by Dave Trecker
North Naples resident Peter Whinfrey was stunned to see the costs and complications associated with his father’s chronic pulmonary problems some 10-12 years ago.
The challenges were many. His father had trouble getting to the hospital for treatment, the paperwork was confusing, and the costs were enormous. When his father passed away in considerable discomfort in the hospital, Peter estimated the total costs were close to $150,000 – a terrible drain of Medicare and taxpayer dollars.
Whinfrey thought there must be a better way – both to provide quality care and to do it cost-effectively – and he set about to find it.
The key, he learned, was home care. Much more it, efficiently run, was needed. So partnering with home-care specialist Dr. Tom Cornwell, he founded the Home Centered Care Institute in a Chicago suburb in 2014 and tapped a group of local philanthropists to fund it.
Another Naples-area resident, Roger Harris, at the time board chairman of a suburban Chicago hospital, put another piece of the puzzle in place by getting local hospitals to back the program.
The need was clear. The population was aging. More than 10,000 Baby Boomers turn 65 everyday. Of that group, the age 85-plus segment is increasing the fastest and will quadruple by 2050. Many have chronic diseases, draining 86% of U.S. healthcare costs, according to the Department of Health and Human Services.
And of some 7 million housebound patients, only about 15% have access to primary care.
That’s where HCCI comes in. “We work with local hospitals and physician groups to ensure a range of home care is available,” said Julie Sacks, CEO and Chief Operating Officer of HCCI. This is, she said, the modern-day version of the physician house call.
HCCI identifies primary care practices and promotes the need to expand into home-care treatment. Drawing on a cadre of medical experts from around the country, it offers training and consultation. Ms. Sacks said HCCI just completed a two-day workshop in Orlando, training caregivers from numerous practices across Florida.
One important service is helping them understand the everchanging payment model for at-home services, a part of the mind numbing bureaucracy that permeates medicine today. Webinars and online courses are offered.
“Our outreach also extends to professional associations,”Ms. Sacks said. “We go to national conferences and engage physician assistants, nurse practitioners, hospice providers …We also work with those seeking more government support for home-care treatment.”
A specific aim is legislation to make it an actual Medicare program.
Who benefits from all of this? Those who have difficulty leaving their homes or assisted-living facilities. Those who need vaccinations, blood tests, diagnoses, physical therapy, routine monitoring, wound treatment, EKGs.
An important niche, said Ms. Sacks, is homebound patients with multiple and complex chronic diseases. It sounds altruistic and it is, but it also saves a ton of money.
A demonstration project for the most frail and costly Medicare beneficiaries showed that over a five-year period home-based primary care resulted in an average $1,840 savings per beneficiary.
Florida has become a recent focus. To no one’s surprise, our state has a high percentage of elderly, many over 85 and many with multiple illnesses.
To serve these people, HCCI started the Florida House Call project with support from the RFF Foundation for Aging. A new network of providers was identified, and 12 primary-care specialists have stepped up to recruit and train others across the state.
I asked Peter Whinfrey, who helped start it all, what this meant to him.
“I’m glad to have played a small role,” he said. “It’s my fondest wish to see more home-care practices up and running in Southwest Florida.”
To learn more about HCCI, go to www.hccinstitute.org.