Approaches to Finance Medical Respite Outlined in New White Paper from Quantified Ventures and the National Institute for Medical Respite Care

By Catherine Stapleton and Sarah Styles Osborn 

If you have questions about medical respite or other evidence-based care models please reach out to Rebecca Gerr (rgerr@quantifiedventures.com) and Susan Donovan (sdonovan@quantifiedventures.com).

In our work with healthcare companies and community-based organizations we are increasingly focused on addressing health-related social needs through the provision of evidence-based care models financed through value-based arrangements.

One such example is medical respite, which provides temporary housing, post-acute medical care, behavioral health support, and wraparound services for individuals experiencing, or at-risk of, homelessness after discharge from an inpatient admission. By providing a safe bed, clean restrooms, nursing assistance, appropriate meals, and other services, medical respite can help individuals heal from acute conditions, stabilize chronic ailments, and break the cycle of hospitalization and homelessness by prioritizing connections to long-term housing solutions.

We are pleased to partner with the National Institute for Medical Respite Care and the National Healthcare for the Homeless Council to produce a new white paper that outlines various approaches to finance medical respite programs. 

This resource offers providers, state and federal Medicaid leadership, policymakers, and managed care organizations specific partnership strategies and demystifies the financial solutions that ensure continuity and quality of care for patients with long-term health and housing needs. 

In “Approaches to Financing Medical Respite / Recuperative Care Programs” we cover: 

• The demonstrated need for medical respite and recuperative care, and challenges to program expansion, such as reimbursement 

• Traditional models for medical respite payments 

• Emerging trends of medical respite payment models 

• Funding opportunities to expand and scale programs 

• The future state and strategies for effective partnerships and funding agreements

As we note in this white paper, “Medical respite will continue to be a needed service across the United States as rates of homelessness, substance use disorders, and mental health issues persist. Novel approaches to finance and scale medical respite programs are increasingly common, as the benefits of (and imperative to move toward) value-based care become more realized. Service providers, health care companies, and state governments are in strong positions to improve services and meet the increasing demand through new partnerships and financing agreements.” 

The table below (from page 11 of the white paper) provides an overview of actions that these various stakeholders can take to advance medical respite financing, reduce the overall healthcare cost burden, and ensure sustainability and quality of care.

Have additional questions about medical respite or other evidence-based care models? Reach out to Rebecca Gerr (rgerr@quantifiedventures.com) and Susan Donovan (sdonovan@quantifiedventures.com).

Future State Timeline and Recommendations

Stakeholder	Short Term	Medium Term	Long Term
Provider	Identify needed medical respite services from landscape assessments	Administer a plan of action for health intervention, including on the ground information to increase user access	Establish sustainable service model that meets population health need
Health Systems	Establish data collection and evaluation systems to evaluate medical respite outcomes	Provide claims data to service providers and health plans to measure outcomes	Track positive outcomes through claims data and cost savings to support research base of health outcomes
Managed Care Organizations	Understand the landscape of data collection and outcomes achieved Understand the need in plan and community, to estimate scale and expansion costs that would play into a contract	If a funding gap exists, determine who provides upfront funding to CBO (health plan or third-party investor or a mix of the two)	Finalize certainty of program outcomes and establish long term capital through an outcomes-based financing agreement
Government Policy Makers	Understand the need and opportunity for expanded reimbursement codes for medical respite Consider how medical respite will benefit internal initiatives and priorities	Encourage FQHCs and other health care providers to include medical respite among their services Authorize medical respite programs to reimburse for expanded services	Implement statewide Medicaid reimbursement benefits for medical respite