Home medical equipment (HME) is a critical, but sometimes overlooked aspect of one of health-care’s hottest trends: the hospital-at-home model.

The hospital-at-home concept has existed in the U.S. for years, but it has failed to gain momentum for several reasons, including supply-chain challenges. The COVID-19 pandemic advanced the model in a rapid way, with the Centers for Medicare & Medicaid Services (CMS) even unveiling a special Medicare waiver for “hospitals without walls.”

Supporting the ‘hospitals without walls’ model

As of Feb. 14, there were 313 hospitals and 13 health systems across 37 states participating in the waiver program, according to federal data.

To support these and other hospital-at-home efforts, Cardinal Health Inc. (NYSE: CAH) launched its Velocare arm in 2022. Since that initial pilot run, Velocare has experienced significant growth.

“I would say there’s not one prototypical customer that we work with,” Alex Hoopes, senior director of strategy and execution for Cardinal Health’s Velocare, told Home Health Care News, a sister publication of HME Business. “We work with large academic medical centers. We work with nonprofits and for-profits. We work with health systems that have taken their very first hospital-at-home patient, and we’ve been able to step in and support some hospital-at-home programs that have been up and running for a while, and are looking for the right partner to help them kick into their higher stage of growth.”

Broadly, Velocare technicians deliver hospital-grade products and services to patients’ homes. The company touts its ability to make these deliveries in under 2 hours.

Again, timely access to HME has been a major pain point for hospital-at-home programs throughout the years. That means the timely delivery of HME through the work of Velocare is a major advantage.

“There is no supply chain yet for acute care at home,” hospital-at-home expert and Johns Hopkins leader Dr. Bruce Leff said in 2018. “That logistics piece is very hard.”

A pilot program now in operation in 12 hospitals

Velocare officially launched its first post-pilot customer in March 2023. Since then, the company has partnered with hospital-at-home programs at 12 hospitals and health systems across the country, including Portland, Oregon; Atlanta; Knoxville, Tennessee; New Haven, Connecticut; and Boston.

Dublin, Ohio-based Cardinal Health is a distributor of pharmaceuticals and a manufacturer and distributor of medical and laboratory products. The company’s at-home business unit offers direct-to-home fulfillment and distribution services in the HME space, as well as in home health and hospice.

In general, Hoopes credits the wider-spread adoption of the hospital-at-home model for Velocare’s growth.

“More patients need higher-acuity care, especially with an aging baby boomer population and especially in urban areas,” he said. “A lot of hospitals are facing really serious capacity issues. You hear a lot of stories of patients who basically have to get boarded in the ER because there aren’t beds available. Health systems are looking for ways that they can increase their capacity in a quicker – and more cost effective – timeline than building another wing of a hospital.”

More specifically, Hoopes points out that Velocare addresses a lot of the pain points that health systems experience when they are trying to stand up and scale a hospital-at-home program.

“We help contain costs with this model, as lots of goods and services need to be delivered outside of the four walls of a physical hospital, and we help dramatically improve the reliability and quality of the supply chain in ensuring things get to where they need to be on time, so that the patient’s plan of care can be executed exactly the way it was intended,” he said.

Aside from health systems and hospitals, Velocare has also received interest from payers that are doing direct care delivery and view hospital-at-home as an effective way to help drive patient outcomes and address high costs associated with traditional inpatient care.

Still, hospital-at-home is a fast-moving and dynamic model. This has meant that Velocare has needed to be able to quickly adapt to change.

“I think that introduces some good growing pains for us,” Hoopes said. “It’s about figuring out how we continue to expand what we do to offer more value and provide more support to the health systems that we’re working with.”

Hoopes is also thinking ahead to what the market will look like once the CMS waiver expires at the end of the year.

“I do think the toothpaste is out of the tube, and hospital-at-home is here to stay,” he said. “The fact that there’s a renewal that’s going to have to come up at the end of this calendar year, and not knowing what that renewal is going to look like, is something that we’re all dealing with.”

Image: istockphoto/KatarzynaBialasiewicz