The following is a guest article by Aaron Timm, EVP and Chief Commercial Officer at Vivalink
In recent years, Hospital-at-Home (HaH) programs have been accepted more widely as a way of providing acute-level care to patients at home. These programs are gaining traction worldwide because they offer solutions to challenges seen in traditional hospitals, such as capacity constraints, increasing expenses, and efforts to improve patient experiences and outcomes.
While the concept of providing acute care services at home is not entirely new, recent advancements in medical technologies, coupled with evolving healthcare policies and shifting patient preferences, are propelling the expansion of HaH solutions.
Home health technologies like remote patient monitoring (RPM) and telemedicine have significantly improved access to care and have been instrumental in supporting HaH programs. However, alongside technological advancements, government support, the transition to value-based care, and effective coordination among healthcare teams play equally important roles in the widespread adoption of HaH initiatives.
Empowering At-Home Hospital Solutions with Remote Monitoring
Remote monitoring serves as a foundational component of at-home hospital solutions, which require access to real-time patient data to inform clinical decision-making. These programs leverage a variety of RPM tools tailored to individual patient requirements, such as wearable devices such as blood pressure cuffs, pulse oximeters, and biosensors.
Vivalink conducted a survey involving hundreds of clinicians to assess the utilization of RPM devices outside traditional hospital settings. The findings show that over 80% of providers currently utilize RPM technology to track patients’ vitals and monitor their recovery progress outside of the hospital. Among these, 45% of providers use RPM for acute monitoring, such as HaH programs.
In recent years, there has been a notable shift toward prioritizing patient-centered care. Patients often prefer receiving care in the familiar and comfortable environment of their own homes, where they feel more relaxed and in control. As RPM technology continues to advance and gain broader acceptance, more healthcare facilities and providers are likely to embrace at-home hospital solutions as a viable alternative to traditional hospital care.
Government Support and Reimbursement Policies for At-Home Solutions
Government support and reimbursement policies are necessary for HaH programs’ continued growth. These policies provide incentives for investing in the required infrastructure, personnel, and technologies needed to deliver hospital-level care at home. Plus, they ensure that patients have adequate access to high-quality healthcare services.
While Australia and several European nations have provided hospital care at home for decades, the United States has been relatively slow to adopt hospital care at home. However, the Centers for Medicare and Medicaid Services (CMS) took an important step to accelerate the adoption of the model in the U.S. with its introduction of the Acute Hospital Care at Home (AHCAH) waiver in 2020.
The waiver allows participating facilities to be reimbursed for delivering acute care at home, encouraging wider recognition and implementation of HaH programs across the country. Since its inception, the AHCAH initiative has led to a significant expansion of at-home care programs, with 277 hospitals in 37 states approved to offer care under the waiver as of March 2023. The initiative has now been extended through Dec. 31, 2024.
The increasing adoption of at-home hospital services indicates that the model is likely to persist. It’s also a consensus among clinicians. According to Vivalink’s survey results, 77% of providers anticipate that within the next five years, RPM-based care will surpass traditional in-patient hospital care in terms of adoption and preference.
The Impact of Value-Based Models
The shift to value-based care models in healthcare is changing how patient-centered care is delivered, further encouraging the adoption of HaH. Unlike the traditional fee-for-service model, where providers are paid based on the number of services they offer, value-based care focuses on quality of care, provider performance, and patient experience.
In the U.S., where healthcare systems have traditionally operated under a fee-for-service framework, there’s a growing interest in exploring and implementing value-based care models. For instance, CMS has piloted value-based payment systems like episode-based payments, which are intended to encourage providers to provide comprehensive and coordinated care for specific medical conditions.
The shift toward value-based care aligns with the mission of HaH care, and hospital systems have long studied its effectiveness. For instance, in the early 2000s, researchers at Johns Hopkins Medicine examined the feasibility of providing hospital-level care to acutely ill older adults at home.
Their findings revealed that the model met quality standards comparable to acute inpatient care, as well as resulted in shorter hospital stays and decreased costs. Specifically, patients treated at home stayed an average of 3.2 days compared to 4.9 days for those in the hospital. Plus, HaH care averaged around $5,081, while acute hospital care cost about $7,480.
Recent research, such as Mass General Brigham’s study of the AHCAH outcomes, echoes similar findings. The healthcare system’s research suggests that home hospitals are important for managing acute illness, particularly for socially vulnerable and medically complex patients. The findings also revealed lower mortality rates and a reduced need for escalated inpatient care compared to traditional hospital settings.
Advanced Technology Expanding At-Home Care Access
As technological advancements continue to accelerate, the adoption of at-home care is poised for further growth. The increasing adoption of HaH solutions worldwide, driven by challenges in traditional hospitals and a focus on improving patient experiences and outcomes, emphasizes the importance of advanced technology in making acute-level care more accessible at home.
Research from respected institutions validates HaH care’s effectiveness. As technology, particularly acute RPM, continues to advance, so too will the adoption and effectiveness of care available at home. The connection between technology and healthcare delivery is reshaping patient treatment, ultimately leading to improved outcomes and experiences for patients across the healthcare continuum.
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