Disruption in Home Healthcare

Home health care began in the 1880s and has survived, largely in its original form for over 100 years.  This legacy healthcare model has remained a cottage industry (with a few large players), the work force is splintered (many are independent contractors) and most of the innovation has been around "how to get paid" by insurers and Medicare rather than how to improve the care model.

It is time to vastly improve home care for the rapidly growing number of elderly Americans. It is time to completely modernize the in-home experience for seniors. It is time to keep find innovative solutions to allow the senior population to remain in their homes for as long as we possibly can by using unconventional methods and technology tools.

As baby boomers age, the number of seniors is exploding. Most would like to stay in their homes as long as possible, in part because the alternatives are generally less pleasant and far more costly. The home care industry already employs 1.5 million workers who help seniors get out of bed, take a shower, fix a meal or make sure they take their medications. Many are independent contractors who work for themselves or for one of the nation’s approximately 50,000 home care agencies. Another 600,000 are expected to join their ranks in the next decade. And with the population of Americans over 65 expected to nearly double to 84 million between now and 2050, the challenge will only grow.

Here are a few key areas that are ripe for disruptive innovation in home health care:

1. Personalized Care Coordination. This begins with understanding the senior's needs, integrating your work with other health providers, and supporting the family care giver - the glue that keeps coordination working between visits and calls.  The soft issues: family dynamics, symptom management, access to resources, the understanding of one's treatment plan - all represent significant ways that care coordination can become much more personalized and result in significant cost reductions and improve customer satisfaction.

2. Expert Care Managers. Highly quality care managers play a central role in disruption. Their contribution to build a person-centered, outcome-focused plan of care is very difficult to replicate. Seniors requiring intense care or a complex plan of care coordinated with others is the future premium market. Finding clever ways (with technology tools) to extend the reach of and access to expert care managers (instead of having them drive around in cars door-to-door) could have significant impact on the outcomes produced by healthcare organizations in the patient's home.

3. Actionable Data & Information. Disruptors in the ‘Connected Senior’ vertical will provide family members, caregivers, and clinicians the information necessary to attenuate the need for costly emergency care, hospital stays, and multiple physician visits. They will produce evidence their models reduce overall costs. The day-to-day patient-reported information (especially signs and symptoms) is the next frontier of data that will be transformative - not only for home care providers, but also for hospitals, physicians, pharmaceutical firms, and medical device organizations.

4. Predictive Tools to Avoid Hospitalization. Today the primary way seniors indicate their need for more supportive care is by showing up in the emergency room.  Costs of emergency room visits average around $2,000.  Hospitalizations in the case of the elderly are often more complicated and expensive and become the trigger event for an individual to become one of the 5% of the US population that accounts for 45% of all health care costs.  Tools to predict and avoid the ER visit and the hospitalization have significant value (as measured in patient quality of life, better health outcomes, and reduced costs).  For example, the cost of care for the senior who moves from home and institutional long term care in a nursing home, will increase by about $1,600 per month. 

5. Family Care-Giver Support.  While the patient interacts with the medical community 20-40 hours a year, the family care giver (normally spouse or child) will spend over 1,000 hours a year supporting the patient. We are just beginning to understand the needs of the family care giver. Resources and tools to help family care givers is the final area for disruptors in home care.