“If the country is serious about reforming our complicated, wasteful healthcare system that underserves too many people, let’s invest in the home.” — Rick Glanz
Introduction
The migration to home-based post-acute care that began years before the COVID-19 pandemic has accelerated in the last 12 months, as families and health plans are recognizing the health and cost benefits of healing at home. Rick Glanz, chairman of onehome’s Board of Advisors, has seen the movement up close, in 25 years of industry leadership positions. Rick was co-founder and CEO of decision support technology resource SeniorMetrix, an enterprise serving over one million Medicare Advantage members. Rick oversaw the successful sale of SeniorMetrix, which became the foundation of naviHealth, where he also served in an executive position. He also managed the Western U.S. division for The Polaris Group (Novacare) consulting firm and was a senior nursing home administrator and multi-facility operator for the Pacific Northwest.
Rick spoke recently about the movement behind the shift to the home and what changes are on the horizon.
Q: You joined onehome’s Board of Advisors two years ago (confirm) and became chairman this year, but you started your career with long-term care organizations. What led you to want to utilize your expertise for a home-based PAC company like onehome?
RG: The need and the opportunity have changed. The population shift in this country is affecting how and where care is delivered more than any other factor in my lifetime, and it’s vital to the overall healthcare system that we’re prepared to address the demand. Ten thousand Baby Boomers are turning 65 and becoming Medicare eligible everyday, and they want to age at home, be cared for at home, and continue to live full lives at home. Those are vastly different numbers and expectations from when I began my career. Half the Medicare Advantage patients discharged from hospitals still require further care, and there are compelling clinical and financial reasons to have them do that at home rather than in a SNF or rehabilitation facility. Long-term care remains a fine option for patients needing a specific type of intervention, but the system isn’t designed to accommodate the demographic surge and cultural change. This is a problem in search of a solution, and the home is the answer.
Q: As you say, the population boom is historic and is projected to grow until at least the middle of the century. Aside from the volume, what has to happen clinically if the home is to emerge as a viable solution for post-acute and other care associated with older populations?
RG: There’s a challenge in front of us that’s key to meeting this imminent need. Let’s talk first about the model of care. A model built to enable coordination, convenience, control and better outcomes has to be the baseline. onehome’s model for home-based PAC brings all aspects of care — clinical, benefits management, IT — into a single organizational structure: they control and coordinate all the moving parts in the delivery of care. The result is better outcomes for patients and plans. It works and it differentiates onehome from much of the industry that’s still wedded to the old-fashioned model of fragmented networks and fee-for-service structures.
Frankly, the model is what got me interested in the company. But the challenge is moving health plans faster to recognizing there’s a home-based solution available to them and their members right now. They see home-based care as a commodity. The legacy of the old model is hard for them to shake, yet they see the poor result of fragmented providers that don’t improve outcomes and close the gaps in care. As onehome expands into new markets, the plans are paying attention, but there’s an urgency to the need, and the evolution of their thinking is essential. As I mentioned, the plans’ member volume is growing and has to be served.
Q: Where do you see the care in the home going, in terms of innovations in technology and the investment?
RG: There’s nothing like demand to drive innovation. There are 24 million Medicare Advantage members in the U.S. The market dynamics of demographics and the health-consumption changes triggered by COVID are having an effect. Though I’d like to see plans moving faster, there’s no question that they’re all interested in the expansion of home-based care. Forty percent of SNF patients can receive services at home, and the same applies for long-term acute populations. COVID has made remote care a reality, but we’re just scratching the surface. We can be doing dialysis at home, hospice at home, behavioral health, medication management, and the activities of daily living. As onehome grows its range of clinical services — utilizing technology and the advanced remote diagnostics and interventions it will enable — the home will only grow as a center of care. There’s no reason patients should have to go to a facility if they can receive equivalent care at home. The cost savings and quality-of-life benefits are incontrovertible. If the country is serious about reforming our complicated, wasteful healthcare system that underserves too many people, let’s invest in the home.
Q: How would you define your role with onehome?
RG: Helping prepare the company to grow rapidly. onehome is strengthening everything from analytics to HR to accreditations. These are the building blocks for intense market expansion.
Q: If you could have, what advice would you have given yourself about the industry when you started in care?
RG: Just because things have been done in the same way for a long time, don’t assume that it’s the best way. Be aware and committed to realizing that while the status quo serves some portion of people, it generally isn’t the best approach for the majority. Looking forward, the changes in care that will need to be embraced for the next 25 years are going to be seismic. It would be tragic to let a failure of imagination stand in the way of what people really need and can have.