Bringing Healthcare Home with HealtheMed and Clinic@Home- Podcast

Jason Dorow 

Hi, everyone, and welcome to another episode of the Champions of Homecare podcast. Let’s jump right into today’s conversation, David. Today we’re going to speak with leaders from one of Accra’s partner organizations, HealtheMed. HealtheMed’s mission is to keep Medicaid waiver participants in the community longer by enabling access to the essential care services they need. And before we jump into that conversation, you want to add a little more?

David Hancox 

Sure, Jason! What you just said is correct. And I would also add to that to say that Accra has partnered with HealtheMed now for a couple of years to offer a new digital system of care called Clinic@Home. And we’re going to talk more about that in the podcast today. Clinic@Home enables better health care access at home through a hybrid telemedicine platform. So, to allow the real experts to talk about that, let’s welcome HealtheMed CEO, Steve Pontius, and VP of Sales, Alisha Miller, to the podcast. Steve, Alisha, welcome. How are you doing today? Wonderful. It’s so nice to have you here with us today. And we really appreciate your taking time from your very, very busy schedules. Alisha, I know that in addition to your role in sales, you’re also leading some legislative activities, so I know that is a real time demand as well. So we really, really appreciate your being here with us. And to just kind of kick things off, Steve, maybe you can lead off by telling us a little bit about HealtheMed’s origins and you know, the company’s journey to the present; how you got to where you are today.

Steve Pontius 

Sure, happy to do that, Dave. So HealtheMed started in 2018, with a group of founders who were sitting around trying to figure out better ways to work on medication adherence, that was kind of the fundamental piece of if we can figure that out in a way to do that, we can actually change how we help these clients across the state. And so that was the original part of it. And then the technology piece around, how do you record that, was the fundamental way that we started. And so we built that piece and realized very quickly that we could add other RPM devices, so that we could then have multiple ways to manage client care, and then throw the telehealth piece on the top of that with the platform. Thus, it was born from there. We ran right into the pandemic. And so we managed our way through that slowly, as you might well imagine, from the state, we got approved for a community based service provider, and then started working with counties and county case managers across the state to work with all waivered clients in the state. And that brings us to where we are today.

David Hancox 

Wow, that’s quite a story. And just for the sake of the listener, as well as myself, RPN I think you was the phrase you used?

Steve Pontius 

RPM: remote monitoring devices.

David Hancox 

Okay, great. Thank you. I thought it was something related to that. But I wanted to be sure and didn’t want to confuse the listener either. So and you know, HealtheMed and Accra have teamed up to offer a new service called Clinic@Home. And it’s a program here in Minnesota, and Alisha, as director of sales, perhaps you can maybe give us a little bit of information about what exactly is Clinic@Home.

Alisha  

Happy to, Dave. So really, similar to what Steve was describing, we are bringing a suite of technology into the person’s home in order to connect them to their health. So we bring a television; it’s a smart TV where the client can access their health via the television. And as Steve mentioned, these remote patient monitoring devices are then Bluetooth enabled to the television. So that when the client, or when the person, checks their blood pressure, or checks their weight, or checks their temperature, it automatically uploads into the Clinic@Home platform on the TV for that person to reflect on then and or later, as well as the person’s defined care team. And the person is choosing who comes into that portal system to see their information. So they might choose their Accra homecare nurse, they might choose their primary care provider from a different system, they might choose their daughter. And all of those care team members can then see that person’s health and their outcomes. They can also access behavioral health providers or primary care providers virtually from the television, where there’s no extra link to click into and access that provider. So really connecting them in a way that’s from the comfort of their home, and an easy way to access health and care from where they’re most comfortable. 

David Hancox 

So if a client were to invite you into their home, I’m going to restate this for the benefit of the listener. If you invite Clinic@Home into your home, it expands your access to health care services within your home, but it doesn’t expose your health care information to a broader audience, correct? 

Alisha  

Correct, it only shares that health information with anyone that person wants to have the information. So if for example, Dave, I’ll just add on to that, if the person is checking any one of their vitals; their blood pressure, let’s just use as an example. And their blood pressure is outside of their typical standard parameters, what’s healthy for them, then that alerts the care team. So a HealtheMed nurse consultant, and Accra nurse consultant, would then would see that, be alerted to that and be able to follow up with that person to find out and give them resources and information on how to maybe correct that proactively versus ending up in the clinic or in the emergency department or urgent care. So really working upstream to help the person stay in their home.

David Hancox 

And I appreciate that additional information. And what’s I think vital there to the listener perhaps is that this service, this opportunity, Clinic@Home, does not expose your health care information to a broader audience. So you still control that, you still manage that. It’s not opening that up. Because you know, in today’s world, we hear so many stories in the news and in today’s world about people’s healthcare information being exposed or, you know, through hackers or things like that. But this does not provide that access to a broader audience, you still manage and control that very tightly. And I think that’s an important part of the value of Clinic@Home, is it does create additional access for health care services, but it doesn’t expose your healthcare related information, your private information, to a broader audience. And I think that’s, I know, I’ve restated that two or three times now, but I think it’s a really, really important facet of this service for people to be aware of. So to the next step, then, I mean, you’ve talked about the equipment, the process, etc. Who’s eligible? How does somebody become eligible for Clinic@Home servicess? Steve or Alicia anyone.

Alisha  

So, any person that is on a Medicaid waiver in the state of Minnesota we can serve. t is based upon their individualized assessment and needs. And so if they need access to behavioral health, or if they’re struggling to get out of their home, based on transportation barriers, or the geographical location they live in, or if they need more reminders about when and how to take their medication, or how to manage their vitals upstream, this could be a perfect system for them. We’ve improved medication adherence by 61% over state average. We’ve reduced emergency department visits, this is probably the most important piece, reduced emergency department visits by over 50%. So really key pieces when we think about someone feeling empowered about their health and staying in their home safely.

David Hancox 

You know, and Alisha, there’s a nice sidebar to that too, because if you’re increasing the use of their self medication by 61%, you’re reducing emergency room visits by 50 some percent you said, that not only contributes to the overall health outcome for the individual, but it lowers the health care cost for everybody. 

Alisha  

100%.

David Hancox 

Yeah, because you know that emergency room –  using the emergency room as your primary health care provider is a very expensive process. So if you’re reducing emergency room visits by that much, you’re actually driving down the cost of health care for everybody. Because it’s such a shared cost in our society. Steve, you look like you want to say something, please.

Steve Pontius 

I would just add that for the population we serve, the Medicaid waivered population, the vast majority of the clients that we work with today, we’re in 29 counties across the state, don’t have a primary care doctor. So their source of help is the ED, that’s where they go. And so one of the things we talk about a lot is we’re taking this high cost population who looks for care in the highest cost setting there is, and bringing them to the lowest cost setting, that is the home, and bringing doctor and nursing visits to around the clients to keep them, and work upstream to keep them out, we end up drastically bending the cost curve for everyone. And oh, by the way, the client feels better. Yeah, and do more and can take advantage of their own health, which up until now they struggled with because nobody has the time to say, how can we help you today? Right. So it puts you on that path. And that’s the sheer beauty of what Clinic@Home offers. 

David Hancox 

So it’s really a win win win situation, it’s a win for the clien, it’s a win for the healthcare system, and it’s a win for the primary health care provider as well, because fewer emergency room visits are fewer visits that the primary health care provider has to manage as well. And it allows them to drive down their costs as well, you know, and it keeps that emergency room available for those individuals who are truly needing that emergency room care. So it really is, as I said, a win win win situation. Steve, you mentioned that it’s available right now in 28 counties across Minnesota? 

Steve Pontius 

29 and growing. 

David Hancox 

29 and growing. And what’s the ambition? Is the ambition to cover all of Minnesota and beyond? Or is it just going to maintain a Minnesota base? Or what’s your ambition? 

Steve Pontius 

It’s a great question. And the answer is we would like to be in all counties across the state. Currently in the state of Minnesota, there’s 85,000 Medicaid waivered clients. So we got a ways to go. And I don’t think we will serve all of them. But we could serve a great portion of them. We have already had inquiries from other states in the country, asking about, Hey, I like what you’re doing in Minnesota, can we have a conversation? So I would think expansion would happen. When that happens, I would assume by the end of 24, you’ll see us at least in one other state, if not two, and then slowly we’ll grow from there. The other interesting piece is that we continue to have people ask about Private Pay. And so you may see that in the future as well. But that’s, our focus is going to be on the waivered population. Because it’s a population that really, really, really needs help. And we have developed something that we think can really help everyone.

David Hancox 

Well you know, and I’m glad you stressed that point about the waivered population because you know, waivered populations and individuals, excuse me, who use Medicaid, it’s becoming more and more difficult to find physicians and others who will take on, you know, Medicaid patients in their practices for a variety of different reasons, you know, many of them are well known that the payments are delayed, that the payments are not sufficient to cover the cost of care and all this. So looking for these kinds of alternatives, I think are really, really valuable. Alisha, back to you for a minute. I know that there’s some things going on legislatively right now that could expand the availability of HealtheMed and Clinic@Home as well. Would you like to talk about that for a moment, please?

Alisha  

Yes, happy to Dave. So, yes, we are pursuing a legislative bill currently. And with that, we’re looking for a value demonstration across at least five counties with at least 500 people that are on a waiver currently. So that’s a really small subgroup of the 85,000 eligible lives in the state. So a very small pilot demonstration. And looking to those counties to determine what are the greatest challenges they have in their county that we can help them solve. So that might be connecting people to behavioral health providers, that might be really targeting the highest users of the emergency department, it might be people that are on X number of medications, right. So the more medications there’s likely more compliance risk and issues there. So really having the county help us determine what their challenges are, and then we will report back to them on the value, the improvement, the outcomes that we’re delivering for those individual clients, and as a group, right. So really trying to offer this to more people and find champions that want to create a difference and truly transform healthcare.

David Hancox 

Well, and Alisha, I’m gonna put you on the spot here and ask you to identify both the House and the Senate bill numbers, because listeners, if this is something, having greater access to health care in your home, you know, with all of the necessary equipment to create that access being provided to you through Clinic@Home, if that’s something that’s important to you, or you would like to see come into your county and become available and accessible to you, then you may want to contact your legislators and encourage them to support these two very important pieces of legislation in the House in the Senate. So Alisha, could you give us the bill numbers so that our listeners could potentially contact their legislators to support?

Alisha  

Yes, you, Dave, did put me on the spot here. And I know the House bill number, I know by heart, it is House Bill 4203. So 4203 and I am frantically, can you tell by the look on my face, looking for the, and I think I found it here, the Senate Bill number. Senate bill is SF 4268. 4268.

David Hancox 

Great, thank you. And I again, I just you know, encourage our listeners, that if this is something that you think would be helpful in your life or in your community, in your county, reach out to your legislator and encourage them to support the bills, because it could be something coming to your community very soon. So Jason, I’m so sorry. I’ve manipulated the conversation here. I don’t want to cut you off if you have questions or that you would like to pose as well, please.

Jason Dorow 

David, you’re like an ace starting pitcher. You don’t go to the bullpen if you don’t have to. Right. And I’m just gonna let you ride it out.

David Hancox 

I can’t believe you’re using a sports metaphor with me of all people.

Jason Dorow 

Well, one thing I want to make sure we cover here is I’m sure there are listeners at this point who have been following along and hearing all the benefits of Clinic@Home and how it works. And forgive me if I missed it. But do we cover how eligible participants could sign up? Like what’s the process that they need to go through to potentially participate in Clinic@Home?

David Hancox 

Good question.

Steve Pontius 

So there’s a couple of ways to do that. You can work through your case manager, if you’d like. You can work through Accra, if you’d like. You can go direct to our website. And if you look at the top right corner, it says refer, you can fill out that information and we’ll contact you and help you walk through the process to be able to do that.

David Hancox 

And to Steve’s point, there are some clients of Accra, or of the Clinic@Home program right now that their care is actually being assisted and managed by Accra employees, some of our nursing staff and that help with some of those clients. I don’t know that they help with all of your clients, but with those Accra clients they do. So our collaboration is a very, very active and participatory one, it’s not just in label only. We are engaged on a daily basis and supporting one another through this process as a team. So yeah.

Alisha  

Really great point, Dave. And it’s really helpful to just call that out that people that are already being served by Accra, and have relationships with those that are serving them in their home through Accra, they know what that person needs, and they can then help to facilitate the connection to Clinic@Home. So having those trusted team members in your home can make a big difference. And then the Accra team members then are serving that person for Accra services in addition to the Clinic@Home needs. So it’s really wonderful. 

David Hancox 

You know, and it occurs to me and Steve, you may want to speak to this, but it occurs to me that the Clinic@Home service actually creates a wonderful opportunity for the client, as well as the caregiver to have a better ability to communicate some of those social determinants of health, kind of indicators, you know, in other words, are they taking their medication? Are they taking their medication in full dose? Are they splitting it to stretch it? Are they taking it at the appointed time? Is there healthy food in the home? Is it fresh? You know, what kind of access to other community resources do they have that contribute to their health? I mean, all those social determinants of health indicators can also be accessed through this Clinic@Home process as well, because that feeds into that larger healthcare discussion for that individual. So in being able to do that, then you can better prescribe and monitor health care needs and that of the client as well, correct?

Steve Pontius 

It’s a fabulous point, and you’re absolutely directly talking about what we want to do. The whole purpose of our technology, and our nursing and physicians on the back end of this wrapping around the client is all about how do we work upstream with this client, so that they can take charge of their health? I think we can all agree that for a good portion of the clients that are on waivers, they’ve had a tough time with health care, because it’s hard to connect with health care. And what we’re saying is, we’re going to be there for you, and we’re going to help you. And so as we start to see our client, we always talk about when our clients come to us and we look at them and say we’ve got you, they kind of step back a little bit and go no, you don’t healthcare has never gotten me, right. And so once our services start to wrap around them, the changes are remarkable, right? If we can just get you to take your medication as prescribed, it’s a great first step, and you start to feel better, for example, and then you then say, Okay, I’ll do a little bit more, you know. So that’s part of what this process is. The other big key to this is that, as a caregiver, one of the things that’s a struggle is, I’m not there when you meet with the doctor, therefore, I don’t know what’s going on. You can be at every one of those appointments if you’d like to. And you could do that from your house, you don’t need to be there, it’s just like a zoom call or anything else where you sit in, you can ask questions of the provider, you can make sure that they talk about the things that you have talked with that person about outside of that. Again, all to get communication to Alisha’s point, where the care team wraps themselves around to be able to go, here’s how we can help Sue Smith or Bob Jones do a better job of their care, how do we help them do that? And I think healthcare in general has a hard time doing that. That’s why we’re so focused on this population.

David Hancox 

Yeah, and I think that’s a fantastic description. And I can relate that to to being a sometimes caregiver for my aging parents, unfortunately, who are now both deceased, but when they were going through the aging process, being able to be with them when they were visiting with their physician, I would often remind them, you know, Mom, Dad, you’re not sharing everything. Remember, last week, when you told me you had this reaction to the pill, or you felt this way after, you know, certain activity or whatever, you need to tell the doctor that too. So I think having the caregiver role changes as well because they become more observant. And just like we want the client to become more participatory in their health care practices, having the caregiver become more participatory as a partner in that not to overwhelm it, but as a partner, that becomes more valuable as well. So I applaud that. I think that’s great. And because again, it relates back to that win win win. If we can have the client and their caregiver become more participatory, in that healthcare practice, then everybody wins as well. Right? So whenever, I’ve just recently been shopping for a new primary care doctor because mine retired. And as I’ve been interviewing different doctors, the first thing that I tell them is, I need to warn you because I’m a very, very participatory patient. I am telling you that up front, so which, you know, I’m revealing now in this podcast, but anyway, I think that’s an admirable desired outcome, Steve, so I applaud it and I know that Accra’s very, very proud to be  a partner with HealtheMed in this Clinic@Home project, I think this is fantastic.

Alisha  

It goes both ways, Dave. You know, you highlighted a few things that I’d like to just add on to. So the client, a key piece of Clinic@Home, is that it is allowing the person to be directing their care in a better, more independent way. And the participatory component from the caregiver is really a critical piece too, because it’s the system is reducing the burden for caregivers, because the technology can enable some of that independence for the person versus the caregiver. The other piece that we often say is that we trust all people to do the right thing and the things that they should do, that their provider’s telling them to do or that their family wants and needs them to do, or that they want to do. But we all need reminders. So the system allows for trust, with a level of accountability. And I think that’s a really key piece where as you talk about things that are important and happening from that subjective perspective, the system allows for objective data to couple with that subjective feedback and insight. So it’s giving both of those pieces that really allows for that more holistic care lens and team to come together. 

David Hancox 

Wonderful. Yep, exactly. That’s a great point as well. Jason, I think we’re getting close on our time here, and I don’t want to abuse the time of our guests that we very, very much appreciate you taking time out of your day to come and give us some information about HealtheMed and Clinic@Home and  your ambitions for that program and how it operates and the value that it can bring to the lives of clients and caregivers. So thank you so very, very much. Are there any parting comments that you want to make sure we don’t forget in our podcast here to our listeners?

Steve Pontius 

I would just say feel free to reach out to Accra. Accra is well versed on what we do, you can find us on the web at HealtheMed.com. And we’ll be happy to answer any questions that you have.

David Hancox 

 I’m sorry, what was that? What was that address again?

Steve Pontius 

www.healthemed.com. Or give Accra a call as well, because we work hand in hand with with you guys. And we love the relationship. And our goal here is to help the people that need help. And that’s really what we’re about and have been about since we started.

David Hancox 

Wonderful. All right. Well, thank you both so very, very much. We really, again, appreciate your taking time out of your busy days to join us for this podcast and to share some incredibly valuable information with our listeners. Jason?

Jason Dorow 

Thank you, Steve. Thank you, Alisha.

Alisha  

Thank you for having us.

Steve Pontius 

Thanks very much. Appreciate it.

Jason Dorow 

Well, that was one of the most illuminating and insightful conversations we’ve had in this podcast series, David.

David Hancox 

Pretty dynamic. I know. And I’m so sorry, again, that I kind of just took over the conversation, I get so excited and you know, wanting to make sure the information gets out there. And I know you are as well, but I get carried away.

Jason Dorow 

The listeners know that you’re driving the car, and I’m just making sure the engine, it’s running before you put the key in the ignition.

David Hancox 

That’s very generous of you. Thank you. 

Jason Dorow 

As we wrap up here, we have one piece of news we want to share, right? It pertains to our most recent episode prior to this one on CFSS or Community First Services and Supports. So at the end of February, CMS approved the Department of Human Services state plan amendments on CFSS, this new flexible healthcare program that will replace the PCA and CSG programs in Minnesota. And as we talked about on the last episode, David, this, when it happens, when this transition occurs, will mean a lot for how homecare services are delivered in Minnesota. 

David Hancox 

That is so true, it’s going to be a pretty dramatic change. And this new self directed option, which Jason just identified as CFSS, will offer a lot of those same home services but with more choice control and flexibility with the services and the supports that are required to live and work in the community. So it will expand some of those services. Now Accra will provide all services under the CFSS model. So that’s both the budget model and the agency model. So current active clients can rest assured that they can continue working with Accra and their current caregiver. So once the client begins the assessment process of CFSS, they have the opportunity to choose who they want their provider to be. And if they are currently an Accra client and want to continue with Accra, they will have that option available to them. So nobody has to worry about, you know, being bumped to another provider against their wishes, they can stay with their current provider, they just have to choose which model, the budget or the agency model they want to use. And DFSS or excuse me, DHS has the responsibility to announce the CFSS launch date with a 90 day notice. And they have not done that yet. So this doesn’t mean that the change is necessarily imminent, but it is coming. It’s going to take a while for us for this transition to occur, and Accra, I assure our listeners Accra will be communicating updates throughout the process to both clients and caregivers as this rollout takes place. So stay tuned for more information and these News and Views sections of our podcasts, and look for other communications announcementsfrom Accra as well, that will keep you informed about the CFSS implementation and its processes and the role and responsibility that you may have as a client or a caregiver in that transition. So you will have a partner through the process and that will be Accra. 

Jason Dorow 

And if you want more information right now, right this moment, go to Accrahomecare.org click on Services at the top of the screen and then you’ll see a bar that says CFSS to replace PCA and CSG. You click on that and you’ll have about as much info as you can find at this point in time as it pertains to CFSS and the transition as the wheels just start to get in motion.

David Hancox 

Yes, thank you, Jason, for reminding us about the location on the website. That’s great. Okay, well, I think this is a wrap for another podcast of our Accra podcast here. And thank everybody for tuning in. I hope that you found the information about HealtheMed and the Clinic@Home service to be really valuable. And if it’s something that you think is of interest to you or that would add value to your life or a valuable service to your life, please reach out and contact either Accra or HealtheMed directly. Jason?

Jason Dorow 

I guess that’s a wrap. Thanks, David. We’ll see you on the next podcast. 

David Hancox 

Okay, and where, Jason, can people find the podcast?

Jason Dorow 

Accrahomecare.org or on Spotify, Apple Podcasts and YouTube.