Every February, the country puts a needed focus on the issue of heart disease, the leading cause of death in the U.S. today. When President Johnson first declared February American Heart Month, he could never have imagined the progress medical science and technology have made in treating this terrible disease. But with more than 800,000 people in the U.S. still dying from cardiovascular disease each year, while about one in every six healthcare dollars is spent on the disease – there is no question that a new approach is needed.
As impactful as medical science and technology innovation are and have been, they aren’t enough on their own to solve the systemic challenges of caring for patients with chronic diseases like heart disease. Value-based care delivery models are a light at the end of the tunnel, offering the new connected and coordinated approach needed to address the complex needs of cardiac patients (inside and outside of the hospital). With the unique ability to own patient care transitions from hospital to home, manage chronic diseases like heart disease, help prevent the costly ER visits and avoidable hospital readmissions that plague cardiac patients – the home healthcare sector is one important key to making value-based care work for cardiac patients.
On the cutting edge of alternative payment models that incentivize value-based care are bundled payments – single, fixed payments for services by multiple providers during an episode of care (like a heart attack or bypass surgery). Because this model holds hospitals accountable for controlling costs from the time of a patient’s specific procedure, through 90 days of follow-up care, they incentivize communication and coordination among all players inside and outside of the hospital – including qualified home healthcare providers. These models also rely on connected technology and data analytics. This means that whether tracking cardiology-specific quality measures or communicating with a patient’s care team, the home healthcare sector can only make an impact and succeed in a value-based care, bundled payment world with the right technology tools in place.
There are two mandatory bundled payment models that are helping to catalyze the shift in the way hospitals approach care outside of their walls. The Comprehensive Care for Joint Replacement (CJR) model, launched officially on April 1, 2016, is showing significant cost savings when patients enter home healthcare following a major joint replacement surgery. Across all settings and geographic areas, the average cost per episode is $24,900, but when home health is the first post-acute care setting, the average cost drops to about $19,900. This is excellent data to share but it is not from the CJR model launched in April 2016. It supports the value of home health in this new model.
And what makes this year’s American Heart Month one to remember is, beginning this July, the mandatory bundled payment program for heart attacks and bypass surgeries will launch. The model will not only offer the home healthcare sector another opportunity to quantify and solidify itself as a key participant in new care delivery models, but also cardiac patient outcomes.
They say home is where the heart is. Here’s to someday making American Heart Month obsolete, and in the process, making the home the center of patient care.