How major healthcare providers can use the hospital-at-home model to limit excessive expenditures and hospitalizations
As healthcare costs in the United States steadily climb skyward, healthcare systems search for effective solutions to contain costs while maintaining high-quality care. In today’s healthcare environment, a single hospital readmission averages $15,200 with an overall 14% readmission rate.
Priorities include managing bed capacity, minimizing resource overuse, limiting hospital readmissions, and protecting vulnerable patients from unnecessary exposure to risks like COVID-19. Healthcare providers must also grapple with the essential Medicare coverage upon which they and their patients rely.
Within a hospital is no longer the only place for treating and care for patients. Hospital-level care at home is becoming the new normal and hospital-at-home programs are bringing big benefits for patients and providers.
What is the Hospital-at-Home Model?
Hospital-at-home (HAH) programs provide a high level of hospital-like care in patients’ homes. It’s a type of robust home-based hospital treatment where healthcare providers communicate via technology to support the patient and ensure they’re always receiving quality care.
HAH services are typically focused on a core set of health conditions that are best qualified for the hospital-at-home model because they cause frequent and expensive hospital readmissions:
- Chronic obstructive pulmonary disease (COPD)
- Uncomplicated congestive heart failure (CHF)
About 92% of potentially eligible patients in HAH programs typically end up qualifying for the program. The four conditions listed above are also usually reimbursable under Medicare for services provided at home. This benefits patients and providers who need coverage for the high costs that come with treating these severe and chronic diseases.
Addressing the Challenges of Hospital Readmissions
The goal of a high-quality HAH program is to reduce preventable readmissions. Not all readmissions can be avoided, but a recent JAMA Internal Medicine study found that 27% of U.S. hospital readmissions within 30 days are preventable.
Traditionally, the strategies hospitals have used to limit readmissions have focused on enhancing internal hospital processes and streamlining the facility’s patient stay procedures. These strategies tend to overlook opportunities found in home-based hospital care.
For example, consider the challenges of caring for acutely ill older adults. Any type of travel or interruptions in care can potentially be life-threatening for these vulnerable patients. Plus, extended hospital stays tend to make these patients feel emotionally drained, which further puts their health at risk.
By contrast, acute care delivery at home has a demonstrated positive impact on the emotional well-being of acutely ill older adults. As these patients remain in place and participate in the hospital at home program, they continue to feel emotional support they need.
This not only enhances their healthcare experience but also prevents the risk of unnecessary hospital readmission. The Centers for Disease Control and Prevention (CDC) have found that social isolation is a key factor in hospital readmission, so surrounding patients with social support is an essential part of providing a positive healthcare experience.
Positive Outcomes of Hospital-at-Home Programs
Hospital-at-home programs are becoming more common in the U.S. and have well-documented benefits. Below is a summary of published studies that show the positive impact of home-based hospital care.
- In a controlled randomized study published in the Annals of Internal Medicine (AIM), costs per health episode were 38% lower in HAH programs than with traditional care.
- In the same AIM study, hospital readmissions among the HAH participants were just 7% compared to 23% for the control group.
- A JAMA Health Partners study found that among patients with high blood pressure, at-home care programs achieved better blood pressure control at 6-month and 12-month intervals compared to the usual care.
- In elderly Medicare patients with heart failure, the probability of all-cause readmission was significantly reduced through the use of post-discharge telemonitoring at home.
- A Medicare patient post-discharge virtual monitoring program was associated with a 44% reduction in 30-day hospital readmissions for a variety of health conditions.
Additional Elements to Consider With HAH Programs
When implementing HAH care, major healthcare providers should follow best practices for the hospital-at-home model. The quintessential model is found in the Johns Hopkins School of Medicine Hospital at Home Program.
The Johns Hopkins model identifies qualified patients using a set of hospital-set criteria. Typically, these criteria are applied at the admission point, meaning during ER intake or as part of a care transfer. Patients must consent to receive HAH care.
As part of their hospital visits, the patients receive evaluations, testing, diagnosis, treatments, and procedures according to the traditional standard of care plus the impending HAH care. When it’s time to transfer from in-hospital care to HAH care, patients continue to interact with their doctors, nurses, and other staff members through virtual care technology until the point of stability and discharge as directed by a doctor.
The advantages of following the Johns Hopkins model include:
- A proven approach that Johns Hopkins doctors have considered medically sound since 2005 when HAH was introduced
- Better clinical outcomes for a wide variety of diagnoses and patient groups
- Lower incidence of complications like hospital-acquired infections
- Higher patient and family satisfaction with the healthcare experience
- Overall 30% lower costs for diagnostics, lab work, and many other types of hospital costs when compared to traditional care
A well-designed hospital at home program aide in reducing readmissions and thus lowers costs associated with care. Major healthcare companies that implement HAH programs now could save millions in the future as healthcare costs are expected to continue growing at high annual rates over into the next decade and beyond.
Smart Resource Allocation with AMC Health
AMC Health is a proven partner for providing high-quality hospital at home programs. We deliver world-class home-based hospital care that helps major healthcare organizations contain care costs while offering a welcome service that’s accessible anywhere, anytime.
Please schedule an AMC Health demo or click the link below to learn more about partnering with us to provide the high level of hospital-quality care your patients prefer to receive in the comfort of their own homes.
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