Health systems and technology companies are betting big on home-based hospital care, despite regulatory uncertainty about the program’s future.
Hospitals are bullish on at-home acute care because it can save money and make more beds available in their facilities for sicker patients. Medicare also pays health systems the same rate as it would for an inpatient admission. Since January, two health systems and 16 hospitals launched hospital-at-home programs under the Centers for Medicare and Medicaid Services’ Acute Hospital Care at Home waiver, bringing the total number of programs to 336 across 37 states, according to the agency’s website. More programs are slated to launch this year as Congress considers whether to extend the waiver beyond its Dec. 31 expiration date.
Related: 'Now is the time for hospital-at-home: Medically Home CEO
Hospital-at-home allows certain patients to receive acute-level care where they live through telehealth and in-person visits, supplemented with remote patient monitoring. The concept gained traction during the COVID-19 pandemic when CMS approved a waiver in 2020 to alleviate overcrowding in hospitals. Large health systems, including Mass General Brigham, Geisinger and the Cleveland Clinic have invested heavily in home-based acute care. Many smaller hospital systems are doing the same by leveraging in-home care technology.
Earlier this week, hospital-at-home technology company Medically Home announced a collaboration with healthcare services company Siemens Healthineers to expand the number of services available through hospital-at-home programs. The Erlangen, Germany-based Siemens Healthineers will provide diagnostic services such as ultrasound, CT scans and lab-quality blood analysis to patients receiving acute-level care at home.
The collaboration could help Boston-based Medically Home extend home-based care to a larger pool of patients. The company currently analyzes blood in the home, but only for a limited number of conditions, according to Dr. Pippa Shulman, Medically Home’s chief medical officer.
“If we could expand the list by 10% or 20% that would allow us to care for even more conditions in the home and also provide physicians with information they need to make decisions faster,” Shulman said.
While Siemens Healthineers has deployed these services across other care settings, this is the company’s first collaboration with a hospital-at-home company, said Francois Nolte, head of global network care for Siemens Healthineers.
“Medically Home’s hospital-at-home program is a natural extension of how our technology can be used to improve care and serve patients no matter where they’re located,” Nolte said in an email.
Other technology companies are also expanding further into hospital-at-home as health systems launch their programs. Last month, St. Louis, Missouri-based SSM Health partnered with in-home care technology company Inbound Health to provide skilled nursing services at home to patients discharged from St. Mary’s Hospital in Madison, Wisconsin.
The partnership with the Minneapolis-based healthcare services company will help SSM Health launch a hospital-at-home program in the fall at St. Mary’s. SSM Health plans to roll out recovery-at-home and hospital-at-home programs later to its 22 other hospitals in Wisconsin, Missouri, Illinois and Oklahoma, according to Kyle Nondorf, vice president of acute care operations.
“We have some bed capacity constraints, so if we can provide appropriate quality care to patients in their homes both on the recovery-at-home side and the hospital-at-home side, it helps free up beds,” Nondorf said. “It also provides a high quality option at a lower cost setting for our patients when we deliver care at home.”
Studies have found relatively low mortality rates and rehospitalizations among hospital-at-home patients. However, a report published last year by Center for Economic and Policy Research, a left-leaning think tank, called on CMS to establish care standards and collect better data on the model.
Despite those concerns, momentum is building in Congress to extend the hospital-at-home waiver. Earlier this week, Sens. Tom Carper (D-Del.) and Tim Scott (R-S.C.) introduced the Hospital Inpatient Services Modernization Act of 2024 that would extend the Acute Hospital Care at Home waiver for five years.
During a Senate Finance Committee hearing on rural health Thursday, Carper said the waiver cannot be allowed to expire.
“Rural communities face an abundance of access and quality of care issues. Alternative care delivery models like hospital-at-home hold potential to improve healthcare delivery in rural communities,” Carper said during the hearing.
Last week, the House Ways and Means Committee passed a similar bill that would also extend the waiver another five years.
