Healthcare worker standing in front of a state capitol building

Lawmakers and hospital systems are urging Congress not to “let progress lapse” by letting hospital-at-home waivers expire with the COVID-19 public emergency.

“Everyone has different treatment needs and plans and we have to make sure that people have continued access to these options as Congress reviews how to make the initial flexibilities from the pandemic more permanent,” Rep. Brad Wenstrup (R-OH) said Wednesday during a webinar sponsored by the Advanced Care at Home Coalition. 

Wenstrup is a sponsor of the Hospital Inpatient Services Modernization Act, which would extend the Centers for Medicare & Medicaid Services’ Hospital Without Walls program two years beyond the expiration of the PHE at the end of next month. 

Medical professionals from a half-dozen healthcare systems providing hospital-at-home said the service not only freed up beds for the sickest patients during the pandemic but helped providers gain deeper access to the communities they serve.

Approximately half of the patients served by UMass Memorial Health in Boston are either on Medicaid or are dually eligible for Medicare and Medicaid. Constantinos Michelidis, M.D, medical director for UMass Memorial’s hospital-at-home program, said treating those patients at home helped build trust and helped providers better address social determinants of health.

“We were able to understand some of the challenges that perhaps patients and their families were ashamed of sharing – challenges with transportation, food insecurity, affording medication and not taking their medication,” Michelidis explained “This is a complex milieu that is hard for brick and mortar teams to see because they’re not in the home.” 

Michelidis said over the past two years, UMass Memorial’s hospital-at-home program has helped reduce 30-day hospital readmissions for that population by 75%. 

Some providers said hospital-at-home made it easier for them to recruit staff because it offered physicians and nurses a different way to practice medicine. Mae Centeno said she has already filled all of the nursing positions for Texas Health Resources soon-to-launch hospital-at-home program.

“Several nurses have thought of retiring, but this offers a welcome change,” Centeno said.

CMS launched the Hospital Without Walls program at the beginning of the COVID-19 pandemic in 2020. So far, approximately 200 hospitals and medical systems have received waivers to offer hospital quality care to patients in their homes.