10 implementation focused initiatives recommended to accelerate policy reforms, standardisation of home care delivery services, and improve accessibility and affordability of care in tier II and tier III geographies
Healthcare Federation of India has come up with a white paper on ‘Indian Home Healthcare 2.0: Redefining the Modern Care Continuum’ – a first of its kind attempt to place forward perspectives from all industry stakeholders and propose recommendations to Government on strengthening and providing market stewardship for the growth of the homecare segment in India. During the pandemic, this segment supported the overburdened Indian Healthcare system by helping augment care capacity and provide COVID care at home to nearly 21 million Indians, decongesting hospitals, freeing up valuable bed capacity and offering appropriate care in settings where hospitalization was not necessary.
The whitepaper outlines top 3 recommendation areas under the focused goal of ‘What can be done at home, must be done at home’:
Regulatory and governance focus:
- Urgent need to establish minimum standards for home care providers in order to streamline and standardise care delivery. As immediate next steps, an industry consultative transparent process required for defining national licensing standards as part of the clinical establishments act or as a separate policy
- Medical care being provided outside healthcare institutions needs to be integrated with institutional care i.e., initiation, referral, handover, discharge, home modification, equipment, monitoring etc
- Need to mainstream QAI’s accreditation standards for home care
- To ensure a transparent care delivery system and maintain trust, safety, and privacy, need to define data privacy and security regulations. Data sharing between the healthcare providers, ensuring visibility and accessibility of data to patients and family will be crucial
Capacity building focus:
- Establish a specialised homecare workforce by introducing curriculum and training standards for home care personnel
- Institutionalisation of multiple models of learning to allow flexibility and interest from aspirants
- Role-based licensing of specialised skilled homecare professionals with periodic renewal mechanisms
- Prioritised inclusion into schemes for indigenous medtech development – PLI Scheme, draft R&D policy 2021, PPO applicability for govt schemes – PMJAY, NDHM and others
- Enhancing the reach and strength of the digital infrastructure – internet connectivity and digital devices that support care delivery beyond metro cities
Care financing focus:
- Urgent need to introduce Standard Treatment Guidelines (STG) based on local and international protocols
- Financing of care for continuity and an inclusive care ecosystem
- 10-year tax holiday for new entrants – this could be associated with care delivery in govt. focus areas or schemes
- Tax breaks to incentivise care delivery in semi-urban and rural areas
- GST benefits as laid out for institutional healthcare providers
According to Dr Harsh Mahajan, President NATHEALTH and Chief Radiologist, Mahajan Imaging, “This is a very significant white paper with 10 implementation-focused initiatives, that the Government and key stakeholders must take, to accelerate policy reforms, bring in standardisation of home care delivery services, and improve accessibility and affordability of care in tier II and tier III settings. There is a need to develop seamless digital connectivity across the Indian healthcare ecosystem to improve access, efficiency and ensure better patient outcomes. The focus has to be on reducing the load on our healthcare infrastructure. Driven by greater consumer preference during the pandemic, the home care segment has unfolded its value as a viable, patient-centric, efficient and sustainable model of care across the public and the private sector not only in India, but throughout the globe. The homecare model is witnessing a sharp growth as countries continue to leverage it to ensure alternate models of care delivery systems with benefits of lower cost, higher efficiency, institutional capacity release, improved care outcomes and resource optimization bolstered by strong consumer preference, adoption of virtual care and digital tools.”
Siddhartha Bhattacharya, Secretary General, NATHEALTH said, “Enroute to unlocking value for patients, payors and providers, the homecare segment has the capability to generate almost 2- 3 million jobs, mainstream a largely unorganized sector and stand strong as a support care pillar beside the overburdened tertiary and secondary care system of the country. With assistance from this segment, 80 per cent of non-specialised care could potentially reach to the patient doorstep leaving the institutional care providers with the bandwidth to focus on specialised tertiary and quaternary care to a much larger population group. The homecare segment is also widely accepted and preferred as a highly sustainable model for providing care to a rapidly expanding elderly population and support the national agenda of ‘Ageing in Place’. Indian seniors, like their global counterparts, prefer to age at home in the community of their choice and homecare is best suited to support this process.”
The Indian homecare market growing at 19 per cent CAGR, expected to grow ~2.5 times by 2025. With the right impetus, this market has the potential of an additional USD 5 billion. Increasing healthcare costs, growing elderly population, lack of skilled manpower and greater demand for care outside institutions has necessitated innovative solutions in the home care space.
With advanced digital care seamlessly integrated to provide cutting-edge care at health-seekers’ fingertips, this segment holds the latent power to provide integrated, personalised care at scale to the very last mile. Public-private partnership is crucial to really execute standardisation of home care services, reform policies and establishing and expanding the required infrastructure with skilled workforce beyond metro cities. In order to reduce the burden on India’s health system, there is an urgent need for all the stakeholders to work in unison.