🔒A new wrinkle in growth of ambulatory care services: in-home visits

As healthcare providers continue to look for innovative ways to save money and offer more accessible care, they’ve been busy opening suburban urgent care centers, which are much more cost-effective than visiting the emergency room.

Now there’s a new wrinkle to the trend: mobile ambulatory care that brings service to patients’ doorsteps.

In-home urgent care provider DispatchHealth entered the Connecticut market a little over a year ago, and has found willing partners with major local insurers and hospitals, including Eastern Connecticut Health Network — parent company to Manchester Memorial and Rockville General hospitals — Waterbury HEALTH, and Anthem Blue Cross and Blue Shield, among other insurers.

Instead of driving to the nearest urgent care clinic, patients call a toll-free number and then talk to a DispatchHealth representative for an initial screening, to help determine the severity of the issue and care needs. If it’s decided a patient doesn’t need to go to an emergency room, a nurse practitioner and medical technician are dispatched to the home.

DispatchHealth was founded in Denver, Colorado, but has local ties. Oak HC/FT Partners, the Greenwich-based venture capital firm run by Annie Lamont, wife of Gov. Ned Lamont, is a major investor.

The company’s services include care for complex illnesses and minor injuries like bronchitis, fever, flu and COVID-19 symptoms, respiratory infections, pneumonia, shortness of breath with COPD and urinary tract infections.

Procedures offered include EKGs, IV fluids and stitches, among others.

Healthcare experts say in-home care is a trend that could gain popularity as payers and providers face pressure — from government, consumers and businesses — to better control the cost of health care.

The service, like telehealth, also helps improve access to care and gained some traction during the pandemic as people have been less willing to visit a doctor’s office or hospital.

“Connecticut is the ideal market for what they provide,” said Michael Jefferson, managing medical director for health insurer Anthem in Connecticut. “It’s a very, very dense market and the needs are broad, both for those with insurance and for those without.”

Investor interest

DispatchHealth is covered by about 80% of commercial insurance providers in Connecticut and also accepts Medicare, Medicare Advantage, and managed Medicaid plans in the state, the company said.

DispatchHealth is in-network with Anthem and the services are much less expensive than an emergency room stay and comparable to an urgent care visit, said Jefferson, who reached out to the company in 2020 and suggested partnering with them in this state.

The cost for the service is about $25 to $50 out of pocket for someone with insurance, or a flat $275 fee for the uninsured.

In comparison, a visit to the Waterbury Hospital emergency room for a non-life-threatening visit costs, on average, about $530, according to Jeremy Rodorigo, director of business development for Waterbury HEALTH, parent company of Waterbury Hospital.

“We saw DispatchHealth as a proven model used in other states and we wanted to partner with them,” Rodorigo said. “A lot of times people can’t get to a doctor because they are booked, but with this service, they will see you usually within two hours and immediately send notes of the visit to your doctor.”

DispatchHealth, which launched services in 2015, is now in 23 states and 46 markets.

Proof that its model has growth potential is reflected in the amount of money the company has raised from investors. In March, Dispatch Health announced it raised $200 million from various funders including insurance giant Humana and Oak HC/FT Partners.

A year earlier it raised $135 million from many of the same investors as well as Optum Ventures, the investment arm of health services company Optum, which has a major presence in Greater Hartford.

The business model

DispatchHealth employs its own care providers and has developed its own tech platform.

Its vehicles in Connecticut are branded with the logos of local partners. Currently, Waterbury HEALTH and ECHN each have one vehicle in their respective coverage areas and those partners pay DispatchHealth a fee for the branding.

As part of the partnership with DispatchHealth, ECHN and Waterbury HEALTH — which are both owned by for-profit California healthcare company Prospect Medical Holdings — work with their physicians, provider groups and case managers to ensure patients are aware of the in-home service.

DispatchHealth providers will also refer patients to Waterbury HEALTH or ECHN if they need a higher level of care.

DispatchHealth sees about 10 patients daily from each health system, according to Phil Mitchell, the company’s chief medical officer.

“We’d like to double that number in 2022,” Mitchell said.

Tiffany Gelsomino, director of business development for ECHN, says her health network partnered with DispatchHealth for a better level of care.

“This could be a wave of the future,” Gelsomino said. “What DispatchHealth does is add value to the services we offer. It’s a missing piece of the puzzle and we are happy we can offer that to our patients.”

Reaction to in-home care has been positive. In fact, Rodorigo said, Waterbury HEALTH patients have given the service an average of 4.9 out of 5 stars in satisfaction surveys received to date.

In addition to visiting homes in Connecticut, high-risk patients also have access to in-home care 24 to 72 hours post-discharge from a hospital stay. That service, known as DispatchHealth Bridge Care, helps to reconnect a patient with their primary care doctor or a specialist after a hospital visit in hopes of preventing a costly readmission.

Mitchell said he anticipates DispatchHealth will be in all 50 states sometime in 2023.

“What we have done has been widely successful,” Mitchell said. “We have seen 200 percent growth year over year.”