QUESTION: I’ve heard that the Centers for Medicare & Medicaid Services (“CMS”) has recently begun a new program called “Acute Hospital Care at Home.” Can you explain more about this? Is this related to the Hospitals without Walls initiative?
ANSWER: The Acute Care Hospital at Home program builds upon Hospitals without Walls, which provided broad regulatory flexibility to allow hospitals to provide services in locations beyond their existing campus. After considerable study and research, CMS determined that over 60 different acute conditions could be treated appropriately and safely in home settings with proper monitoring and treatment protocols.
Note that this is different from more traditional home health services. Acute Hospital Care at Home is for beneficiaries who require acute inpatient admission to a hospital and who require at least daily rounding by a physician and a medical team monitoring their care needs on an ongoing basis.
In late November, there were six health systems who had received approval for new waivers under the program. By mid-January, the program had expanded to include 88 hospitals across 24 different states.
To enter the program, hospitals must submit a waiver request to CMS. There is an abbreviated process available, but most hospitals will be required to submit a detailed waiver request. As part of this request, the hospital will need to show that it can provide or contract for services such as:
- Pharmacy
- Infusion
- Respiratory Care (including oxygen delivery)
- Diagnostics (labs, radiology)
- Monitoring (with at least 2 sets of patient vitals daily)
- Transportation
- Food Services (including meal availability as needed by the patient)
- Durable Medical Equipment
- Physical, Occupational, and Speech Therapy
- Social Work and Care Coordination
More information is available on the CMS website, including an FAQ document. CMS also held a conference call on December 22, 2020, which explained further details of the program (transcript and recording available here). We expect that more information will be made available in the near future as the program evolves.