20 February 2022 |

Hospital Bed & Breakfast

By Jared Dashevsky

MyMichigan Health announced it will officially launch a hospital at home (HaH) program, joining 100+ other U.S. hospitals that are trying to deliver high-value care. While the HaH concept has been around for over two decades, only now is it starting to take off.

HaH 101

HaH programs allow for intensive care in the comfort of the patient’s home. The program is for patients who are sick enough to be hospitalized but stable enough to be treated in their homes by visiting (in-person or virtual) doctors and nurses. With well-monitored care, HaH is safer, cheaper (no need to pay for fixed facility costs) and more effective than traditional hospital care (link).

There have been several barriers to HaH adoption throughout the healthcare system:

  • Reimbursement ➡️ no matter how good the experience is for the patient, if hospitals are losing money by not treating the patient in-house, they won’t adopt HaH.
  • Physician buy-in ➡️ even if hospitals adopt the program, physicians need to trust that outcomes will be the same, if not better, than care in the hospital. HaH is quite untraditional.
  • Tech-enabled ➡️ a lot of technology goes into HaH programs, especially if there’s virtual care. The patient will need access to the internet and other technology. The reliance on tech could perpetuate existing health inequities and disparities.

HaH 🤝 Covid-19 

The surge in hospital demand during the pandemic prompted CMS to create an Acute Hospital Care at Home Program to reimburse hospitals for HaH programs (link). The number of hospitals participating grew from 12 to 186, largely because there was/is a solid reimbursement program in place to care for patients at home.

Now What? 

Once the public health emergency ends, so will CMS’ HaH program. Since the HaH program has been so popular, I envision CMS will create a more formalized design of the program and reimbursement model. More and more hospitals will then hop on the HaH train to remain competitive. 

Lastly, where CMS goes, so do startups. I predict we’ll see current and new startups shift their focus to creating necessary tools and resources for hospitals to run robust HaH models. This can be a hot area for remote patient monitoring companies, travel nursing agencies and telehealth platforms.


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