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Reduced Costs, Improved Outcomes: At Home Support™ Results Treating Chronically Ill Patients Affirmed by Peer-Reviewed Journal

Detroit, November 4, 2014 – A three-year study of patients and caregivers coping with advanced illness found that utilizing At Home Support™ services significantly reduces health care costs while improving outcomes.

Published in the October issue of American Journal of Hospice & Palliative Medicine, the peer reviewed study conducted by Wayne State University and Hospice of Michigan found that patients enrolled in a trial of At Home Support reported:

  • An average decline in monthly spending on outpatient and inpatient health services of 36.8 percent
  • A decrease in hospitalization rates of 34.9 percent
  • A decrease in length of hospitalization stay of 24.6 percent
  • Total cost savings of 44.0 percent

The study examined 148 chronically ill patients with advanced cancer, congestive heart failure and chronic obstructive pulmonary disease during a period from 2007 to 2011. Ongoing Hospice of Michigan research of At Home Support patients from the end of the study through today demonstrates similar cost savings.

“We are very gratified by the publication of this article, which affirms the significant reduction in expense achieved with At Home Support,” said Dr. Michael Paletta, co-author of the study and executive director of the Hospice of Michigan Institute, which developed the program. “Patients suffering from chronic illness often find themselves thrust into a ‘care gap’ that requires them to make difficult choices. Not yet ill enough to qualify for hospice benefits yet in need of assistance to manage their disease, patients and their families find few options that offer real answers.

“At Home Support works to fill that gap by taking an interdisciplinary approach to providing curative treatment in combination with comfort care. Patients and their families report better outcomes, lower costs and increased satisfaction with our proprietary program.”

First piloted in 2007, At Home Support now serves more than 550 patients daily throughout the Lower Peninsula of Michigan and Northern Ohio. In order to improve functional and clinical outcomes, At Home Support program focuses on key components of the care continuum that include interdisciplinary collaborations, chronic disease management, decision making support, caregiver support and individualized care.

  • Interdisciplinary collaborations involve teams of nurses, counselors, personal care assistants and volunteers. The teams develop treatment plans that focus on pain and symptom management, disease process education and goals-of-care. By organizing shared knowledge among the healthcare team, the patient is able to avoid unnecessary duplication of work, testing or treatment and harmful interactions that may result.
  • Chronic disease management provided by At Home Support teams includes assistance with activities that are necessary for quality of life. The activities and assistance vary based on each patient’s individual needs, but may include help bathing, dressing, preparing meals, eating, shopping and navigating transportation.
  • Decision making support is provided to keep the patient’s medical condition and the patient’s personal values and priorities at the forefront when determining care. Sometimes health care surrogates –caregivers who hold a patient’s medical power of attorney – make decisions based on their own values and preferences, not those of the patient. At Home Support helps clarify the role and responsibilities of the surrogate so that they can be proper advocates for the patient’s expresses wishes.
  • Caregiver support was found to be a key component of home-based palliative care intervention. Primary family caregivers can become exhausted from the daily grind of care giving and crisis trips to the doctor’s office and emergency room, to the point of almost welcoming a hospitalization for respite. Following the At Home Support program model, staff prepares caregivers to communicate effectively with and advocate for the patient to health care providers and payers. Caregivers are also trained in home safety, proper delivery of medication and disease management.
  • Individualized care is provided to a home-based palliative care patient depending on the patient’s condition, identified needs and trajectory of decline. Patients have the opportunity to discontinue services at any time. Although they are referred to hospice care when appropriate, patients and families who decide not to access these services may still receive palliative and comfort care from At Home Support staff who are trained in these types of end-of-life care.

In one sample, the recent study found average monthly outpatient costs declined from $6,322 to $2,849 and monthly numbers of outpatient services were reduced from 25.4 to 16. Additionally, home-based palliative care intervention patients monthly acute care hospital days declined from 7.65 to 5.77 when compared to traditional hospice patients.

“We see tremendous – and growing need – for programs like At Home Support, which provides care for families coping with a life-altering illness,” Paletta explained. “We have clinically demonstrated that At Home Support reduces the burden on family caregivers while reducing costs and improving quality of life.

“As we shared in the conclusion of the study, we have successfully challenged the perception that adding home-based services contributes to escalating health care costs. Our findings suggest that a preventative, home-based program that adds services and benefits can actually lower total health care costs.

“As the burdens of managing chronic conditions for patients and providing end-of-life care continue to shift to family caregivers, programs such as At Home Support will become increasingly necessary.”

For a copy of “Cost Analysis of a Novel Interdisciplinary Model for Advanced Illness Management, or more information about At Home Support, please call Michael Jasperson at 313.578.5023 or e-mail mjaspers@hom.org.

About Hospice of Michigan
A nationally recognized leader in end-of-life care, Hospice of Michigan is the original – and largest – hospice in the state. The non-profit cares for more than 1,400 patients each day in 56 counties across Michigan, raising more than $4 million each year to cover the cost of care for the uninsured and underinsured. HOM offers a broad range of services to enhance the quality of life at the end of life, including At Home Support™, our advanced illness management program, community-based palliative care and pediatric care programs. HOM provides grief support and counseling, caregiver education and support, and education programs for physicians and healthcare professionals through its research, training and education arm, the Hospice of Michigan Institute. For more information, call 888.247.5701 or visit www.hom.org.

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