‘The Final Frontier’: Mount Sinai Partners with Contessa for Home-Based Palliative Care Initiative

Mount Sinai Health System is doubling down on its partnership with Contessa. Specifically, the New York-based health system announced Monday that it’s working with Contessa to expand its community-based palliative care service.

Mount Sinai’s network includes eight hospital campuses, in addition to the Icahn School of Medicine at Mount Sinai. On its end, the Nashville, Tennessee-based Contessa helps health systems provide hospital-level care in the home through its Home Recovery Care model.

The new initiative, dubbed “Palliative Care at Home,” will offer care at home for a mix of “seriously ill COVID-19 patients” and others, including individuals with complex chronic conditions who need daily treatment. This includes people living with cancer, end-stage renal disease or congestive heart failure, for example.

For Mount Sinai, offering palliative care services in the home allows the health system to scale a model that moves care into an alternative setting and lowers hospitalization rates.

“For the estimated 2 million Americans living with serious illness, many of whom are confined to the home by their physical limitations, the final frontier of care is in the community,” Niyum Gandhi, executive vice president and CFO of Mount Sinai, said in a statement.

Contessa’s role in the partnership is to operationalize the new program while lending expertise in staffing, Travis Messina, CEO of Contessa, told Home Health Care News. Contessa will additionally spearhead payer negotiations and more.

“We provide all the administrative and operational support and oversight,” Messina said. “We also provide care management functions and select care provision functions.”

Mount Sinai originally launched a pilot version of this program — funded by the West Health Institute — last spring as a response to the public health emergency.

Palliative Care at Home builds on this pilot and two previous home-based care programs: Rehabilitation at Home and Hospital at Home. The latter program was launched in partnership with Contessa in 2017.

“Hospital at Home provides a discrete episode of care, designed as a mechanism to replace hospitalization,” Dr. R. Sean Morrison, chair of the Brookdale Department of Geriatrics and Palliative Medicine at Mount Sinai, said in the statement. “Palliative Care at Home provides ongoing care and support day after day, month after month, for seriously ill patients and their families in their own homes, thus avoiding unnecessary and burdensome emergency department visits and hospital admissions.”

Morrison is one of the original architects of Mount Sinai’s palliative care program.

On the home-based care front, Mount Sinai also recently partnered with Boston-based Current Health, a remote patient monitoring platform, to provide cancer care.

For Contessa, a hospital-at-home veteran, this partnership with Mount Sinai allows the organization to enter the palliative care space.

“Palliative care was always on our roadmap,” Messina told HHCN. “A significant portion of the patients we treat in hospital-at-home or SNF-at-home are eligible for palliative services, but we were focusing on that highest-acuity episodic encounter first and foremost.”

Generally, SNF-at-home models work to shift skilled nursing facility (SNF) patients into home-based care.

Looking ahead, Messina believes the industry will continue to form partnerships similar to its own with Mount Sinai.

About two-thirds of all palliative programs in the U.S. provide in-home palliative care. In most instances, hospices and hospitals oversee those programs.

“This is just another example of health systems realizing the increased consumer preference to receive more care in the home,” he said. “Obviously, there are a lot of hospital-based palliative care programs. This is a testament to the fact that more health systems are focused on providing services outside of the four walls of their hospital.”

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