Innovations: Bringing hospital-level care home

Nashville-based Contessa Health will pilot its home-healthcare bundled-payment service from 1 September. In partnership with Marshfield Clinic Health System, the new scheme will allow customers to receive hospital-level care for six conditions including congestive heart failure and urinary tract infections. Costs for hospital-at-home services however are not covered by the Centers for Medicare and Medicaid Services (CMS).

Home hospitalization programs have been around for about 20 years in the U.S. Pioneered by researchers at Johns Hopkins Medicine in 1994, the programs initially targeted elderly patients. But in the shift toward value-based reimbursement, large hospitals and systems are starting to see home hospitalization as a way to reduce inpatient admissions for a wider array of patients.

Nashville-based Contessa Health seized this opportunity to truly change the way care is delivered and do it in a way that reaches the elusive goal of lowering costs and improving quality of care. Co-founded in 2015 by former venture capitalist Travis Messina, Contessa provides medical and surgical acute-care services to patients in their homes at a bundled rate.

The company recently landed its first partnership with Marshfield (Wis.) Clinic Health System, which runs 50 clinics in the state along with insurance plans.

Members of Marshfield's Security Health Plan, which offers Medicare Advantage as well as other commercial plans, can receive hospital-level care for six acute conditions: congestive heart failure; chronic obstructive pulmonary disease; deep vein thrombosis or pulmonary embolism; urinary tract infection; cellulitis; and pneumonia. For a prospective bundled payment, Contessa caregivers administer intravenous drugs and provide lab testing and other medical services during a 30-day period. The bundled price is still being set.

The pilot program is expected to begin Sept. 1 around Marshfield, Wis. About 350 patients will enroll in the first year, the company reported. The pilot will expand to other health plans if successful.