13 major health systems lobby for home healthcare reimbursement

The news: Two major US health systems, Mayo Clinic and Kaiser Permanente, are spearheading a new home care coalition, dubbed Advanced Care at Home Coalition, along with 11 other US health systems.

• They’re coming together to advocate for extending pandemic-era telehealth, remote patient monitoring, and in-home care flexibilities.
• To add, they’ll be lobbying to get the CMS to establish a new care delivery model for more advanced clinical care in a home environment.

How we got here: The creation of this coalition comes just a few months after Mount Sinai and Kaiser announced their joint $100 million investment in home healthcare startup Medically Home in May.

Moreover, this marks the second coalition for advancing digital health-enabled home care.

• Back in February, 14 major US health systems launched Moving Health Home.
• Just a couple weeks after the launch, non-health system players like Amazon, Dispatch Health, and Signify Health joined the coalition.

What’s driving these health system-driven coalitions? As vaccine rates rise and coronavirus cases fall, payers are walking back on pandemic-era telehealth reimbursement leniencies.

• Telehealth has taken root and is moving the needle further on widespread digital health-enabled care—particularly in the home health space.
• But without proper reimbursement, this momentum could be halted.
• For example, even though 75% of clinicians acknowledged that telehealth enabled them to provide quality care, 73% are worried about low to no payment, per the COVID-19 Telehealth Impact study.

The bigger picture: Digital health-enabled home care programs have been on the rise because of reimbursement flexibilities and policies—and programs that have launched during the pandemic will need them to be sustained in the long-term.

• For example, notable hospital-at-home solutions like Biofourmis’ and Deloitte’s heavily lean on reimbursement waivers offered by the CMS’ Hospital Without Walls program.
• These waivers may be more difficult to get outside of a public health emergency like the pandemic, however.