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Joseph McDonough ’96MSN

Patients who have complex mental health challenges are often in and out of hospitals. An average hospital stay costs around $3,500 per day and lasts more than 11 days—amounting to more than $38,000, a sum often paid by the state through Medicaid. “And it is not uncommon for a lot of these patients to be hospitalized ten to twelve times per year,” says Joseph McDonough. At the upper end, that rounds out to $450,000 per patient per year, to say nothing of ER visits. “This is an incredibly inefficient way to take care of the population.”

McDonough is the founder and CEO of Innovive Health, based in Massachusetts. Innovive provides in-home care for these kinds of patients, but the cost is only $27,000 per year. By preventing just one visit to the hospital, Innovive saves Massachusetts $11,000. And this, McDonough notes, speaks only to the economic upside.

“It’s traumatic for patients to go into hospitals,” he says. “It should be considered a failure.” Home visits are more comfortable, and they can give a more holistic form of care. Rather than 15 minutes at a clinic every six months, home visits are both more frequent and informative. Care providers get a window into broader determinants of health: is the patient eating well? Can they pay the electricity bills and keep their insulin refrigerated? Do they have family or friends to assist them? “This way we can get everything coordinated, everything in alignment, a full treatment plan in place,” McDonough says.

In April 2023, Innovive expanded to a second state, Colorado—where, McDonough says, very few treatment options are currently available: “It’s probably the forty-fifth worst state right now for behavioral health services.” Nearly half of patients who need help cannot get it. A tragic crisis, but, for McDonough, one that can—and hopefully will—be righted.