In modern history, the hospital has been the center of the health care universe. Other care delivery models were considered ancillary.
With the rise – or reemergence – of home-based care, that notion is starting to change, according to Andy Slavitt.
“The home is going to be the center point … with some obvious exceptions, you probably won’t have heart surgery performed in my living room,” Slavitt said during a fireside chat at the Hi2 conference last month.
Slavitt is the founder of Town Hall Ventures, a New York-based health care focused venture capital and private equity firm. Before re-entering the private sector, Slavitt served as the acting administrator for the Centers for Medicare & Medicaid Services (CMS), from 2015 to 2017.
In addition to his role at Town Hall Ventures, he serves as a board member for a number of health care organizations, including Cityblock Health and Bright Health.
For Slavitt, there are a handful of different care models that are exciting and, in his view, progressing health care forward.
“One of our companies, Cityblock Health – which serves dual-eligible populations – will bring the ER to you within 45 minutes,” he said.
Slavitt also identified home-based renal treatment as an innovative care delivery model that should be expanded in the U.S.
“In Japan, 70% of dialysis occurs at home. In the U.S., that’s been in the single digits,” he said. “I went and saw a dialysis machine the size of a college refrigerator that you can work with your phone. It seemed pretty straightforward to use. Still, we are under 10%.”
Along these lines, companies such as Virginia-based Somatus Inc. are working to change the underutilization of home-based renal care, according to Slavitt.
He considers the Program of All-Inclusive Care for the Elderly (PACE) “the ultimate” senior care model.
“The PACE model is the only prescribed clinical, social, behavioral model that exists,” he said. “It works, and it’s the only thing I know about in health care that has a greater than 95% satisfaction rate. It’s the only thing in health care that I know makes people live longer, reliably. It keeps people in their homes and the model pays attention to the needs people have as they get older.”
Among PACE members, there’s a 24% lower hospitalization rate compared to dually eligible beneficiaries who receive their care in nursing homes.
Slavitt also has his eyes on hospital at home’s progression.
“I think we are looking at a pre-lift off category,” he said. “It’s a whole different rubric when you think about keeping people at home, but having all the things that they need from a hospital perspective there, so I’m interested in watching that category.”
Ultimately, Slavitt believes models that bridge the equity divide will be key differentiators in health care.
“We can create for people who don’t have much, something completely new,” he said.
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