DispatchHealth, an in-home medical care company that started in 2013 and is now in 18 states and 33 markets across the country, wants to grow its skilled nursing-at-home model coming out of COVID.
Since its inception, DispatchHealth has seen in excess of 300,000 patients in the home setting, saving more than $350 million in the form of unnecessary ER visits, according to the company.
The Denver, Colo.-based DispatchHealth offers hospital-at-home and mobile high-acuity services through its emergency medicine-trained teams. Now with 150 vehicles operating throughout the country that can do everything from lab testing, medication administration, ultrasounds and more, DispatchHealth aims to treat the sickest of the sick inside the home.
Some SNF operators may see DispatchHealth as competition and a direct threat to their traditional model.
But DispatchHealth co-founder and Chief Strategy Officer Kevin Riddleberger sees opportunities for SNFs to work with his company, he told Skilled Nursing News. Specifically, SNFs and DispatchHealth can team up around improving transitions of care for geriatric patients moving between different settings.
Riddleberger spoke with SNN about how he sees DispatchHealth working with SNFs in 2021 and beyond. This conversation was edited for length and clarity.
Tell me a little bit about DispatchHealth.
Riddleberger: We got our start back in 2013. During that time, it was really a proof of concept for us to identify ways that we could deploy a medical team to be able to intervene inside the home.
We had great success avoiding unnecessary ambulance rides and ER visits.
We went further upstream starting in 2015 [and started having] individuals contact us directly, whether that be individuals with acute medical problems contacting us directly, home health agencies that would typically escalate their patients to the emergency department because there is no other option, or assisted living and independent living communities with a resident with acute medical problems.
We could screen them clinically to make sure that we are appropriate to be able to send out the team, take care of them inside the home and avoid that trip to the emergency department.
We now operate across the country in 18 states and 33 markets. We have nearly 25 vehicles operating today in the Denver market. That will be close to 40 vehicles by the end of this calendar year.
How have you been working with skilled nursing facilities?
Where we’ve aligned really well with SNFs is to help transition patients. Those individuals that are ready, or on the cusp of transitioning into the home setting, we are available to take care of them inside the home if there’s a high risk of that individual bouncing back to the hospital.
We’re there working with them to be able to schedule those visits usually 24 to 72 hours after they transition out of the SNF in conjunction with standard home health agencies to bridge them back to their primary care physician or specialist.
Are you going into SNFs at all?
The majority of the time right now [as patients] transition out of the SNF, we will intervene with them once they get into the home. There have been cases, I’d say less than 2% of the time, that SNFs will call us to be able to come in and provide advanced capabilities or procedures, like a G-tube replacement. We’ve also come in to do laceration care if an individual falls.
It’s really more procedural based if we go into a SNF-setting, but more commonly intervening on patients as they transition out.
How do you think the post-acute care industry will change coming out of COVID?
We were certainly bullish on higher acuity care delivery being pushed inside the home pre-pandemic, but there have been a tremendous amount of tailwinds of people getting on board with care inside the home.
It’ll push SNF operators to really look at their acuity mix a little bit differently and collaborate with health systems around this. There will still be a huge need for skilled nursing facilities in the future, but I think the acuity mix is going to shift.
You may see, if you go all the way upstream, hospital length of stay decreasing, which will then push the acuity to SNFs, and then that will push individuals to the home-setting as they transition back into the home and back into the primary care physician.
Some may just be treated even further upstream than the hospital to take care of them inside the home setting. It’s what the industry is needing at this time, but there’s still a big need for everyone collaborating and working together on these patients.
Are you looking to partner with SNFs more?
Our SNF-at-home line of businesses is still pretty new. We’re only operating it in the Denver market, with one payer that’s contracted. It’s a collaboration with Denver Health and Denver Health Medical Plan. We identify those patients coming out of Denver Health, individuals with Denver Health Medical Plan, that meet SNF criteria and manage them inside the home.
We work with inpatient staff to identify patients that meet criteria, both clinically and socially, to be able to safely take care of them inside the home.
I do believe there’s an opportunity to continue to expand and continue to contract the service with the payers as we start to roll out our hospital-at-home program in multiple markets across the country this year because I think payers are looking at this as well.
Talk to me more about you SNF-at-home model?
It started in November of 2019. Currently, we’re looking to partner and align further with payers in the markets we operate.
We’ll be expanding to six additional markets in the second half of the year.
Part of our strategy is to identify and partner with health systems as well as health insurance companies to be able to contract for hospital-level as well as SNF-level of care inside the home.
It’s a priority for us to grow the program.
How are you looking to grow in the future?
We’ll continue to scale the model across the country. We’ll be in just under 50 markets by the end of this year.
Success is really about caring for patients and the outcomes that we’ve been able to achieve with this care model.
We’ve aligned our success with decreased costs, improved quality and improved the patient experience.
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