Hospice of Michigan Announces Decreased Patient Costs from Innovative Home Care Program

DETROIT, March 13, 2012 /PRNewswire/ -- Persons with advanced illness experienced decreased medical care costs while participating in an innovative home care program, according to a research study released today by Hospice of Michigan. By shifting a number of services to the home environment through the @HOMe Support™ Program, patient costs were reduced significantly, for one group by over $3,000 per month.

This independent pilot study on advanced illness management strategy was funded by a grant from the Blue Cross Blue Shield of Michigan Foundation and conducted by Hospice of Michigan's Maggie Allesee Center for Quality of Life in collaboration with Wayne State University's School of Social Work.

Dottie Deremo, RN, MSN, MHSA, ACHE, President and Chief Executive Officer of Hospice of Michigan, said, "This is a groundbreaking study that has significant implications for reducing high-cost medical services during the last 24 months of life and addresses the desire of older adults to receive care at home." Michael Paletta, MD, Co-Principal Investigator of the study and Vice President of Medical Affairs and Executive Director of the Maggie Allesee Center notes that "these results were achieved through a program that provides 24/7 access and comprehensive support to patients and their caregivers."

The study examined changes in service utilization and costs during patients' advanced stages of illness in four primary areas: inpatient, outpatient, emergency room, and inhome support. The costs of inpatient, outpatient, and emergency room visits were significantly reduced following program enrollment, while the cost of at-home care rose as expected when patients were managed in their own homes. Most importantly, even with some costs shifted to the home environment, overall costs decreased significantly. One group of @HOMe Support™ patients, which included both Medicare and non- Medicare adult patients with a variety of illnesses, experienced an average reduction in total costs of $3,416 per month (from an average cost of $9,294 per month) for a cost savings of more than 36 percent. The program provides 24/7 access to professionals for education, counseling, and home visits at times when they are needed most – times of medical crisis occurring after hours, on weekends, and during holidays.

The U.S. Department of Health and Human Services estimates that a typical four-day hospital stay costs more than $20,000. This equates to 22 months of advanced illness management at home or five full months in hospice care. An aging population and rising end-of-life expenditures generate significant challenges for the future of health care and health care reform. Medical care costs during the last year of life consume approximately 10% of the US health care budget and about 27%-30% of costs for those aged 65 and older. As a growing population of baby boomers approaches retirement age, the prevalence of chronic disease and advanced illness conditions is expected to rise exponentially along with costs. Family caregivers, who are often female, provide the bulk of care to people with chronic illness. They are faced with the often stressful task of helping their loved ones navigate the health care system and cope with progressive illness while dealing with their own careers and medical challenges.

Hospice of Michigan – the oldest and largest hospice organization in the state – introduced its "@HOMe" program in 2007 and is a pioneer and leader of in-home patient care. Hospice of Michigan's @HOMe Support™ Program provides an interdisciplinary, comprehensive, home-based program for persons with advanced chronic illness intended to integrate services focused on disease management, symptom relief, health care system navigation, and psychosocial and caregiver support to augment the disease-focused model of the current health care system.

The @HOMe Support™ program is a unique delivery model that is neither home care nor hospice, but a home-based delivery model with an advanced illness management focus. Services are provided by an interdisciplinary team of registered nurses, social workers, patient-family assistants, and other members (e.g. patient-family advocates, volunteers) trained in a group of interventions known as "Advanced Illness Management (AIM) strategies." AIM strategies are based on creating a safety net for patients and families by providing 24/7 accessibility to staff along with information, education, and counseling focused on addressing and managing the trajectory of advancing illness. Services are primarily home-based but, by design, support and services continue across the care continuum as needed. Services are delivered as an enhancement or addition to the current treatment plan, and in collaboration with the patient's primary care physician.

Up to this point, very little information has been available concerning program outcomes in terms of service use and cost. The new study was designed to obtain information on service use and cost trends associated with @HOMe Support™ participation, as a means of informing future program development and intervention efforts.

"Because our @HOMe Support™ Program provides 24/7 access to professional guidance and at-home assistance, we're able to reduce emergency room visits as well as unwanted tests and treatments while assisting the patient's primary caregivers – a husband, wife, adult child, or other loved one – to make decisions and do the things necessary to make the patient comfortable without frequent, stressful trips back and forth to the doctor or the hospital," said Dr. Paletta.

Roxanne Roth, RN, Corporate Director of Innovative Programs at Hospice of Michigan, comments: "Since most patients express a strong desire to be at home rather than in a hospital or other care facility, these results point to a better patient quality-of-life and reduction of stress on their caregivers who are often the decision makers."

"The findings of this research study support the notion that at-home care is the best solution for most patients with advanced illnesses who are at or near the end-of-life," said Ira Strumwasser, PhD, Executive Director and CEO of the Blue Cross Blue Shield of Michigan Foundation. "But, this is a pilot study, and more comprehensive research is needed to verify and expand on these results. If we get the same or similar results, this research may trigger an entirely new approach to making patients' last two years of life better for themselves and their families and will reduce health care costs for everyone."

Faith Hopp, PhD, faculty member at the Wayne State University School of Social Work and Co-Principal Investigator on the study, adds that "these results are exciting and promising, and point to the need for further research on the outcomes from @HOMe Support™ compared with advanced care patients with similar illness severity and mortality risk. We look forward to future collaborations with Hospice of Michigan, with the goal of helping to improve the lives of patients with advanced illness and their families, both by reducing their costs as well as by improving the quality of the end-of life experience."

About Hospice of Michigan

A nationally recognized leader in end-of-life care, Hospice of Michigan (HOM) is the original hospice in the state of Michigan, and is the largest. The non-profit organization cares for more than 900 patients each day in 56 counties. HOM takes a leadership position in end-of-life care with innovative programs to enhance quality of care for people at the end of life, education programs for physicians and healthcare professionals, caregiver education materials, cultural diversity programs for end-of-life care, and research and education programs at the Maggie Allesee Center for Quality of Life.

Hospice of Michigan was founded in 1980 by volunteers. Today, the organization delivers care to a large geographic area that includes underserved urban and rural communities. With a mission to serve all who need and seek care regardless of their ability to pay, Hospice of Michigan raises more than $4 million annually to cover the cost of care for the uninsured, underinsured, and for innovative programs.

For more information, call Hospice of Michigan's CARE Center 24/7 at 888-247-5701, or go to www.hom.org.

SOURCE Hospice of Michigan