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The Expansion and Future of Hospital-at-Home Care Programs

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Mason Walker
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The Expansion and Future of Hospital-at-Home Care Programs

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CMS Authorizes Hospital-at-Home Programs Across the Country

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The Centers for Medicare & Medicaid Services (CMS) have given the green light to 312 hospitals in 37 states to implement hospital-at-home programs. This initiative allows patients to receive acute care at home through nurse visits and virtual physician appointments. The top health systems are already attending to dozens of patients per day at home. In the past six months, nine new health systems have received approval for the CMS hospital-at-home waiver.

Proposed Expansion of Hospital-at-Home Care Model

A new bill is currently before Congress, proposing the creation of a pilot program to explore whether the Hospital at Home care model could be extended to other patient populations. U.S. Senators Marco Rubio and Tom Carper have introduced this bill, suggesting that the Acute Hospital Care at Home initiative could be expanded beyond those needing acute care services. This model gained significant traction during the pandemic, with more than 300 health systems participating in a national model supported by CMS through a waiver enabling hospitals to seek Medicare reimbursement. However, the waiver is set to expire at the end of the year, and supporters are advocating to make it a permanent fixture, citing positive clinical outcomes from the Hospital at Home programs.

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The Role of the Hospital at Home Users Group

The Hospital at Home Users Group is a collaborative organization of hospital-at-home programs in the United States and Canada. They are conducting research projects related to caregiver issues and building a Minimum Data Set survey for patient and safety data. This group has also developed a Hospital at Home Technical Assistance Center and a webinar series for hospital and system leaders interested in learning about implementation opportunities and challenges related to the new CMS waiver supporting Acute Hospital Care at Home.

Benefits and Future of Hospital-at-Home Programs

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Hospital-at-home is an emerging concept that aims to improve patient outcomes, enhance patient experience, and reduce healthcare costs. Research indicates that these programs can successfully achieve these goals. Technology and population classification systems are proving instrumental in identifying suitable candidates for these programs. Addressing social determinants of health is crucial to improving healthcare, and hospital-at-home programs could serve as a great avenue for this. As we see a shift in inpatient services moving to outpatient care, we could witness a surge in hospital-at-home services. This trend is part of the growing health care consumerism that providers and payers need to consider.

Legislative Efforts to Expand Hospital-at-Home Care

Senators Rubio and Carper have introduced the At Home Observation and Medical Evaluation (HOME) Services Act, aimed at expanding hospital-at-home care in the U.S. This bill builds on the Acute Hospital Care at Home program, created by CMS during the COVID-19 pandemic, to include 'observation status patients.' This means health systems could place patients in at-home programs before reaching a higher level of acuity. The hospital-at-home model has grown significantly over the last few years, with promising results indicating only 7.2% of patients needed to be transferred to the hospital. Health systems are developing their own programs, and select payers are supporting this model as well.

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