Nurse gives older female patient hospital care at home

Blue Cross, Michigan Medicine Expand Hospital Care at Home Program

Blue Cross Blue Shield of Michigan and Michigan Medicine have expanded their Hospital Care at Home Program — a program that allows patients with certain acute conditions to be safely treated in the comfort of their own home.

The pilot program began last year for our Blue Cross and Blue Care Network commercial members as a way to treat patients with the following conditions who meet the criteria for an inpatient admission:

  • Congestive heart failure
  • Cellulitis
  • Chronic obstructive pulmonary disease
  • Pneumonia
  • Urinary tract infection

The program subsequently has been expanded to include:

  • Other acute care diagnoses that can be safely treated at home
  • Our Medicare Advantage (Medicare Plus BlueSM and BCN AdvantageSM) members
  • Observation care that meets Inpatient InterQual criteria
  • Currently discussing an observation care program (when the stay does not meet Inpatient InterQual criteria) plus 30-days of patient monitoring

The Hospital Care at Home program is the first of its kind to be deployed in Michigan.

A major impetus for this program was to consider new ways of delivering care in anticipation of new demands that will be put on the health care system as Baby Boomers age.

“It’s an innovative approach to meeting people where their needs are, while being able to rest and recover in their own beds,” said Steve Anderson, vice president, Provider Contracting and Network Administration, at Blue Cross. “Blue Cross approached Michigan Medicine about collaborating on this pilot in 2019, with the goal of developing this new model of care, and they have enthusiastically embraced it. The program not only provides patient-centered care, but it can also be more cost-effective.”

The program is currently limited to Washtenaw County and Belleville residents who present to the emergency room at Michigan Medicine.

How it works

  • A patient goes to the emergency room at Michigan Medicine. He or she is examined, receives tests as necessary and, if appropriate, given the option of being admitted or to receiving further care at home.
  • Once part of the program, a patient’s day might start with a visit from a nurse, who would come to the patient’s home to samples for lab tests, assess their condition, administer medication as needed and perform any other necessary tasks.
  • Based on the patient’s health status, adjustments in therapy could be made by a doctor or nurse practitioner. If necessary, the patient could receive a second nursing visit later in the day and be supported by physical therapists and home health aides.
  • A typical recovery time may take three to five days.

“This has been a great collaborative effort,” said Fred Schaal director of Hospital Contracting and Network Administration at Blue Cross. “Throughout the course of the program, we’ve been discovering what works well, what doesn’t and adjusting the program as necessary.”

He pointed to one success story: a male patient with diverticulitis. He was in a great deal of pain and discomfort and had gone to an urgent care facility several times before finally going to the Michigan Medicine emergency room due to fear of going to a hospital during the COVID-19 pandemic. During his ER visit, he was presented with the opportunity to be treated at home, which he gladly accepted. Within two days of at-home treatment, he was no longer experiencing symptoms.

“The patient was so happy with his experience that he went back to the hospital recently to thank those who had treated him,” Schaal said. “He said the program really met his needs at the time, and he was very grateful.”

Anderson said the Hospital Care at Home Program may be expanded to include other regions of Michigan and additional hospital systems in the future.

“This is the latest example of moves Blue Cross is taking to reduce the overall cost of care while maintaining quality of care for our members,” Anderson said.

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Photo credit: Getty Images

 

 

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