Earlier this year, Corporate Insight attended the America’s Health Insurance Plans (AHIP) webinars on integrating healthcare into the home. Industry leaders, health insurers and policy makers recognize the benefits of home healthcare. Recently, the bipartisan Expanding Care in the Home Act has piqued the interest of providers and healthcare tech groups, such as Moving Health Home, a coalition of health and technology companies that includes Amazon and Signify Health.

Multiple companies have tackled the challenge of bringing healthcare into the home. The goal of each endeavor is to increase access to preventive care, decrease the burden of social determinants of health (SDOH) and increase the clinical benefits of home healthcare. Bringing healthcare into the home takes many forms: companies are making patient friendly health data tools, creating health programs that leverage AI, and using virtual platforms to drive down cost and increase accessibility. It’s not only health systems looking to create such change, but health plans, third-party tools and startups as well.

This screenshot from BCBS of Minnesota shows an activity challenge creation page, a way to engage with patients
BCBS of Minnesota Activity Challenge Creation Page

One such company, Sword Health, is tackling the opioid epidemic by making physical therapy more flexible, convenient and affordable, to decrease the amount of people turning to opioids for musculoskeletal pain relief. Corporate Insight recently covered Swords digital physical therapy model in our February 2023 Health System Monitor Report (subscription required).

Virtual care is no longer a nice to have—it’s a need to have

With the COVID-19 pandemic, virtual care had to adapt to the at-home care needs of the population. However as discussed in the Discovering Value Addressing Health-Related Social Needs Across the Post-Acute Continuum webinar, virtual care has now had three years to develop and modernize, no longer being a value-add for a health plan but an expected feature. The Corporate Insight 2023 Q1 Health Plan Matrix (subscription required) reflects this claim, showing that 95% of firms within the coverage set offer telehealth to their members. Like Kaiser Permanente, firms should offer a plethora of virtual visit options, optimally allowing members to schedule appointments directly through and find related resources on their member sites. Virtual care maintains its importance, as in-person care struggles to consistently provide available and accessible care for patients. While virtual care is convenient, convenience does not guarantee productive patient outcomes. Virtual care must have personalized attributes, availability and adaptability to give it the competitive edge that increases its positive results.

This screenshot shows the Kaiser Permanente E Visits Page
Kaiser Permanente Member Site E-Visits Page

Virtual care can be used to support traditional health interactions, or substitute for them entirely, when appropriate. Different approaches include virtual first primary care platforms, such as Firefly Health, which incentivize individuals to use telehealth before brick-and-mortar facilities, adequately addressing many health concerns with higher cost efficiency. Other virtual health platforms focus on individuals concerns, like Sword Health, which embodies a highly personalized approach to care by integrating real time sensor feedback and continuous communication between user and licensed physical therapist, resulting in positive patient experiences and improved physical outcomes.

Qualities of At-Home Care that Produce Advantageous Outcomes

Jenny Wuehrmann of Included Health, who spoke at the Results-Driven Tactics to Give Your Virtual Care Program a Competitive Advantage AHIP webinar, summarizes four qualities of virtual care that promote the best clinical outcomes, as confirmed by Included Health’s clinical outcomes and cost of care data.

First, virtual care providers must offer comprehensive care with an easy-to-use user experience, mitigating unnecessary difficulties. Sword embodies this by providing members with much of the necessary equipment for digital physical therapy sessions, even an internet router for users with no Wi-Fi. While much of the technology, including the provided tablet and the mobile app are user friendly, users can find the necessity of multiple digital devices overwhelming, or place barriers for technologically challenged individuals.
These photos show the welcome kit from Sword Health

Virtual care must also combat health-equity issues, increasing access to care. Sword continues to push forward at home care by rolling out new pelvic floor therapy programs, allowing an even more intimate form of therapy to be done from the safety of one’s own home. While many of the individuals who engage in pelvic floor therapy are often antenatal women, the flexibility of care mitigates child care concerns on top of other logistical barriers.

Additionally, these virtual care programs must be adaptable to sustain various economic climates, making them sustainable, and directly combat the issues of in-person care, including long wait times, geographic barriers and limited hours. Currently, many individuals find physical therapy inaccessible, due to transportation, time, physical or financial barriers. Not only does bringing health services, such as physical therapy, into the home reduce transportation time, but the financial and physical barriers of transportation as well. Additionally, as an employee benefit, Sword tackles the financial burden of physical therapy.

The Future of At-Home Care

While virtual care begins to combat patient’s social needs, connecting their virtual experiences to in-person treatments provides a connected experience that improves overall health outcomes. Particularly in the case of post-acute care, allowing patients to receive treatments in the comfort of their home also relieves overworked providers who may gloss over social needs due to their lack of time. Jonathan Vitale, MyNEXUS Manager of Home Health Medical Directors, emphasizes that at-home care for medication management, occupational and physical therapy double as preventative care measures. The benefits of home healthcare eliminates some social issues that prevent patients from getting in-person care, which in turn results in the reoccurrence of their issues.

Alexandra Bolshakov

Alexandra Bolshakov is an analyst on CI's healthcare team.

Julia Boule