Encouraged by the government’s two-year extension on acute care at home, hospitals are now poised to move emergency department care into the home as well. Boston-based Medically Home is paving the way.
Earlier this week, Medically Home announced the national rollout of ED in Home, following a two-year pilot in Massachusetts. Company co-founder and CEO Rami Karjian told McKnight’s Home Care Daily Pulse emergency department care is a natural extension for his firm, which provides hospitals and medical systems with technology and staffing to deliver hospital-level care at home.
“This is something that we would expect health systems — like a Kaiser [Permanente] or a Mayo [Clinic] — to adopt,” Karjian said. “It’s also a really powerful tool for physician groups who are taking risk on their patients and want to be able to provide that front door to the hospital.”
Emergency care at home is not really a new concept. For a couple of years, MedArrive has been using emergency medical technicians and paramedics to deliver in-home care to patients who are frequent visitors to emergency departments.
Medically Home also will use EMTs and paramedics to deliver care, but Karjian said ED in Home is distinctly different. The program aims to treat sicker patients who can quickly transition to hospital-at-home if they need additional care.
“This certainly takes the burden off of the EDs, particularly those areas where there is such overcrowding,” Karjian continued. “This will take some of the pressure and the stress off and it will allow the patients in the EDs to be those who truly need a brick-and-mortar ED. Think about trauma, think about stroke.”
Medically Home treated 5,000 patients during ED in Home’s pilot. More than 80% of those patients were able to stay at home without a transfer to a brick-and-mortar hospital.
The Centers for Medicare & Medicaid Services introduced the Acute Hospital Care at Home waiver program in 2020 to allow hospitals more flexibility in treating patients at home during the COVID-19 pandemic. Approximately 350 hospitals and medical systems nationwide have launched hospital-at-home programs.
The omnibus bill that President Joe Biden signed at the end of last year extended the program until the end of 2024. Karjian believes the hospital-at-home will become permanent but said CMS could alter the way providers are reimbursed for the service.
