Lawmakers propose extending hospital-at-home programs | Bills and Laws

The skinny

Two House members have drafted legislation to extend hospital-at-home programs.

U.S. Rep. Brad Wenstrup, R-Ohio, left, and U.S. Rep. Earl Blumenauer, D-Oregon

Sponsors

U.S. Rep. Brad Wenstrup, a Republican from Ohio, and U.S. Rep. Earl Blumenauer, a Democrat from Oregon, crafted the proposal.

Summary

Health systems have launched and expanded more hospital-at-home programs since the emergence of the COVID-19 pandemic in 2020. The government lifted restrictions on the programs during the pandemic, and lawmakers extended waivers through the end of 2024. The lawmakers proposal would allow the waivers to continue until 2027.

Wenstrup, a physician, said the programs offer patients another option for care.

“This program will allow thousands of Americans to continue receiving quality care from the safety of their own home,” Wenstrup said in a statement. “Patients are less anxious, and heal better, when they can heal at home."

Blumenauer said hospital-at-home programs emerged as a positive development in the pandemic.

“We know that patients fare better and enjoy their experience more when they’re at home,” Blumenauer said in a statement.

• Read more: Saint Luke’s Health System sees early success with hospital-at-home

Supporters

The American Hospital Association has said that it supports the lawmakers’ effort to continue hospital-at-home programs.

In a letter to the two lawmakers, Lisa Kidder Hrobsky, the AHA’s senior vice president of advocacy and political affairs, wrote that an extension of hospital-at-home programs “would provide much needed stability for existing programs to continue providing care to their patients, and it would give time for others to start programs.”

The American Telemedicine Association has also been pushing Congress to extend waivers for hospital-at-home programs.

• Read more: Hospital at home and health equity: Aiming to close disparities

Perspective

Many large health systems have been operating hospital-at-home programs. As of April 22, 322 hospitals from 133 systems have been approved to operate hospital-at-home programs in 37 states, according to the Centers for Medicare & Medicaid Services.

Health systems that have operated hospital-at-home programs tout a host of advantages for patients. They note that patients are more comfortable in their own surroundings and can get better rest in their own homes. Hospitals have touted high satisfaction from patients.

Researchers have found encouraging results from hospital-at-home programs, including low mortality.

Hospital-at-home programs had a mortality rate of 0.5%, according to the findings published Jan. 9 in the Annals of Internal Medicine.

David Michael Levine, clinical director for research and development for Mass General Brigham’s Healthcare at Home and the lead author of the study, told Chief Healthcare Executive® in January that the low mortality rate is heartening. But he said just as significantly, people being treated in hospital-at-home programs are truly in need of acute care.

“These are acutely ill patients,” he said. “And so to me, that was a really reassuring takeaway that these are hospital-level patients that are getting care.”

While more hospitals are building and expanding hospital-at-home programs, analysts say some health systems have been hesitant to begin providing acute care at home because of the uncertainty of federal reimbursements. Some have been waiting to be sure that the government is going to continue support of hospital-at-home programs before investing the resources and energy required to move forward.

Levine said that he hopes to see permanent reforms to allow hospital-at-home programs.

“At the very least, I would like to see it extended for at least several years,” Levine said in January.

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