How Intermountain, Ascension and Amazon Care coalition is advocating for permanent hospital-at-home care

The Moving Health Home coalition is working to acquire additional data and long-term solutions to establish a permanent hospital-at-home care program for patients in the wake of uncertainty as the Acute Hospital Care at Home waiver may come to an end.

Intermountain Healthcare, Ascension and Amazon Care, the founding members of the coalition, are looking to disrupt the current model of care by advocating for hospital-at-home programs.

The coalition, formed on March 3, 2021, aims to change federal and state policy to enable the home to be a clinical site of care. 

Nathan Starr, DO, medical director for home services at Intermountain Healthcare in Salt Lake City, spoke to Becker's Hospital Review about how the colatition is moving along efforts to make sure care is being moved to patients. 

Question: Moving Health Home supports and updates healthcare policy changes to designate the home as a site of clinical service. What significant policy changes has the coalition made or proposed?

Dr. Nathan Starr: There's a lot going on in that space right now. One of the things the coalition did was present a letter to Congress, signed by more than 35 different health systems, to support the extension of the Acute Hospital Care at Home waiver. We wanted to take advantage of the existing momtemum of the program. 

We know that this may not be the best long-term solution for hospital-at-home care, but we thought it would continue the momentum to give time to decide what is the best long-term solution for these kinds of programs. 

Q: How did the coalition identify that hospital-at-home care was a need for patients?

NS: We conducted a survey to analyze the importance of hospital-at-home care for our patients. 

We found out that patients want care in the home. Out of those who had received it, 85 percent said they would recommend it to other patients. So that was our first step, to identify why care in the home needs to move forward. 

Q: What is the coalition working on to improve advocacy for home hospital care?

We're looking at the cost of care in the home. It's really important to us that this ends up being a cheaper model of care, so we can pass that savings onto our patients and the payers. That's the next big piece we're working on in the coalition. We need to make sure we are not adding on medical expenses with this model of care. 

We also talk a lot about replacing hospital days and acute hospitalizations. We are looking at how we can admit patients to care at home that would otherwise need to be admitted into a hospital, and that we are truly replacing the hospitalization and decreasing the overall expense. 

Q: Why is this hospital-at-home advocacy so important, and what do you think can be accomplished from it?

NS: The coalition wants a five- to 10-year vision. We feel that healthcare needs to move care to patients, move care to where patients are at and move care out of the high-cost settings. 

This model of care can help keep patients happy and healthier. 

If we do it right or do it close to right everyone wins. The patient gets to heal at home, the payer wins because it's a cheaper model of care and the health system wins because it can save money and offload some of our busy hospitals. 

This is a win-win-win for everyone.

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