HealthcareDive reports that the Centers for Medicare and Medicaid Services (CMS) has released new guidance to permit hospitals to deliver more inpatient care in people’s homes. The policy is a response to the surge in COVID-19 cases, the limited supply of hospital beds, and the value of keeping older adults and people with disabilities isolated.
For the first time, because of the increase in COVID-19 hospitalizations since Thanksgiving, CMS is permitting hospitals to provide hospital care at home. The CMS guidance lists more than 60 acute conditions for which hospitals can provide in-home treatment. Conditions include asthma, pneumonia, congestive heart failure and chronic obstructive pulmonary disease.
Hospitals must seek waivers to provide in-home hospital care. To date, CMS has granted waivers to six health systems. Brigham and Women’s Hospital in Massachusetts; Massachusetts General Hospital; Hunstman Cancer Institute in Utah; Mount Sinai Health System in New York City; Presbyterian Healthcare Services in New Mexico; and UnityPoint Health in Iowa. CMS expects to grant many more waivers as spread of the novel coronavirus is high. And, hospitals are stretched thin.
This new hospital care at home program is an extension of the CMS Hospitals Without Walls. Hospital Without Walls permits hospitals to deliver inpatient care outside the hospital, such as in hotels and dormitories.
Health systems are increasingly relying on providing inpatient services outside hospitals. With the advent of the novel coronavirus, expansion of these services is greater than ever. Telehealth is also rising dramatically.
Most hospitals have not been allowing patients visitors, including family members. But, visitors are permissible with at-home hospital care. So, patients understandably tend to prefer it. There is also evidence to suggest that at-home hospital care is less expensive than in-hospital services.
Under the CMS guidance, hospitals can admit patients for at-home acute care if they have been in an emergency room or an inpatient bed. The hospital must provide a minimum of two daily in-person visits from a registered nurse or paramedic. In addition, only patients who are found to be living in conditions that do not make it hard to deliver at-home care are eligible. For example, if heat or electricity are not working or there is a risk of domestic violence, patients are not eligible.
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