As a leader of one of the nation's largest home hospitals, I urge Congress to pass, and the president to sign, a five-year extension of the Acute Hospital Care at Home waiver before it expires at the end of this year. Failure to do so could create a major disruption for the thousands of patients receiving this care and for the hundreds of home hospitals nationwide.
Patients in home hospital receive hospital-level care in the comfort of their own homes. The waiver was issued during the pandemic because CMS recognized that traditional brick-and-mortar hospitals had limited bed capacity and patients were either too scared to come to the hospital to get treatment or eager to leave after being admitted in order to avoid COVID-19. So, in response, health systems worked with CMS to implement a temporary regulation that allowed physicians, paramedics, nurses, and advanced practice providers to begin delivering hospital care in patients' homes, where they felt safe and secure.
Today, more than 300 hospitals in 37 states are providing home hospital care to patients. Since 2022 alone, our home hospital care model has served over 3,000 patients — a diverse patient population that spans age, gender, ethnicity, income and insurance status.
The benefit of home hospital is enormous. Researchers have found through numerous studies that patients and family caregivers prefer home hospital, which delivers excellent clinical outcomes, including substantial reductions in adverse events (e.g., mortality), better patient and family experience, lower caregiver stress, better functional outcomes, high provider satisfaction and shorter lengths of stay. Home hospital also is popular with our clinical staff, who report high job satisfaction when involved in these services. Importantly, home hospital also helps address the capacity challenges many hospitals face, freeing up inpatient beds for those who need around-the-clock care.
Being inside a patient's home also provides unexpected benefits. It gives our medical team an opportunity to identify other factors that could be impacting a patient's health — issues we would not uncover if the patient was in the hospital. For example, our teams are trained to routinely check the refrigerator and the pantry to understand food availability. They can see if there is hot water and determine if the heat or air conditioning works. Are there any signs of pests or environmental hazards in the home? All of these can create risks to the well-being of the patient. If our team identifies these types of issues, they connect the patient to services that will address them.
If Congress fails to act, patients may lose access to this beneficial and innovative care delivery model. Only the most sophisticated home hospital programs will be able to continue providing care through alternative regulatory pathways for only partial reimbursement. This will only further exacerbate inequities in care — an outcome no one wants.
Home hospital served patients on many levels during the pandemic, and it is serving our patients well today. That is why physicians, physician assistants, nurses, paramedics, pharmacists, physical and occupational therapists, patient advocacy organizations, hospitals, health systems and many others co-signed a letter recently sent to congressional leaders urging them to extend the waiver for at least another five years.
We need to pass this extension now. It's a win-win for everyone.