- Highmark Health has signed a deal with home care company Contessa, forming a joint venture that will provide "essential elements of inpatient care" in a patient's home.
- Highmark Health, an integrated health system, said services through the joint venture called Home Recovery Care are available to commercial plan members in Western Pennsylvania. Medicare Advantage members will be eligible beginning Jan. 1. Highmark hopes to eventually expand the offering to West Virginia and Delaware.
- The program will be able to provide home care, infusions and durable medical equipment to patients, according to a statement Highmark released Wednesday.
Health systems face continual pressure to provide care at a lower price point. At the same time, more care is moving beyond the hospital to outpatient settings and into patients' homes, both of which tend to be less expensive than an inpatient setting.
Nashville-based Contessa, founded in 2015, engages in risk-based models, which move away from paying for each service or volume and instead pay more for value.
The company employs care coordinators that talk with doctors to determine which patients can be treated at home and are available for patients 24/7 via a telemedicine tablet. Contessa's proprietary technology platform coordinates nursing visits and medication by tracking symptoms and vital signs.
Contessa's protocols cover more than 150 diagnoses, and its website provides more information on the type of conditions it targets. For example one patient, instead of going to the hospital, received intravenous antibiotics to treat cellulitis in his home.
The company was co-founded by Travis Messina, who is now CEO. Prior to Contessa, Messina was the chief investment officer for a healthcare-focused venture fund, Martin Ventures. He also served as vice president of development for Vanguard Health Systems, a hospital operator spread across five states, which was acquired by Tenet in 2013.
Pittsburgh-based Highmark Health operates its own health system, Allegheny Health Network and insurance arm. It is a dominant player in Pennsylvania.
The deal comes as some turn to virtual care to treat less acute illnesses. The shift is in response to patient preferences as tide of consumerism in healthcare rises. More recently, the nation's largest commercial payer said it was launching its own virtual care app for patients in employer-sponsored plans.