BLOG — Protecting Hospital at Home

This week, the Alliance of Community Health Plans (ACHP) is proud to join dozens of organizations from across the health care industry urging Congress to protect critical access to hospital-level care at home.

Temporary waivers rolled out by the Centers for Medicare and Medicaid Services (CMS) under the public health emergency have allowed Medicare enrollees to receive acute hospital-level care from the safety and comfort of their own home.

Bringing Care to Patients

Sanford Health Chief Medical Officer Dr. Jeremy Cauwels explains how providing care in patients’ homes has enhanced the quality and convenience for their members.

For years, evidence has shown that moving acute care into the home can have a profound effect on patients’ health. Hospital at Home programs can cut the length of stay, lower readmission rates and reduce mortality rates, while improving the patient experience.

As longtime proponents of providing Care Anywhere solutions, ACHP member companies have innovated to provide Hospital at Home programs in their communities, seeing the power of this model first-hand.

Security Health Plan, part of Marshfield Clinic Health System in Wisconsin, became the first payer in the country to implement an episode of home care that lasts 30 days. The program reduced post-acute utilization and readmissions for 150 inpatient conditions—including congestive heart failure, pneumonia and asthma—resulting in improved outcomes and patient cost savings of 15-30 percent compared to traditional hospital-level care.

New Mexico-based Presbyterian Health’s high-touch Complete Care program—which provides home care for patients with complex medical needs—has reduced hospitalization rates and lowered the cost of care per member by 38 percent, all while increasing patient satisfaction.

Gaining Insights into Consumer Needs

Fallon Health Chief Medical Officer Dr. David Brumley discusses how Hospital at Home programs have helped providers build stronger relationships and gain more insight into consumers’ lives.

Under the CMS waivers, Hospital at Home programs were expanded, improving access to critical care for seniors nationwide. Unfortunately, that access may be short-lived. When the public health emergency ends, the waivers will expire unless Congress acts.

Bipartisan legislation by Senators Tom Carper (D-DE) and Tim Scott (R-SC) and Reps. Earl Blumenauer (D-OR) and Brad Wenstrup (R-OH) recognizes the effectiveness of Hospital at Home programs. It extends the current waivers, providing certainty for health systems and plans to provide personalized at-home care.

We thank these legislators for their leadership, and we urge Congress to pass this vital legislation.

For more on the Alliance of Community Health Plans members’ Hospital at Home programs, read about an ACHP member company executive panel at this year’s ATA2022.