In February, Congress extended the Acute Hospital Care at Home program through the end of 2030. The program provides waivers to hospitals to provide inpatient-level care at home to qualified Medicare beneficiaries. The five-year extension will help participating hospitals – in place at more than 400 organizations – demonstrate the value of hospital at home and, according to the American Hospital Association (AHA), provide evidence to other payers that the program can work.
Many hospital at home programs predate the program approved by Congress, which the Centers for Medicare & Medicaid Services (CMS) first launched during the COVID-19 pandemic. Here’s a look at some of these key programs and what makes them successful.
Johns Hopkins Medicine has been operating its hospital at home program since 1994. Positive outcomes were first reported in 2005, including a 32% drop in care costs and a 35% drop in length of stay. Along with clinical care services, Baltimore-based Johns Hopkins now offers social services, home health aides, and help with day-to-day household management. Not surprisingly, the health system’s success has served as a model for Hospital at Home programs around the country.
Advocate Health launched its North Carolina-based program in just 10 days during the pandemic, AHA said, and has achieved a 15% reduction in readmission rate coupled with higher patient satisfaction scores. Patients can transition from a hospital or skilled nursing facility (SNF) to home-based care, and the program covers short- and long-term care.
Atrium Health serves about 90 patients per day in its North Carolina-based hospital at home program, which was also the model for what the health system said is the first-of-its kind pediatric hospital at home. The program also offers transitions to advanced care or palliative care at home.
The Cleveland Clinic Florida program, launched in 2023, has seen some of the highest patient satisfaction scores across all inpatient wards at the health system. It helps that the health system contracts with community-based providers. The health system’s Clinically Integrated Virtual Care (CIViC) Center covers remote monitoring and virtual care.
Kaiser Permanente has reported smoother care transitions and better patient experiences for its program based in Northern California, which provides care for more than 1,000 patients annually. It’s part of a larger care at home strategy for the health system, which in 2021 partnered with Mayo Clinic and Medically Home to found the Advanced Care at Home Coalition.
Los Angeles General Medical Center emphasizes virtual, concierge-level care, though rideshares can be dispatched if patients need to be evaluated at the hospital. The public safety net hospital’s program has reduced inpatient stays by 4 days and saves the system about $5.6 million annually, and leaders say it’s a model for providing “financially responsible” care.
Wisconsin’sMarshfield Clinic Health System is another early adopter (2016), according to the American Medical Association. The Home Recovery Care program covers 30-day medical care or 60-day rehabilitation care. The health system has reported a 44% reduction in readmission rate, a 35% decrease in average length of stay, patient satisfaction of more than 90%, and increased physician satisfaction.
At Mass General Brigham, the readmission rate for the hospital at home program is less than one-third the rate for inpatient care, AHA said. Aling with typical clinical and ancillary services, the hospital offers medically tailored meals and supports in-hone X-rays. The program has also been adapted to provide hospital-level care for veterans experiencing homelessness.
Mayo Clinic Arizona has reported a 35% decrease in readmission rate for hospital at home patients. The program also demonstrates equivalent rates of patient safety and higher rates of patient comfort. Patients receive a technology kit that, in addition to medical devices, can include a direct-dial phone, Wi-Fi extender, and backup power supply.
Mount Sinai Health System launched its program in 2014 thanks to a CMS grant, according to AHA; it built on an existing program providing home-based primary care to homebound New Yorkers. Only 7% of participating patients need to return to the hospital. The program also includes at-home palliative care, dialysis, and infusion.
The Ohio State University Wexner Medical Center has focused on disadvantaged neighborhoods. AHA reported readmission rates are roughly half as high as inpatient care, and 95% of patients rate the experience as 9 or 10 out of 10. Available services include an in-home safety assessment to help reduce the risk of falls.
Oschner Health prevented hospitalization and readmission for 92% of eligible emergency department patients in its initial pilot program, which it subsequently expanded in 2024. Along with covering chronic conditions, the program is available for Louisiana-based patients recovering from a transplant or those with a cancer diagnosis.
Presbyterian Healthcare Services launched its hospital at home program in 2008 in partnership with Johns Hopkins Medicine. Most patients receive two care visits per day for several days before discharge. The cost of care is 42% lower than inpatient hospitalization, AHA reported. The New Mexico-based health system also tripled at-home admissions capacity during the pandemic.
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About Dennis P. Sweeney
The following is a guest article by