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POLICY RECOMMENDATIONS Human Health
Policy Recommendation 9:
State policymakers can create standards for how they will adapt to new health care technologies while maintaining a high standard of care as a priority and without eliminating the human factor in health care provision. Policymakers may examine technological use in settings such as (1) hospital at home, (2) long-term hospital at home and (3) other forms of remote patient monitoring.
The Human Health Subcommittee approved this recommendation, citing a desire to improve and maintain a high standard of care without eliminating the detail oriented, personalized aspects of human delivered and centered health care and telemedicine. Specifically, states should examine how new technologies are being adapted and implemented in at-home settings amongst other forms of remote patient monitoring.
The pandemic taught us more about the benefits of technology by forcing us to employ it in ways we had not done before. We should capitalize on those lessons by creating standards or best practices for using technology in a wide variety of settings, always being mindful that we don’t become robotic about Its use. The human touch is so important in providing health care so we need to use technology without losing sight of the human factor.”
— Judge Melanie May, Florida
Hospitals can provide a wide array of services in the home setting, including:1
Diagnostic tools such as electrocardiograms, echocardiograms and x-rays.
Treatments such as oxygen therapy, intravenous fluids, intravenous antibiotics and other medicines.
Services such as respiratory therapy, pharmacy services and skilled nursing services.
A growing body of research shows that hospital-at-home is an effective strategy that improves all three components of the value equation: improve outcomes, enhance the patient experience and reduce cost.2
Likewise, remote patient monitoring allows for the collection of a wide range of health data from the point of care, such as vital signs, weight and blood pressure.3 The data is transmitted to health professionals in facilities such as monitoring centers in primary care settings, hospitals and intensive care units and skilled nursing facilities.
A little over half of state Medicaid programs reimburse for remote patient monitoring. However, there are a multitude of restrictions associated with its use. The most common include:4
Offering reimbursement only to home health agencies.
Restricting the clinical conditions for which symptoms can be monitored.
Limiting the type of monitoring device and information that can be collected.
As the popularity and convenience of telehealth grows, so do hospital-at-home services and remote patient monitoring. State policy leaders might consider how to enable these technologies while maintaining quality of care for their residents.
State Examples
In Connecticut, the Connecticut Home Care Program for Elders provides care management, adult day health, companion and homemaker services as well as home delivered meals.5 To be eligible, applicants must be 65 years of age or older, be a Connecticut resident, be at risk of nursing home placement and meet the program’s financial eligibility criteria.
In Alabama, Alabama Medicaid reimburses remote patient monitoring for specified conditions through the In-Home Remote Patient Monitoring Program.6 The program is administered by the Alabama Coordinated Health Network (ACHN). Patients may be referred to the program by any source including a physician, ACHN care coordinators, patient or caregiver, the health department, hospitals, home health agencies or community-based organizations.
Additional Resources
The Council of State Governments State Leader Policy Brief: Human Health (2022) — https://web.csg.org/csghealthystates/ wp-content/uploads/sites/23/2022/05/Healthy-States-National-TaskForce-Policy-Brief-Strategies-for-Improving-Health-Equity.pdf
Annual Meeting of The Council of State Governments Southern Legislative Conference in Oklahoma City — https://web.csg.org/ csghealthystates/wp-content/uploads/sites/23/2022/08/CSG-HealthyStates-National-Task-Force-Human-Health-Subcommittee-MeetingReport-July-2022.pdf
