Background: “Hospital at Home” (HaH) models of care have existed for over 20 years in the U.S. Demand for healthcare value has driven renewed attention to HaH, including from the Centers for Medicare and Medicaid Services. The COVID-19 pandemic has only magnified consideration of alternative sites of care. Where studied, HaH models have had desirable [...]

Background: Academic medical centers and other quaternary hospitals struggle with capacity challenges that manifest in longer ED wait times, delayed or cancelled elective surgical procedures, and delayed transfers from community hospitals[1]. The Hospital at Home model is an obvious and elegant solution to increase capacity[2], but its nationwide implementation has been limited due to lack [...]

Background: “Hospital at Home” (HaH) models of care have existed for over 20 years in the U.S. Demand for healthcare value, advances in relevant technologies, and the ongoing global pandemic have driven renewed attention to HaH models, by way of policy-based and academic pilot programs – and even commercialization attempts. Where studied, these models have [...]

Background: “Hospital at Home” (HaH) models of care have existed for over 20 years in the U.S. Recent demand for healthcare value, advances in relevant technologies, and the ongoing global pandemic have driven renewed attention to HaH models, including from the Center for Medicare and Medicaid Services (CMS), and have spawned several pilots within the [...]

Background: Hospital at home (HaH) programs have shown efficacy as substitutes for high-cost, traditional hospitalization in patients who are primarily low-acuity and with a range of medical conditions, including community-acquired pneumonia (CAP) and urinary tract infection (UTI). However, wide-spread adoption is minimal as providers and patients are challenged to consider HaH at the time of [...]

Background: Hospital at Home (HaH) care is an alternative to traditional hospitalization with potential to address issues of cost and hospital capacity, while improving outcomes and patient satisfaction. In 2017, the US Department of Health and Human Services began to consider bundled payments for HaH despite a lack of US-based evidence on patient outcomes, real-world [...]

Background: Hospital at home is a novel healthcare delivery model offering acute inpatient care outside hospital walls. In the United States, hospital at home programs are almost exclusively offered in urban settings. Many rural regions of the United States have difficulty with adequate healthcare access, and there is little data on rural hospital at home [...]

Background: Hospital at Home (HaH) programs provide feasible and effective inpatient-level care in patients’ homes, with interest in this value-based care model increasing substantially as health systems strain to meet capacity and resource demands.1-6 Despite well-documented benefits, adoption of HaH outside of capacity surges remains limited, hindering scalability efforts.7 Furthermore, patient and provider experiences of [...]

Background: In November 2020, CMS issued the Acute Hospital Care in the Home waiver which allows hospitals to care for appropriate Medicare inpatients in a patient’s home. UNC Health launched its home hospital program Advanced Care at Home in August 2021. Hospitals issued the CMS waiver are required to subject patients to both clinical and [...]

Background: Hospitalization at Home (HaH) has demonstrated clinical quality and patient experience superiority in general inpatient medical patients. Expansion of this service to sub-specialized inpatient populations would be highly beneficial to patients and health systems. Mount Sinai Health System (MSHS) HaH enrolls oncology patients with active disease admitted for acute general medical conditions and for [...]