Background: People experiencing homelessness (PEH) face barriers to accessing regular ambulatory care, which increases their risk of having poorly controlled chronic medical conditions and contributes to high acute care utilization. The role of field-based homeless healthcare teams in improving hypertension and diabetes control and reducing acute care utilization (e.g., emergency department [ED] visits, inpatient hospitalizations) [...]

Background: People experiencing homelessness (PEH) face barriers to accessing regular ambulatory care, which increases their risk of having poorly controlled chronic medical conditions and contributes to high acute care utilization. The role of field-based homeless healthcare teams in improving hypertension and diabetes control and reducing acute care utilization (e.g., emergency department [ED] visits, inpatient hospitalizations) [...]

Background: Hospital at Home (HaH) provides inpatient level of care to patients within their homes and replaces the brick and mortar inpatient experience. Our institution’s HaH program has had incredible success and has enrolled over 2000 patients to date and continues to expand. The growth of our program has allowed us to accept more complex [...]

Background: Hospital admissions among nursing home residents with Alzheimer’s Disease and related dementias (ADRD) are burdensome, expensive, and provide limited clinical benefits. Compared to other patients, those with ADRD are more likely to experience adverse events, such as delirium, urinary infections, pneumonia, and functional decline. Research on nursing home residents has focused on the consequences [...]

Background: The Center for Medicare and Medicaid Services (CMS) enables Medicare-certified hospitals to provide inpatient-level care at home through their Acute Hospital Care at Home (AHCAH) initiative. A CMS report on 9/30/24 revealed demographic differences between AHCAH patients and traditional inpatients from the same hospitals. AHCAH patients were more likely to be white, live in [...]

Background: Hospital-at-home programs deliver hospital-level care in the comfort of patients’ homes, offering an innovative alternative to traditional hospitalization. These programs have gained traction since the COVID-19 pandemic and Medicare’s expanded reimbursements for virtual visits. Studies have demonstrated that they effectively manage heart failure with outcomes comparable to traditional hospital care. In 2020, Kaiser Permanente [...]

Background: Hospital at Home (HaH) delivers hospital-level care to eligible patients in their homes, offering an alternative to traditional inpatient hospitalization. Longitudinal research has demonstrated that HaH can enhance patient outcomes, increase satisfaction, and decrease rates of hospital readmissions. Patients are first identified for HaH program enrollment through referrals by inpatient providers or our internal [...]

Background: Discharge planning is an important component of safe and efficient hospital care. While standardization of these practices can be useful, adopting general approaches may overlook important nuance for unique patient populations. In particular, we are interested in how patients who live in a baseline unsafe situation conceptualize a “safe” discharge plan. Thus, our study [...]

Background: Michigan Medicine’s Hospital Care at Home (HCAH) Program was designed to provide eligible patients living in Southeast Michigan hospital level care from their own homes. Since the advent of the CMS Hospital at Home Waiver in Nov 2020, 93% of HCAH programs have been in urban locations, with prominent programs in cities such as [...]

Background: Hospital at Home (HaH) is an expanding clinical model that delivers inpatient-level care to patients in their homes, substituting a traditional hospital stay. It is becoming a standard of care at many institutions, yet there are still few formally established processes for integrating medical trainees despite clear benefits for both the program’s growth and [...]