Physician Spotlight: Bringing Care Home

Nov 12, 2020 at 12:50 pm by Staff

Mark Montoney, MD, MBA

Mark Montoney Delivering More Options to Chronically Ill Patients

Managing the health of chronically ill patients is an ongoing challenge, but it's one Mark Montoney, MD, MBA, is embracing through an innovative care model. As chief medical officer for Contessa Health, Montoney is helping to revolutionize the home hospital care model while keeping patients where they're most comfortable.

Intro to Life Sciences

A native of Columbus, Ohio, Montoney's early interest in life sciences was piqued by high school jobs in a local hospital's housekeeping department and later as an orderly in the ER. "That was my first-hand view of healthcare and the acute care setting, and it really resonated with me," he said.

Montoney received his bachelor's degree in psychology from Cleveland's Case Western Reserve University and his medical degree from the University of Cincinnati College of Medicine. He remained in Columbus for his internal medicine residency and, following years in private practice, grew interested in the administrative side of healthcare.

In 2000 Montoney received an MBA from Regent University and served in leadership roles at OhioHealth System before relocating to Nashville in 2008 to accept a new position. In his role as executive vice president and chief medical officer of Vanguard Health Systems, Montoney worked alongside Travis Messina, future founder of Contessa Health. In 2013, he accepted the position as CMO at Tenet Healthcare, where he remained until being recruited by Contessa in 2016.

A Promising Model

"As I learned about what Travis was developing, I was interested because it was an emerging area in the industry," said Montoney, who had cared for a largely geriatric population in his Ohio practice.

And while home care has been around since the era of horse and buggy, Montoney said the first in-home hospital model was developed more than 20 years ago at Johns Hopkins University, where researchers had partnered off similar models in other countries. "There was kind of a long hiatus where the model grew very slowly, and the industry perhaps wasn't quite ready," he said. "Certainly, in the last five years there's been a great deal of interest in bringing acute level services closer to patients, and you can't get any closer than home."

Home Recovery Care

Through Contessa's Home Recovery Care model, patients are treated for their inpatient-eligible condition in the comfort of home without being admitted into the hospital or a skilled nursing facility. The majority suffer from chronic illnesses like congestive heart failure, diabetes or COPD - diagnoses that result in frequent hospitalizations. The primarily elderly population also is prone to acute episodes of illness or infection including pneumonia and UTIs, and they are at increased risk of hospital-acquired infections.

Having more options in care has led to better outcomes and efficiencies. Contessa patients experience a 35 percent decrease in mean length of stay and a 44 percent decrease in hospital readmission rates. They also report a 22 percent increase in patient satisfaction.

How it Works

Patients are typically seen by a hospitalist in the ER, with subsequent visits facilitated via telehealth. During their acute phase, a nurse visits the home for one to two hours at least twice a day and is present during the physician's virtual rounding. All partners, including recovery care coordinators, receive extensive training and onboarding, and Montoney said providers adapt rapidly.

Contessa works in local communities to form provider partnerships and has proven that the model excels across all demographics. Partner facilities now include Marshfield Clinic Health System in rural Wisconsin, along with New York City's Mount Sinai Health System and Nashville's Ascension Saint Thomas, to name a few. Montoney said more than 90 percent of (appropriately screened) patients introduced to the idea of home care accept it as an alternative to traditional hospitalization, particularly in the age of COVID-19.

The Future of Home Care

"Telehealth has been part of our model from the beginning, well before the pandemic," Montoney said, noting a substantial uptake in telehealth utilization in 2020. He believes technology also is helping to extinguish physician burnout by extending the reach of providers.

"As we work our model across the country, we find it's been energizing for physicians. Those who participate in our model find it to be very fulfilling to be able to deliver care at home while seeing great results and high patient satisfaction," he noted.

As chief medical officer, Montoney hopes to see the model gain in traction and scalability over the next few years. "We're catching the industry at a point where there's increasing interest in this type of model," said Montoney, who frequently writes articles for providers on Contessa's website. "Being part of it through clinical operations is very fulfilling."


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