Q&A: Regence’s Vince Porter on Home Care and How the End of PHE Could Affect Service-Related Waivers – State of Reform

Regence Health Policy Center Director Vince Porter worked on several key pieces of legislation, including the creation of Oregon’s Prescription Drug Price Transparency Program and the Sustainable health care cost containment program since he began working at Regence in 2017. Prior to his tenure at Regence, Porter was an employment and economic policy advisor to the Oregon government. John Kitzhaber and Kate Brown.

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Régence saw its home care services expand after CMS approved acute hospital care at home waivers for hospitals in Washington, Oregon, Idaho and Utah in November 2020, at the height of the COVID-19 pandemic. Porter discusses the benefits of home care services and what the upcoming end of the public health emergency (PHE) could mean for Regence and other organizations in this Q&A.

State of the reform: What are some of the key benefits that home care offers patients from a Régence perspective?

Vince Porter: Home care delivery has been part of our health care system for over 100 years, it’s just that it was [previously] called a home visit. But over time, most care shifted to established hospitals and other institutions.

While acute hospital care will always be a vital pillar of our healthcare system, bringing some care home is more possible than ever and we believe the evidence shows this movement offers more affordable solutions with equal or better health outcomes.

During the COVID-19 emergency, our entire healthcare system was strained and there was an urgent need for innovation and new models. Fortunately, new models of care and digital technologies had been in the works for several years and were ready when the pandemic hit. For some cancer patients who prefer to receive care at home, the model may be more convenient and personalized for the patient.

Policy makers often talk about promoting policies that prevent people from going to the emergency room. As entities like Dispatch Health grow and improve the delivery of acute home care, we can prevent our emergency rooms from being overcrowded and provide savings for patients.

OR: In the Regence service area of ​​Washington, Oregon, Utah and Idaho, 9 hospitals have received dispensations of acute hospital care at home since the start of PHE. What could the end of PHE mean for home care?

“V.P.: Declaring a PHE has given the federal government a significant degree of flexibility to waive or modify certain requirements such as insurance costs and coverage, expansion of telehealth, access to COVID-19 testing, vaccines and treatments under FDA Emergency Use Authorization. The end of the PHE could also mean the end of a reversal of the innovations achieved through these flexibilities without thoughtful analysis of the data obtained during this process.

Letting these programs expire, especially hospital-at-home waivers, at this point would set everyone back a few years in research, data analysis, and process improvement. This is a pivotal moment and a key opportunity that could help bring the ball closer to a quality community health care system that improves access and lowers costs for patients.

OR: Why is it important that these waivers be extended?

“V.P.: We are just beginning to understand the benefits of providing different levels of home care and there needs to be more opportunities for more innovation. The Home hunter program at the Huntsman Institute in Utah is an example of a model demonstrating affordable and positive results that have only scratched the surface of what is possible in providing cancer care at home.

Extending waivers will allow others to improve and innovate their models and begin to develop best practices and standards of care in these settings. This would allow federal and state regulators to dig deeper into the data and demonstrated results from the waiver program. Once further analysis is complete, necessary policies can be introduced and implemented to move the home care model forward.

OR: What does the future of home care look like for Régence?

“V.P.: We envision that our members will have the ability to access the right care in the right place at the right time, and new models of care offering home care will be key to meeting this expectation.

Any at-home model should be affordable and deliver the same, if not better, results, but we think there’s already evidence that the best models deliver both. It will be important to communicate with our members so they know what tools are in front of them, but we are confident that when our members know what they can access at an affordable price, they will engage and improve their care experience. health.

This interview has been edited for clarity and length.

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