October 9, 2024  – The Centers for Medicare & Medicaid Services (CMS) published a detailed report evaluating its Acute Hospital Care at Home (AHCAH) initiative, a program that facilitates inpatient-level care in patients’ homes. Initially launched during the COVID-19 public health emergency, this initiative has been extended through December 31, 2024, due to provisions in the Consolidated Appropriations Act, 2023.

The AHCAH initiative has been a part of the broader “Hospital Without Walls” program, allowing certain Medicare-certified hospitals to deliver acute hospital-level care outside traditional hospital settings. The recent study looks to provide a thorough analysis of the program and through qualitative and quantitative data, covers various aspects from patient demographics to healthcare outcomes and cost implications.

Study Findings Highlight Extensive Benefits and Some Challenges

The CMS report delves into several critical areas:

• Patient Selection Criteria: Hospitals participating in the AHCAH program developed specific criteria to determine eligibility for home-based care, often based on existing hospital-at-home literature and tailored to individual hospital capabilities and patient needs.
• Demographics and Clinical Conditions: Patients treated under AHCAH were predominantly diagnosed with conditions like respiratory and circulatory diseases, renal issues, and infections. The demographic profile showed these patients were typically white and urban-dwelling, and less likely to receive Medicaid or low-income subsidies.
• Quality of Care: The quality of care provided at home was comparable, if not superior, to traditional inpatient care, with lower mortality and hospital-acquired conditions rates among AHCAH patients, but higher readmissions.
• Cost and Utilization: The report noted a slight increase in the length of stay for home-treated patients but highlighted overall lower Medicare spending post-discharge, suggesting cost-effectiveness of the home care model.
• Enhanced Patient and Caregiver Experiences: Feedback gathered from patients and caregivers indicated high satisfaction with the home care model. They praised the convenience and personalized nature of the service. Care providers also echoed this sentiment.

Future Considerations and Legislative Needs

While the AHCAH initiative is set to continue through the end of 2024, its future beyond this point depends on further Congressional action. CMS has committed to continuing its evaluation of the program, but there are still hurdles to overcome.

This CMS report not only confirms the viability of hospital-level home care but also underscores the need for ongoing support and legislative backing to fully realize its potential in reshaping healthcare delivery.

For more information and to view the full report, click here.