person in bed

Hospital-at-home providers called Tuesday for a better regulatory framework and targeted quality measures to expand the Acute Hospital Care at Home Program. Leaders from Mayo Clinic, Kaiser Permanente and Brigham Health made the appeal during a webinar sponsored by Permanente Medicine.

“We know what to do at brick-and-mortar hospitals for quality metrics, but how does that pertain to hospital-at-home and all of the other programs that are out there?” Mayo Clinic Advanced Care at Home lead physician Michael Maniaci, M.D., asked. “How do we build the right metrics and feed that back to CMS and to commercial payers?” 

Northwest Permanente Chief Operating Officer Mary Griswold, M.D, said hospitals and healthcare systems must make sure they are offering hospital-at-home programs equitably across the communities they serve. 

“We have to get creative in thinking about who we bring care to in order to be inclusive of all of our patients,” Griswold said. 

SCAN Foundation CEO Sarita Mahanty, M.D., agreed. She wants to see established quality measures across all populations.

“Are we seeing differences in access to the hospital-at-home programs across racial and enthnic groups,” Mahanta asked. “What about those people in rural communities? Are we able to give them access to these types of programs?” 

Also, while she applauded hospital-at-home programs for coordinating services in the home for older adults, she said the programs need to connect seniors to other home-and-community-based programs. 

Hospital-at-home waiver in question

The healthcare leaders’ comments come at a pivotal time as the Centers for Medicare & Medicaid Services and Congress debate the future of Acute Hospital Care at Home. Last week, a bipartisan team of senators introduced the Hospital Inpatient Services Modernization Act, which would extend the Acute Care at Home waiver two years beyond the April 16 expiration of the COVID-19 public health emergency. That legislation requires CMS to establish health and safety regulations for hospital-at-home programs. 

CMS launched Acute Care at Home at the beginning of the pandemic, allowing hospitals greater flexibility in care delivery. More than 200 hospitals and health systems in more than 30 states are participating in the waiver program.