TRENDS
BY DANIEL BEAIRD
Expanding Care Delivery Services Healthcare organizations and associations put pressure on Congress to help bolster home care models
A recent report from McKinsey & Co. stated that as much
“One driver to more enrollments is the barrier of obtain-
as $265 billion worth of care services for Medicare fee-for-service
ing reimbursements for short-term oxygen,” Peter Read, MD,
and Medicare Advantage beneficiaries could shift to the home by
medical director of Des Moines, Iowa-based UnityPoint Health’s
2025, representing a three- to fourfold increase in the cost of care
hospital-at-home program, told AHA’s Advancing Health podcast in
being delivered at home for this population.1 The COVID-19
February.2 “We worked with our ACO to develop a waiver that allows
pandemic accelerated this movement and a significant portion
us to dispense short-term oxygen to overcome reimbursement.”
of it came through Hospital-at-Home (HAH) programs, which
UnityPoint Health has achieved $900,000 in shared savings from just
enable some patients who need acute-level care to receive it in
its hospital-at-home program, and many of its other home-based
their homes rather than in a hospital, thus aiming to reduce costs,
services were in increased demand due to the pandemic. The
improve outcomes and enhance the patient experience.
Midwestern health system has enrolled over 150 patients in its program and averted over 100 hospitalizations during the pandemic.
Advanced Care at Home Coalition UnityPoint Health is part of the Advanced Care at Home Coalition led by a steering committee comprised of the three founding members, including Mayo Clinic, Kaiser Permanente and Medically Home. Its 12 other members is a list of prominent health systems, including Baltimore-based Johns Hopkins Medicine, which was a leader under Bruce Leff, MD, in these programs in the mid-1990s. The coalition has applauded the recent introduction of the Hospital Inpatient Services Modernization Act, which would extend the Acute Care at Home waivers that have allowed expanded delivery of hospital-level care at home for Medicare beneficiaries during the pandemic. The bipartisan legislation sponsored by Sens. Tom Carper (D-DE) and Tim Scott (R-SC), and Reps. Brad Wenstrup (R-OH) and Earl Blumenauer (D-OR) extends the waivers for two years beyond the duration of the COVID-19 public health emergency CMS launched the Acute Hospital Care At Home program
and it requires CMS to issue regulations establishing health and
in November 2020, during the first year of the pandemic. It pro-
safety requirements for Acute Hospital Care at Home programs
vided hospitals the flexibility to care for patients in their homes,
within one year of the bill’s enactment. It’s supported by more
originally helping relieve facilities of non-COVID patients to
than 100 health organizations and healthcare associations.
assist in tackling the surge of COVID-positive patients. As many
“By extending these flexibilities, Congress will create a pre-
HAH programs evolved throughout the pandemic, they shifted
dictable pathway for medical professionals to fully realize advances
to enrolling COVID-positive patients as well to finish their hos-
in the care delivery system that enable patients to be treated with
pitalization at home. Now, COVID-positive are enrolled directly
safe, equitable, person-centered care in the comfort of their own
from emergency departments.
homes,” said Stephen Parodi, MD, executive vice president of The
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Aprill 2022 | The Journal of Healthcare Contracting
