key quality, operations, and marketing functions across the organization to focus efforts and understand goals is critical, Dr. Parodi said. He also described the importance of pressure-testing at-home care programs to identify potential problems and ensure operations are stable before going live.
He stressed the need to communicate the work-life benefits of at-home care programs to key care team members, especially important in a time of rampant worker burnout. For example, hospitalists in Kaiser Permanente’s program report improved job satisfaction, as well as finding joy and meaning from communicating with patients recovering in the comfort of their home.
The final lesson from Dr. Parodi: understand that building a new program takes time. To foster confidence and help physicians, care teams, administrators, and patients embrace care-at-home programs, organizations should be open, transparent, and think long-term.
Looking ahead, Dr. Parodi emphasized the broad need for more quality, safety, and efficiency data. The good news is that the omnibus bill signed into law late last year extends the Centers for Medicare and Medicaid Services hospital-at-home waivers through the end of 2024, assuring an opportunity to develop a regulatory framework that will help organizations grow and develop more care-at-home programs. The extension also offers the opportunity to create more performance benchmarks and expand more services outside the hospital setting.
Note: Read the full article at HealthLeaders.