JANUARY 15, 2020 Prakash Patel, M.D., Executive Vice President
and President, Diversified Business Group
In the Diversified Business Group (DBG) at Anthem, we are
focused on delivering high touch and high tech, whole person coordinated
care to those who need it most, wherever they are—whether at home, in the
hospital or in a skilled nursing facility.
I often refer to these three places as the “Bermuda Triangle
of healthcare” because of how difficult it is to stabilize and improve a
patient’s care level so they don’t end up back in facility settings. Often the
driver of the care challenge is due to episodic, fragmented care that does not
take into account a person’s entire health picture and journey, but we are
working hard to change that.
We are driving a new era of whole
person care and the critical need is for the hyper-personalization of
services and support, with the greatest need for patients with
chronic and complex conditions. These individuals are responsible
for more than 70% of every dollar spent on healthcare in the U.S.
To further understand and to better serve the needs of
chronically ill patients and caregivers, we commissioned a survey on
attitudes toward bringing care back to an in-home setting via the house call.
We found strong belief that care of the chronically ill could be better managed
by meeting them where they are: at home. This requires an evolution of our care
delivery models and what we learned in our research could help us begin to
dismantle the “Bermuda Triangle.”
We define the modern house call as a team of healthcare
professionals travelling to a chronically ill patient’s home or care facility
to provide medical care, consultations and social services. Our survey
asked Americans about this model and the findings
suggest the resurgence of the house call could enable high quality
and more accessible care for Americans living with chronic
conditions, while also alleviating caregiver burden. In
fact, many respondents (64%) expressed interest in the
house call, with an even larger majority (79%) agreeing that people
would be able to better manage their health if they could have
consultations with their healthcare providers in their own home.
We also explored the perceived benefits of
in-home care in comparison to care delivered in the office or clinic. The vast
majority (92%) said the quality of care provided in home would be better
or equal to the quality offered in an office or clinic. They also cited more
personal attention (42%) and less stress (44%) as key benefits,
with half (50%) agreeing that care provided at home would reveal much more
than what is seen in the office or clinic.
This survey adds to mounting evidence that patients and
their caregivers desire more personalized, convenient and collaborative
care. For example, early results from Independence at Home, a five-year Medicare study to
evaluate the effectiveness of home-based primary care, showed that all
participating programs reduced emergency department visits, hospitalizations
and 30-day readmissions for homebound patients.
The team-based approach we offer in Anthem’s care
delivery businesses helps keep the sickest, frailest patients
out of the hospital. It also helps those who are at risk improve and
maintain their health through comprehensive treatment and prevention programs.
We are constantly evolving our models to
provide a team-based approach for patients via at-home care, and via
our community-based palliative care support for chronically ill
patients. Our home care teams provide integrated physical and mental healthcare
to our patients in the space where everyone feels most comfortable—their
homes—and bring together physicians, nurses, case managers and social workers
who work in concert to deliver comprehensive support.
Our focus on prevention and highly coordinated
whole person care, with a clinical model and a designed-for-purpose
approach to managing chronic disease, allows
us to proactively address the medical, social and personal
health needs of patients. For example, during the 10-month period after we
launched Home-Based Integrated Care in Connecticut, hospital
admissions and emergency visits were down 12.5% and 27.2%, respectively.
The resurgence of home-based primary, acute and palliative
care is the future and this model has shown its potential to
improve outcomes and reduce costs for our country’s most vulnerable
patients. Patients living with chronic conditions are calling for
it. Let’s meet them where we are – by redefining and delivering the
house call.
1This
survey was conducted online within the U.S. by The Harris Poll and commissioned
Anthem Inc., between September 26, 2019 and October 11, 2019 among 2,009
U.S. adults ages 23+ including quotas for age for those 23-64 (1,000) and 65+
(1,009). Figures for age by gender, education, income, race/ethnicity,
region, size of household, marital status, and employment status were weighted
where necessary to bring them into line with actual population proportions,
separately by age quota group, which were then post weighted together in total,
proportionally.
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