Congress Eyes Expansion of Hospital at Home Care Model

By Eric Wicklund

Congress is wading into the question of whether the Hospital at Home model of care should be made permanent.

U.S. Senators Marco Rubio (R-Florida) and Tom Carper (D-Delaware) have introduced a bill that would set up a pilot program to test whether the Acute Hospital Care at Home initiative could be expanded to new populations beyond those needing acute care services.

The At Home Observation and Medical Evaluation (HOME) Services Act, if passed, would give the strategy some life beyond the planned December 31, 2024 expiration date for the Medicare waiver that supports the program.

“Addressing our healthcare challenges requires innovative solutions,” Rubio said in a joint press release issued yesterday. “The At HOME Services Act builds on the success of the hospital-at-home program to lower costs and burdens and improve patient outcomes and satisfaction.”

The bill adds a new wrinkle in the ongoing debate over whether the program should continue after this year.

The model targets patients who would otherwise be admitted to the hospital, creating a home-based care management plan that includes often-multiple daily visits by care teams, virtual care services and remote patient monitoring. Some programs have added ancillary services to address social determinants of health, imaging and tests, and pharmacy and rehab needs.

Supporters, including an advocacy group formed out of several of the more than 300 hospitals using the CMS model, are lobbying both CMS and Congress to make the Medicare waiver permanent, arguing that many programs would struggle or even shut down without Medicare support. They also point to a recent nationwide study that shows positive clinical outcomes in the Hospital at Home model.

On a related front, New Jersey recently passed a law that enables Garden State health systems to expand the Hospital at Home program to residents on Medicaid or NJ Family Care programs, as well as those on private insurance.

Eric Wicklund is the associate content manager and senior editor for Innovation, Technology, and Pharma for HealthLeaders.