Historically, patients have moved from home to hospital. Might COVID-19 help change that dynamic? Certainly, there are signs that hospital-at-home models are gaining traction.
The concept is simple: deliver hospital-level care in a patient’s home as a full substitute for acute hospital care. Numerous providers are implementing the approach. They include VA hospitals, health systems, home care providers and even managed care programs.
The approach appears to be particularly effective for older patients with conditions such as congestive heart failure and chronic obstructive pulmonary disease. Advocates note that the hospital-at-home approach is generating many benefits. They include reduced care costs, improved clinical outcomes, lower mortality rates, reduced medication use and higher patient/family satisfaction.
Policymakers note that greater use of this approach could dramatically reduce Medicare program outlays. Some see COVID-19 as a catalyst for growth as many hospitals struggle to supply beds, staff and equipment.
One possible hurdle, however, is reimbursement. Traditional Medicare and Medicaid programs are not structured to fully compensate healthcare systems. The Centers for Medicare & Medicaid Services temporarily remedied the problem this year by allowing hospitals to bill for care delivered offsite. Hospital groups are pushing to make the change permanent. Should that happen, home health might soon be tapping into a new revenue stream.