Innovative homecare program keeps 1,000 Intermountain Health patients out of the hospital

Intermountain Health and Castell’s Hospital-Level Care at Home program continues to expand and has reached the milestone of safely and effectively treating 1,000 patients. Hospital-Level Care at Home has been treating patients with acute and chronic conditions in the home since May 2020.??

This service is available for patients at 16 Intermountain hospitals in Utah, from Logan to St. George, with an additional hospital being added this year. As Intermountain continues to move forward with population health and cost-saving initiatives, leaders will look for opportunities to expand Hospital-Level Care at Home into all regions.??

“Our goal is to be able to offer patients the right level of care in the right place at a lower cost,” said Nathan Starr, DO, Internal Medicine physician and medical director of Home Services for Castell and Intermountain’s Tele-Hospitalist program. “Our comprehensive in-home services provide the technology to monitor vital signs remotely, plus daily in-home nurse visits, daily telehealth rounding by a medical provider, and access to 24-hour on-call nurses and physicians.”???

Hospital-Level Care at Home offers services to Intermountain patients who meet specific clinical and non-clinical criteria and come in through an emergency department visit or have been admitted to the hospital and qualify for early transfer home.??

“The program is so diverse,” said Raeme Sendzik, Hospital-Level Care at Home operations manager. “It supports social determinants of health and covers diverse ethnic backgrounds, diversity of age, and a variety of financial backgrounds, including people who are unhoused.”??

Care for patients is provided through a partnership with Castell, the Intermountain population health entity, which helps improve patient outcomes and keep costs more affordable. The services are provided by in-person caregiver visits by Intermountain Homecare, as well as remote monitoring and virtual visits by telehealth providers located at the Intermountain virtual hospital in Murray, Utah.??

“Since its beginning, Hospital-Level Care at Home has saved Intermountain over 3,000 bed days from participating hospitals and costs 30% less than traditional hospital stays,” said Anna McMillan, director of Home Services at Castell. "This program is a great example of how Intermountain is transforming the patient experience by making care more accessible, more convenient, and less expensive for patients and Intermountain."??

But cost-savings and high-quality healthcare aren’t the only benefits to patients and Intermountain. “I really love that this program tells patients, ‘We’re looking at you as a whole,’ because research has shown time and time again, we heal better in our homes,” said Raeme. “We heal better around things that mean something to us, like our family, our pets, and in our environment. Patients can be around their primary support systems like partners and family, get the care they need, and continue to work.”??

When patients are healing from a physical illness, many other things can also get in the way of full recovery, which Raeme has seen addressed through the program. “As humans, sometimes we worry about things like whether or not our dog got fed, or if it’s picture day, or if our spouse is taken care of,” said Raeme. “By being at home, patients can still get the care they need and take care of the things we know they worry about.”??

Raeme also mentioned learning more about how patients implement new routines like medications. She said providers don’t often get to see how medications or discharge instructions are being followed or implemented after a hospital stay. By being in the patient’s home environment, there’s a higher success rate of following discharge instructions with the ability to problem-solve for people having difficulty with new routines and medications.??

“Patients can ask better questions and really understand their condition, their plan of care, and can learn what they’re doing and why they’re doing it,” Raeme said. “This program is preventive because we’re preventing readmission rates. We’re showing patients they’re more than their diagnosis — they can thrive with their diagnosis in their own home.”??

Hospital-Level Care at Home has also been approved for the Medicare waiver at Riverton Hospital in Utah, allowing the program to provide services to patients who have traditional Medicare. Hospital-Level Care at Home will be working with other hospitals to apply for the Medicare waiver and expand services to more patients.?