As cities across the United States have been preparing for influxes of COVID-19 patients, the nation’s acute healthcare providers recognize the unprecedented stress this has created now and in the future. Even with social distancing measures, some hospitals are facing an increasing number of high-need patients, and health systems have a finite amount of staff, space, and personal protective equipment (PPE). A challenging combination of new types of admissions and longer stay durations has resulted in overcrowded facilities, a stretched healthcare system, and mounting patient risk.
As the U.S. healthcare system has been contending with these strains, the home-based healthcare industry is in a unique and important position to provide relief. Home-based care providers serve tens of millions of people annually across settings that include skilled home healthcare, home infusion, personal care services, and home-based hospice. While these services and providers have historically been less visible across communities in the U.S. compared to their acute-care counterparts, home-based care providers have a vital role to play in addressing this pandemic, future emergencies, and whole-person care. With their skilled, versatile, and mobile care workforce, in-home care organizations can make a difference in our nation’s COVID-19 response.
Throughout the U.S., home-based care organizations employ over 340,000 nurses, 50,000 therapists, 30,000 social workers, and 900,000 personal care (also called “home care” or “private duty”) aides, according to the National Bureau of Labor as of 2019. Because these providers can deliver care services across patient acuity levels and within a diverse set of care environments, this workforce of over one million providers is well-positioned to be quickly mobilized in innovative ways to help our nation meet the COVID-19 challenges.
In this critical time for our healthcare system, here are four key ways that home-based care providers can support the ongoing COVID-19 response:
- In-home care can transition non-COVID-19 patients out of hospitals: Ahead of COVID-19 patient surges, home-based care providers can partner with their local hospitals to discharge stabilized non-COVID patients to their homes. Even though these patients could be more acute than the patients typically cared for in home-based settings, in-home care providers are equipped to handle more acute patients and can collaborate with hospital and physicians to deliver acute clinical care and personal care services, such as preparing food, bathing, cleaning, and other non-medical services.
- Home-based providers can remotely conduct pre-acute COVID-19 monitoring at patients’ homes: In-home care organizations can safely help keep less severe COVID-19 patients out of hospital beds and substantially reduce the financial pressures on the U.S. health system. The average COVID-19 hospitalization costs a healthcare system around $40,000. If home healthcare providers can leverage protocols to reduce the hospitalization rate of the riskiest quarter of COVID-19 patients from 20% to 15%, the health system could save an estimated total of $1.5 million per 1,000 COVID-positive patients, assuming a $2,000 cost for in-home care. In addition to the significant cost benefit, this would provide the advantage of letting people remain more comfortable in their home and avoid hospitalization.
- In-home care can support COVID-19 patients post-discharge: Home-based care organizations can also greatly help local hospitals by assisting stabilized patients return home safely. With many of the typical post-discharge locations like skilled nursing facilities and long-term acute care hospitals (LTACH) resisting COVID-19 admissions for resident safety reasons, accelerating home discharges with supervisory care is likely to become even more critical. For patients who can be discharged to their home safely, the clinical and personal care support provided by home-based care organizations can allow patients to recover from COVID-19 at home — while also keeping their families and communities safe.
- Home-based providers can deliver care in dedicated COVID-19 facilities: Home-based care organizations could also play a critical role in a more creative solution. Currently, COVID-19 patients who do not have a supportive or safe environment to recover at home, often spend the duration of their care in an expensive and scarce hospital bed. Instead, home-based care organizations could staff “COVID-19 Recovery Centers.” These centers could be housed in currently under-occupied hotels and dorm facilities. By providing a combination of housing, food services, and clinical and daily living support, cities around the country could partner with their local home-based care providers, hotels, and restaurants to create a safe recovery location for moderately acute COVID-19 patients. This reflects an approach successfully implemented in South Korea that has allowed the country to reserve hospital capacity for the people who need it most.
The bottom line: Home-based care providers are ready and able to alleviate health system pressures. The more than one million providers of home-based care can help serve patients, reduce care costs, and strengthen the U.S. healthcare system for the future. However, it is incumbent upon national healthcare leaders and public and private payers to engage in creative solutions to address COVID-19, like leveraging the benefits home-based care industry can provide. With the right equipment and a payment structure to creatively solve problems, home-based care providers can be the difference between success or failure, life or death, for communities and the nation.
To get educational resources for providers facing the pandemic, visit the WellSky COVID-19 Resource Center linked here.