Study of At-Home Cancer Care Finds Lower Costs, Improved Outcomes

Program participants had 55% fewer hospitalizations, 45% fewer emergency department visits, and shorter hospital stays by 1 day in the 30 days after study entry.

An analysis of a cancer hospital-at-home model from the Huntsman Cancer Institute (HCI) at the University of Utah found fewer hospitalizations and emergency department visits, as well as lower health care costs during a 30-day period, according to results published in the Journal of Clinical Oncology.

The Huntsman at Home program was launched in 2018 as one of the first in the country to provide acute cancer care at home. The service combines research and clinical expertise for in-person care, remote patient and caregiver support, and acute-level clinical care provided by nurse practitioners. It includes a variety of home-based services including symptom management and acute medical, post-surgical, palliative, and end-of-life care.

The findings add to the body of evidence that providing cancer care at home can lead to a reduction in costs and unplanned health care visits, according to a press release. The study analyzed aspects of the program’s acute care, meaning a level of care that is typically provided in an inpatient hospital setting.

“Acute cancer care in the home had not previously been evaluated,” said Kathleen Mooney, PhD, RN, the program research director and leader of the study, in the press release. “We sought to create a model that extended the compassionate care of HCI to provide services in a patient’s home that otherwise might require urgent or emergency care or a longer hospitalization to resolve. Yet we also knew it had to be sustainable and would require new insurance reimbursement models. Therefore, we evaluated our Huntsman at Home program on health care utilization and costs to determine the value added by the acute care model.”

According to the press release, in the 30 days after study entry program participants had 55% fewer hospitalizations, 45% fewer emergency department visits, and shorter hospital stays by 1 day. Furthermore, participants had 47% lower health care costs during the same 30-day period when compared to patients who did not participate in the Huntsman at Home program.

The program is led by nurse practitioners who work in conjunction with oncologists. Additionally, it operates in partnership with Community Nursing Services, which provides registered nurses, social workers, and physical therapists.

“We found that emergency department visits and hospitalizations were approximately cut in half for patients who participated in Huntsman at Home,” Mooney said in the press release.

The team is planning further studies to evaluate other aspects of the program and are currently examining patient and caregiver satisfaction as well as potential reductions in symptom severity and caregiving burden. In addition, they plan to investigate whether the model can improve care for patients who live far from a major medical center.

Mooney said the program is expanding to 3 rural counties in southeastern Utah, which require a 2- to 4-hour drive for patients to come to HCI. It was initially offered to patients within a 20-mile radius of the flagship cancer hospital in Salt Lake City, and this will be the first expansion of the service area. According to the press release, the team will partner with local providers and community organizations to provide care through a combination of in-person, remote monitoring, and telehealth approaches.

REFERENCE

Study of Utah Cancer Care-at-Home Model Demonstrates Lower Costs, Better Outcomes [news release]. Huntsman Cancer Institute; May 18, 2021. https://healthcare.utah.edu/huntsmancancerinstitute/news/2021/05/study-of-utah-cancer-care-at-home-model-demonstrates-lower-costs-better-outcomes.php. Accessed May 24, 2021.