In light of the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) introduced the Acute Hospital Care at Home waiver, allowing hospitals to provide hospital-level care to patients in their homes. Over 300 hospitals in 37 states have taken advantage of this waiver, resulting in numerous benefits for patients, families, and healthcare providers. However, without further action from Congress, this waiver is set to expire at the end of 2024.
Recent reports have shown that patients who receive hospital care at home experience low rates of emergency returns to the hospital, 30-day readmissions, and mortality. Additionally, individuals who are dually eligible for Medicare and Medicaid or have a disability or dementia have shown similar or better outcomes compared to those in traditional hospital settings. This highlights the effectiveness and potential impact of hospital-at-home programs.
There is widespread support for age-friendly hospital-at-home programs, including endorsements from major health professional organizations like the American Medical Association and the American Hospital Association. Healthcare professionals have also reported positive experiences working in these programs. Patients, in particular, prefer receiving care in their homes, where they can be surrounded by loved ones and familiar surroundings, leading to improved overall well-being.
The temporary pandemic-era waiver has allowed for the rapid expansion of hospital-at-home programs, demonstrating their feasibility and success in a variety of settings. A 5-year extension of the waiver has been recommended to further foster the growth of these programs and provide opportunities for research and improvement in care quality, safety, and cost savings. However, challenges remain in ensuring equal access to hospital-at-home care, especially for low-income residents and underserved populations.
Despite the challenges, hospital-at-home has the potential to revolutionize the way healthcare is delivered, particularly for older adults. Extending the waiver will not only ensure the continued success of these programs but also pave the way for further innovation and improvement in care delivery. With the right support and resources, hospital-at-home care can become a standard practice that benefits patients, families, and healthcare providers alike.