Why UMass invested millions in 'hospital at home'

Hospital-at-home care is a big part of the strategy for boosting care quality at Worcester, Mass.-based UMass Memorial Health, a C-suite leader told Becker's.

The four-hospital system initially launched acute hospital care at home in 2021 to address bursting-at-the-seams capacity issues. But then UMass Memorial recognized other benefits from the care model.

"Being a hospitalist for my entire career, the light bulb moment for me was, 'Geez, these patients really have better outcomes,'" said Eric Alper, MD, chief quality and clinical informatics officer of UMass Memorial Health. "It's as good a tool for improving quality of care as any other tool we could possibly have for improving acute care-related harm. My personal bias is we ought to be doing everything we can to get as many patients as possible into the hospital-at-home approach because of that, but also because of our overcrowded healthcare system."

Despite being a $3.8 billion organization, making it about the 150th largest U.S. health system, UMass Memorial has one of the most robust hospital-at-home programs in the country, serving an average of 15 to 20 patients per day.

The initiative cost between $1.5 million and $2 million to launch, according to program director Taki Michaelidis, MD. "Our C suite is very strategically oriented: How do we build and create the health system of the future for the patient?" he told Becker's for a December story.

UMass Memorial partners with Best Buy's Current Health on the remote patient monitoring technology. UMass uses its own physicians and nurses for the program.

The health system has a dashboard with live hospital-at-home data. It shows the program has saved more than 4,700 hospital days and has lower rates of mortality, infections, readmissions, harm from halls and transfers to skilled nursing facilities than in-hospital care, Dr. Alper said.

For the care model to truly take off, the federal government will have to show its support by extending or making permanent the CMS reimbursement waiver that is set to expire at the end of 2024, Dr. Alper said. Several bills have been introduced that would lengthen the program by five years.

The main challenge has been identifying the right patients for the program, Dr. Alper said. "There are a number of factors behind that: There's geography, there's insurance, there's patient comfort, there's provider comfort," he said. "Ultimately once we start to get the word out about this more, and we can share some of these outcomes, I think it's all going to fall into place."

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