Home-based care veterans finally see a viable way for seniors to be cared for properly after COVID-19 proved a lot of their long-standing hypotheses.
Their hope now is that the rest of the health care world notices the power and effectiveness that comes with at-home care. The same holds true for seniors themselves.
“I think what we’ve learned during COVID-19 is that there’s a lot of medical events that didn’t happen with seniors, and I think a lot of senior patients did okay without going to the emergency room and the hospital,” Dr. Kris Smith, the new chief clinical officer at Prospero Health, told Home Health Care News. “Obviously, there’s probably some care that should have been rendered. But by and large, I think patients and families recalibrating around the risks and rewards of going to the emergency room highlights that there’s a lot of low-value health care that happens to the frail elderly.”
Looking to enter the rapidly growing home-based care field, Smith officially joined Prospero in May.
Boston-based Prospero Health is a home-based medical care provider that treats seniors facing serious illness through a team-based approach. Those teams include doctors, nurses and social workers trained to address complex medical needs.
“If anything, I think the last year and half just affirmed that hospitals are unsafe places for the frail elderly,” Smith said. “And as we come out of COVID and no longer have that fear of the hospital, how do we continue to support patients and families in making what I think is the right decision — to try to treat them in place, at their homes?”
Smith came to Prospero after he served as the president of the home-based medical care division at naviHealth, a convener that works with health plans, hospitals and post-acute providers to arrange care in the home.
Smith was named Prospero’s chief clinical officer in May alongside an announcement that Dr. Theresa Soriano would also join the company as the associate clinical chief clinical officer.
Both Smith and Soriano have spent years working in home-based care, each working at one point in the New York-based Mount Sinai health system — an early adopter of home-based care initiatives.
“For all of us who have been in [home-based care], COVID confirmed that it is an important aspect of health care on the spectrum of delivery,” Soriano told HHCN. “And I think it woke up the entire health care industry, hopefully for the long haul, that this is something that is worth investing in.”
Smith and Soriano have joined Prospero during a period of rapid growth.
In January of 2020, the privately held Prospero had just 1,700 patients in three states. It currently works with over 12,000. By this year’s end, it plans to have 25,000 patients in 26 states.
“I’m anticipating we will probably enter at least 10 more states next year, but that’s still to be decided,” Prospero CEO Doug Wenners told HHCN earlier this year. “But we’re also going to work to continuously add to the clinical services that we provide to patients and families, including increasing the number of point-of-care solutions that we can provide to patients in their homes to make sure that their needs are being addressed.”
Before joining Prospero Health, Soriano was a chief health officer at the primary care startup Cityblock Health. She is also the current president of the American Academy of Home Care Medicine (AAHCM).
Emphasizing in-person home-based care
Prospero provides in-person and virtual care, both through scheduled appointments and when unexpected needs arise.
Telehealth skyrocketed during COVID-19, but began declining month by month at the beginning of this year, according to Fair Health’s examination of claims data.
The company’s in-person emphasis is part of the reason why Smith and Soriano were enthused by the opportunity to grow the Prospero brand.
“It’s definitely exciting to have the opportunity to participate in a company that’s putting — at scale — a home-based medical model that could work,” Smith said. “Because they didn’t fall back on telephonic-only or video visits. This is a company that’s committed to being in the field, in our cars, driving to see patients and building trust.”
Even as the telehealth boom proliferated during the pandemic, Smith was sure — based on his experience — that Prospero’s commitment to in-person, on-the-ground work was the only way forward if the company wanted to keep scaling.
“That in-person and trust-building model is what helps you to be successful in getting patients to reach out to you for help when they need it,” Smith said. “And when they reach out to you when they need it, that’s when you can prevent emergency room visits or hospitalization.”
Prospero’s rapid growth since the beginning of last year is a testament to the company, but it also presents challenges.
Just like with any growing company, both Smith and Soriano are focused on making sure that the expansion does not take away from quality.
“The model is really centered around those in-person, in-home capabilities and doing them really, really well,” Soriano said. “We’ve both been involved in models that were sort of stymied. Many other companies out there, including ones we have known and worked with, are doing home-based care. But they’re also doing multiple other things with it. And I think that can be effective, but the perfection of in-home medical care is really what this population needs.”
After this year, the company will continue trying to grow to all 50 states with the model that’s gotten them this far.
If it does, Prospero believes it can be a frontrunner among companies focused on patients almost exclusively in the home.
“So that’s our vision, to be the outlier,” Smith said. “And to be a successful story, rather than another cautionary tale.”