Imagine a patient who is immunocompromised. It may not be in her best interest to admit her to the hospital and risk exposure to infection, yet she needs hospital-level care. Or consider an older adult with congestive heart failure whose condition suddenly worsens during the height of respiratory virus season, when hospital beds are scarce and inpatient resources are strained.
In these cases and more, hospital-at-home (H@H) programs have become a lifeline, enabling patients to receive high-quality, intensive care in the comfort of their own homes. However, these programs operate under a Centers for Medicare and Medicaid Services waiver set to expire on Dec. 31. Congress should take action and pass a five-year extension to bring financial stability to the program.
H@H programs unite a dedicated team of community paramedics, nurses and other health care professionals to ensure patients receive the right care at the right time in the most appropriate setting. With remote monitoring technology and daily in-home visits, patients receive a full array of services – from IV infusions and wound care to EKGs and lab testing. Each day, they speak directly with a doctor through video conference and have 24/7 access to a nurse. Most importantly, these services are fully integrated into a wide continuum of care that connects patients with other providers as needed, including pharmacists, physical therapists, behavioral health specialists, social workers and more.
Initially authorized during the COVID-19 pandemic, H@H programs arose out of necessity to provide hospitals more flexibility to allocate resources when and where they were needed most.
Since, H@H has evolved into an effective approach to patient care that also enables providers to address the significant health equity and rural health challenges facing many patients by delivering essential, personalized health care directly to them. What’s more, H@H has proved to be a revolutionary tool in an increasingly unpredictable health landscape, allowing health systems to flex hospital capacity as seasonal needs dictate and bring hospital-level care to our patients in times of crisis, such as when Hurricane Helene devasted our North Carolina communities in September.
As the nation’s largest H@H program, Advocate Health has treated more than 13,000 patients to-date, delivering results that rival – and in some cases surpass – traditional hospital care. Patient satisfaction scores for H@H are 13% higher than in the brick-and-mortar setting, and readmission and mortality rates are lower. In short, H@H patients are happier and healthier than ever.
By combining technology with the human touch, H@H reduces barriers for patients who face transportation, mobility or other challenges that could prevent timely access to care.
"This is the coming together of technology and empathy," says my colleague and Advocate Health chief innovation officer, Dr. Rasu Shrestha, "combining digital tools with compassionate, patient-centered care."
Health systems like ours that are pioneering this new care model are proud of what we have created and the impact H@H is having on our patients. We believe it has immense potential to be scaled even further.
H@H was born in reaction to a health crisis, but it has grown up to be an adaptable, resilient and forward-looking hospital model available to all members of our communities in times of stability and times of crisis.
The sustainability of this model hinges on the continued support of legislators. As Congress considers its health care agenda, it is essential that lawmakers recognize the long-term value of H@H and pass the Hospital Inpatient Services Modernization Act. Extending the waiver for five years would secure a brighter future for patients nationwide and continue to transform health care for the better.
Dr. Scott Rissmiller is chief physician executive at Advocate Health, the nation’s third-largest nonprofit health system, based in Charlotte, North Carolina.