Smart spending: Healthcare services at home need not be expensive

Since there is little insurance cover, one has to meet the expenses out of one's own pocket

With growing urbanisation and a busier lifestyle, staying with parents is almost impossible for most. So, there is always the fear of their deteriorating health and need for specialised help in tough times. Don’t worry, now there is help.

A number of home healthcare providers have started offering these services. And, these aren’t necessarily more expensive than hospitals. The demand for such services is picking up pace because of the convenience they provides to already ill patients. “Inter-connectivity through devices and portability of treatments and equipment make it feasible to provide critical care in the comfortable environment of a residence,” says Vaibhav Tewari, chief operations officer, Portea Medical. 

Vivek Srivastava, founder and chief executive officer of HealthCareatHome, adds that over 70 per cent of patient’s healthcare requirements can be met at home. “Health services at home are an extension of hospital care to patients, and these work as a distributed hospital within the precinct of the patient’s home.” There are two kinds of players in this market – insurance companies like Max Bupa and Apollo Munich, and start-ups like Portea.com, HealthCareatHome and HealersatHome.

Services on offer

There are four major segments: primary care, chronic disease management, elder care and post-operative care. Basic treatments like common illnesses, clinical services, including medical procedures, physiotherapy and healthcare attendants are commonly offered. Other intensive care facilities like home cancer care, ICU at home, post-surgical care, and management of chronic diseases are also provided. 

Other special programmes, such as stress management at home and post-natal care programme – a video-based exercise programmes specifically designed for new parents – are also offered. Portea has come up with DiabetaSmart, a diabetes management programme. The programme provides proactive management of the condition with smart glucometers. PSTakeCare is another initiative that provides surgical care to people. These services include home visits from physiotherapists, nursing attendants and doctors, along with a collection of lab samples from homes. These companies also provide medical equipment, such as ventilators, dialysis machines, special beds, which can either be purchased or rented.

Useful for many

Home healthcare services come as a big relief to people with prolonged ailments, as they save the hassle of frequent visits to hospitals. Moreover, there also negate the chances of catching any secondary infection at hospitals as the patient is treated at home. “At-home care allows people to stay in control of the situation, especially when it comes to elders. Often, older people lose the ability to adapt quickly to people and surroundings, so being with family helps hasten the process of healing,” adds Srivastava. To a certain extent, these services also benefit working individuals with busy schedules who don't get enough time to visit a clinic or hospital. 

It need not be expensive

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Some popular home healthcare services, such as geriatric care, physiotherapy, ICU and chemotherapy at home, surgery recovery, diagnostics, medical consultations and nursing, come at a significantly lower cost when compared with an extended hospital stay. The cost for these turns out to be low as nurses or caregivers hired at home are for specific needs or for a certain number of hours, based on which they are paid. “There is a misconception that at-home and personalised care are costlier. The monthly cost of in-home care is, on an average, 20 per cent less than that at a nursing home,” adds Tewari.

An ICU at home costs almost 50 per cent less than hospital ICUs. Physiotherapy treatment, on an average, costs Rs 1,000 per day at hospitals or physiotherapy centres, whereas the cost goes down to Rs 15,000 for 25 days at home. The cost for chemotherapy at hospitals ranges between Rs 250,000 and Rs 2 million for six months. At home, the cost of these services is reduced by 15 per cent.

Little insurance

Indemnity plans do not cover home care as a separate category. However, some homecare services are covered, only if prescribed by doctors or if the expenses incurred are an extension of hospitalisation. “Home healthcare services are covered only if there is an in-patient care hospitalisation claim made. Home healthcare services are available after hospitalisation,” says Ashish Mehrotra, MD & CEO, Max Bupa Health Insurance. 

There are some medical procedures that fall under daycare treatments and OPD, such as cataract surgery and hemodialysis, which do not need the patient to stay in the hospital for 24 hours (the basic condition for getting covered under an insurance plan). Insurance policies that provide OPD insurance provide covers for these treatments.

Domiciliary treatment is provided at home when the patient's condition does not allow them to be moved to a hospital or there is a lack of accommodation at a hospital. Most insurance companies cover these treatments but only under certain policies. Some plans cover full expenses, while for others only a part of the sum assured is allocated to cover these expenses. An additional premium is charged by the insured for some plans to avail of the domiciliary treatment. “Currently, an insured patient is forced to avail of treatment at a hospital, even though the same can be delivered at home in a more cost-effective and convenient manner. The need of the hour is that insurance providers cover home healthcare services more widely,” says Tewari.