A Summary of the Acute Hospital Care at Home Initiative by CMS (Article)

On September 30, 2024, the Centers for Medicare & Medicaid Services released a report related to the Acute Hospital Care at Home initiative. The AHCAH program was implemented during the COVID-19 public health emergency as a way for Medicare-certified hospitals to provide inpatient-level care in the home. That program, initially part of the COVID-19 response, was extended by the Consolidated Appropriations Act of 2023 through December 31, 2024.

The report from CMS encompasses many issues of the AHCAH initiative, including:

Patient Eligibility: The participating hospitals used various criteria inspired by the literature on hospital-at-home and their own resources in determining the eligibility of the patient for AHCAH care.

Demographics: AHCAH patients were more likely to be white compared to brick-and-mortar inpatients, live in areas classified as urban, and less likely to get Medicaid.

Clinical Conditions: Respiratory, circulatory, renal, and infectious diseases comprised the top diagnoses treated during the experience.

Quality of Care: Overall, patients treated under AHCAH had lower mortalities than hospital inpatients. While mortality was less varied across the different condition groups studied, AHCAH patient readmission rates were varied. Similarly, HACs for AHCAH patients were fewer, although generally not statistically significant.

Costs and Utilization: AHCAH patients had, on average, longer hospital lengths of stay but had lower post-discharge Medicare spending for more than half of the top 25 diagnostic groups for hospital inpatients.

Patients and caregivers reported positive feedback during virtual listening sessions that reflected positive perceptions about the AHCAH model.

This study examines successes of the AHCAH initiative as well as its limitations. Its findings point toward avenues of further research and program improvement. Whether AHCAH will continue beyond 2024 is left to future Congressional action.

A link to the full report can be found here: https://www.cms.gov/newsroom/fact-sheets/fact-sheet-report-study-acute-hospital-care-home-initiative

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