The Centers for Medicare & Medicaid Services (CMS) announced an expansion of the Hospital Without Walls1 project to include the Acute Hospital Care at Home program on November 25, 2020. The goal of this initiative is to boost hospital capacity by allowing patients to be seen outside of a typical hospital setting, while simultaneously protecting patients and ensuring that they are treated effectively and safely in their homes during the COVID-19 public health emergency (PHE).
The Acute Hospital Care at Home program distinguishes acute hospital care at home from more standard home health services, which include skilled nursing and other skilled care services at a beneficiary’s home. Acute Hospital Care at Home, on the other hand, is for patients who require acute inpatient admission to a hospital and require at least daily rounding by a physician and a medical team monitoring their care needs on an ongoing basis. Acute hospital care at home services give health care to critically sick patients in their homes through the use of telehealth, remote monitoring, and regular in-person visits by nurses.
Extensive interaction with academic and private sector industry leaders inspired the development of this program, ensuring proper protections are in place to protect patients and that patient safety is never jeopardized. CMS believes that with suitable monitoring and treatment regimens, more than 60 different acute illnesses,1 including as asthma, congestive heart failure, pneumonia, and chronic obstructive pulmonary disease (COPD), can be treated appropriately and safely in home settings.
Telehealth and Remote Monitoring
The Acute Hospital Care at Home program enabled participating hospitals to minimize inpatient volume and relieve pressure on emergency departments by treating specific acute care patients at home via a telehealth platform with daily check-ins and monitoring.
Remote Patient Monitoring technologies help manage a patient’s acute or chronic conditions at home, and is also largely used for Hospital at Home programs. RPM technologies are often equipped with medical devices such as a pulse oximeter, blood pressure monitor, ECG monitor or smart scale linked through a smartphone via cloud service to transmit data to healthcare providers on a continuous and real-time basis.
Patients are monitored continuously to detect any changes in their biometric data. One of the monitoring objectives is to observe any major changes in the patients’ vital signs as soon as possible. This allows healthcare practitioners to provide timely medical intervention.
How hospitals can participate?
Hospitals interested in participating in this program must apply directly to CMS for the waiver at Acute Hospital Care at Home2 and submit all required information to verify they meet the program’s eligibility requirements. To protect beneficiaries, CMS will closely monitor the program by requiring hospitals to report quality and safety data to CMS on a regular basis based on their prior experience with the Hospital At Home model.
Participating hospitals must undergo proper screening methods in place before beginning home care to assess both medical and non-medical considerations, such as operating utilities, physical impediments, and screenings for domestic violence concerns.
Beneficiaries will be admitted only from emergency departments and inpatient hospital beds, and an in-person physician examination is required before beginning home care. Based on the patient’s nursing plan and hospital policies, a registered nurse will review each patient once daily, either in person or remotely, and two in-person visits will occur daily by either registered nurses or mobile integrated health paramedics.
CMS expects patients to value the chance to spend time at home with family and caregivers without the visiting restrictions that occur in typical hospital settings. Furthermore, patients and their families who have not been diagnosed with COVID-19 may opt to receive care at home if local hospitals are seeing a higher number of COVID-19 patients. It is the patient’s decision whether to receive these services at home or in a regular hospital setting, and those who do not desire to do so will not be obliged to do so.
As of September 2, 2021, 69 systems, 156 hospitals in 33 states3 are in the current list of approved facilities or systems for Acute Hospital Care at Home.
To view testimonials from health systems participating in the Acute Hospital Care at Home, please visit: https://qualitynet.cms.gov/acute-hospital-care-at-home/resources#tab4
Link to FAQs:
https://www.cms.gov/files/document/covid-hospital-without-walls-faqs-ascs.pdf
To know more about how DrKumo Next-Gen Remote Patient Monitoring supports Acute Hospital Care at Home Program, click here: DrKumo Announces the Next-Gen RPM Connected Health Technology Solutions to Power Acute Hospital Care at Home Program
References:
- https://www.cms.gov/newsroom/press-releases/cms-announces-comprehensive-strategy-enhance-hospital-capacity-amid-covid-19-surge
- https://qualitynet.cms.gov/acute-hospital-care-at-home
- https://qualitynet.cms.gov/acute-hospital-care-at-home/resources
