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ACOs: What are transitions home visiting programs like?

With permission, [the home visitor will] look in the refrigerator, they’ll look to see that the patient has food or that the area that they’re living in is safe to get around in.  Are we dealing with a home that is infested?”

Use of transitions home visits by accountable care organizations (ACOs) for patients with complex needs was studied based on recent data from the National Survey of Healthcare Organizations and Systems.  The motivation for these visits was found to be:

  • Conducting needs assessment (the condition of the home and patient’s support system)
  • Checking on patients who have stopped making office visits
  • Building relationships

ACOs found to be more likely to have this type of program were those which are part of an integrated delivery system, to have a hospital member and to participate in risk-bearing contracts.

Source: ‘Eyes in the home’: ACOs use home visits to improve care management, identify needs, and reduce hospital use. Health Affairs, 38(6), 1021-1027. Click here for abstract:  https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2019.00003  Also described in a news release here:  https://tdi.dartmouth.edu/news-events/dartmouth-institute-study-reveals-how-acos-use-home-visits-improve-care-and-reduce-hospital-use  Posted by AHA Resource Center (312) 422-2050 rc@aha.org

 

 

 

EMERGENCY DEPARTMENT: Use of home-based care

Just over half of the 682 emergency physicians who responded to this 2015 survey indicated that they have chosen home-based care options (overseen by a nurse or physician) instead of observation stays or inpatient admissions for elderly patients who visit the emergency department.  This is not a frequent occurrence  – the majority of ED physicians reported doing this for 5 or fewer patients per month.  The most common barrier to home-based care after an ED visit was reported to be the sense of an unsafe or unstable environment at home.  Patients who were recommended most frequently for home-based care had these diseases or conditions:

  • cellulitis
  • urinary tract infection
  • diabetes
  • pneumonia, community acquired

Note: This is a medical journal article reporting the results of a survey.  The authors are with West Health Institute (La Jolla, CA) and UC San Diego Medical Center.

Source: Stuck, A.R., and others. (2017, November). National survey of emergency physicians concerning home-based care options as alternatives to emergency department-based hospital admissions. The Journal of Emergency Medicine, 53(5), 623-628.  Click here for free full text: http://www.jem-journal.com/article/S0736-4679(17)30488-2/pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org