Several large health systems have banded together to advocate for the continuation of current hospital-level care-at-home flexibilities during and beyond the COVID-19 public health emergency, and for the creation of an advanced-care-at-home delivery model at the Center for Medicare & Medicaid Innovation.
The Advanced Care at Home Coalition will seek to overcome regulatory and legislative barriers, to having more patients across the country to receive acute and restorative care in their homes. The coalition will also strive to share best practices and provide thought leadership, supporting additional health systems across the country to participate in this new model of care delivery.
To take pressure off hospitals during the surging pandemic, the Centers for Medicare & Medicaid Services (CMS) in November 2020 took several steps to increase the capacity of healthcare systems to provide care outside a traditional hospital setting, including in the home. As Healthcare Innovation reported earlier this year, CMS’ Acute Hospital Care at Home program is an expansion of the CMS Hospital Without Walls initiative launched last year as a part of a comprehensive effort to increase hospital capacity and maximize resources, while keeping Americans safe. The updated program creates additional flexibility that allows for certain healthcare services to be provided outside of a traditional hospital setting and within a patient’s home.
More than 90 hospitals signed onto the CMS program in just a few months, which David Levine, M.D., the medical director of strategy and innovation for Brigham Health Home Hospital in Boston called “phenomenal uptake.” Speaking during a Healthcare Innovation panel discussion earlier this year, Levine said that “in discussions with CMS, it’s not entirely clear what [will happen next], but a lot of us hope it will become a permanent benefit for Medicare beneficiaries.”
Founding members of the coalition include Mayo Clinic, Medically Home and Kaiser Permanente, Adventist Health, ChristianaCare, Geisinger Health, Integris, Johns Hopkins Medicine, Michigan Medicine (University of Michigan), Novant Health, ProMedica, Sharp Rees-Stealy Medical Group, UNC Health, and UnityPoint Health.
“Offering acute-level, hospital-quality care at home allows physicians and care teams to treat a whole person to meet their individualized care goals, while also helping address some of the social determinants of health," said Stephen Parodi, M.D., executive vice president of The Permanente Federation, part of Kaiser Permanente, in a statement. “This coalition supports a policy foundation for this more equitable future of healthcare.”
The coalition argues that a delivery model through the CMS Innovation Center is the most effective way to test and implement a long-lasting Advanced Care at Home model. Given the time needed to launch an Innovation Center model, the group is working with Congress to ensure that there is no gap between the end of the public health emergency and the beginning of the model, likely requiring an extension of the PHE flexibilities.
