Delivering Hospital-at-Home Services to Achieve Whole-Person Care

According to a recent survey of more than 130 CEOs, hospitals are growing their business lines to provide approximately 20% more services outside of the hospital and/or in the home than in 2021. The survey, from the University of Colorado Denver and Guidehouse, revealed creative steps health system leaders are taking to implement change by prioritizing caregiver and consumer satisfaction.

One way to improve caregiver and consumer satisfaction is by delivering acute hospital care in the home. Hospital-at-home services can help providers grow their networks by delivering a true whole-person care experience. 

In April, the Department of Health and Human Services renewed the COVID-19 public health emergency, which extended the Centers for Medicare & Medicaid Services (CMS) Acute Hospital Care at Home waiver program another 90 days. For industry leaders looking to improve access to care, the patient experience, and gain a competitive advantage in their markets, the waiver provides support beyond the COVID-19 pandemic. 

It is critical for leading organizations wishing to pursue the waiver to act fast.

It can take approximately three months to organize, submit, and receive approval for the Acute Hospital Care at Home waiver.

For example, when leaders at Palomar Health, the most comprehensive healthcare delivery system in northern San Diego County and a member of the Mayo Clinic Care Network, needed to offer more capacity due to COVID-19 pandemic surges, they engaged Guidehouse to help them achieve CMS Acute Hospital Care at Home waiver approval as well as build their program in-house via an enterprisewide redesign initiative. 

While Palomar Health achieved CMS Acute Hospital Care at Home waiver approval in just three months, they also worked to redesign their clinical operations strategy to meet the needs of the new model. Key initiatives included aligning acute and ambulatory workflows and integrating them into their EHR. Additionally, Palomar Health’s financial team worked with Guidehouse to build a proforma for the Acute Hospital Care at Home program to forecast volume, DRG reimbursement, staffing costs, and other related health equipment and IT needs for future program growth.

Palomar Health’s investment in an innovative and highly technological model has also positioned the system to mitigate risk and enhance patient safety. Success means that the health system’s goals will have a long-lasting impact on the communities that Palomar Health serves while strengthening its market position.

“It took a village to achieve this large-scale transformation in such a short amount of time – including leaders, physicians, staff, and Guidehouse experts working harmoniously every day,” said Sheila Brown, Chief Operating Officer, Palomar Health. “This work will enable our organization to improve margin while maintaining high-quality care delivery for our community during and after the pandemic.”

The CMS Acute Hospital Care at Home waiver could get extended again. 

Policymakers and leading hospitals have expressed clear interest in pursuing hospital-at-home programs. For example, CMS has modified several of the requirements to ease the burden of applying and bipartisan legislation has been introduced to extend the waiver by two years beyond the PHE. Additionally, extended reimbursement could be available for organizations with approved waivers in the future.

For health systems looking to improve acute care capacity, shifting targeted patient populations to hospital-at-home care is a strategic growth opportunity. These models can also decrease acute length of stay and skilled nursing facility usage, improve patient transitions and safety (especially during surges), and reduce the total cost of care. 

Named Best in KLAS for Strategy, Growth, and Consolidation Consulting for the last three years, leading consultancy Guidehouse offers a comprehensive approach to assessing, designing, and deploying home care and remote patient monitoring services. Learn more.

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