The epidemic has to light some of America’s healthcare system brightest points — as well as its most pressing needs. On the one hand, we have seen the dynamism of America’s innovation engine, with substantial contributions for vaccines and therapies from American scientists and firms. The epidemic, on the other hand, has brought to light both the distribution issues and cost inefficiencies of the healthcare system, which now accounts for roughly a fifth of our GDP — considerably more than any other country — yet still falls behind many other affluent countries in clinical outcomes.
A lack of alignment between payment and incentive models, as well as an overreliance on hospitals as care delivery hubs, is at the root of many of these issues. Hospitals account for a third of healthcare spending, yet at-home models can be more successful and cost-effective. Furthermore, most providers rely on fee-for-service contracts rather than preventative care plans. Because of these reasons, care in this nation is reactive, transactional, and inefficient. By returning treatment from the hospital to where it began — at home — we can improve both outcomes and costs.
In-home care is not a new concept. Over 40% of physician-patient, contacts took place in the house in the 1930s, but by the 1980s, that number had decreased to less than 1%, thanks to developments in health economics and technology that led to today’s hospital-dominant style of care. This 50-year transition resulted in cost consolidation, centralized access to specialist tests and treatments, and the establishment of centers of excellence.
It also resulted in a shift from proactive to reactive treatment, thereby ending the patient-provider connection. Patients frequently diagnosed and treated by individual doctors who do not consult one another in today’s system. These highly compartmentalized therapies frequently administered just after the patient requires emergency care. Higher expenses — and worse results — result from this.
This is when in-home care comes in handy. In-home care now accounts for barely 3% of the healthcare sector. Within the next decade, we expect it to increase to 10% or more. This expansion will enhance the patient experience, improve clinical results, and save healthcare expenditures. In-home healthcare initiatives will need to use next-generation technologies and value-based care techniques to achieve these gains. Fortunately, there is currently a window of opportunity for reform.
Five major advances in the last several years have generated new incentives to promote drastic changes in the way care delivered. Remote patient monitoring (RPM) and telemedicine are examples of technologies that have evolved to the point where they can apply at scale. Providers may treat patients remotely in a proactive, long-term relationship from the comfort of their own homes at a lower cost using these technologies.
