Worcester, Mass.-based UMass Memorial Health already has one of the largest hospital-at-home programs in the country. Now the health system is expanding into other home-care domains.
The four-hospital organization recently started offering subacute rehabilitation at home for patients who would otherwise go to skilled nursing facilities. UMass Memorial has also expanded hospital at home to post-op patients following cesarean sections and urological and colorectal procedures.
"We continue to have challenges with getting patients discharged to skilled nursing facilities in a timely way," Eric Alper, MD, senior vice president and chief quality and clinical informatics officer of UMass Memorial Health, told Becker's. "Local skilled nursing facilities are just overwhelmed, and they can't handle the level of patients that we and others want to give them."
The Sub-Acute Rehab at Home, or SARAH, program is currently in the pilot stage as part of a randomized controlled trial with UMass Chan Medical School and Springfield, Mass.-based Baystate Health. The state of Massachusetts provided a $6 million grant to study the efficacy of the care model. Like the hospital-at-home program, nurses visit the patients but so do physical, occupational and speech therapists. No payers currently reimburse for subacute rehab at home.
"Our hypothesis is that patients can receive care at home, at lower costs, for lower periods of time," Dr. Alper said. "We're still relatively early in this program, but so far our outcomes have been positive."
UMass Memorial Health is also in the early stages of offering remote patient monitoring in the home for chronically ill patients, and is up to continuously tracking 150 patients at a time. The hospital-at-home program has an average daily census of 15 to 20 patients, while one to two patients are in subacute rehab at home.
Since launching a hospital at home for about $2 million in 2021, the health system has prevented about 16,000 inpatient bed days, Dr. Alper said.
The expansions are yet another illustration of the UMass Memorial Health C-suite's commitment to innovative care models using digital technology, Dr. Alper said.
"We're trying to build an entire continuum of care where you've got care-at-home options and one may have the potential to lead into the other, where it can be hospital at home, SNF [skilled nursing facility] at home, which can go to chronic disease monitoring at home," Dr. Alper said. "And we believe those patients will have better long-term outcomes."