A couple years back, UMass Memorial Health outlined new strategies and ideas for the future, with a hospital-at-home program being one of them. At the end of the exercise, that idea ranked 17th on its internal priority list.
Fast forward to the end of 2020, and the installation of a hospital-at-home program had shot up to the top of that priority list, Eric Dickson, the president and CEO of UMass Memorial Health, told Home Health Care News.
“The reason it ranked 17th was because we had no funding mechanism available. So for years, it had kind of been on that list of something we’d love to do,” Dickson said. “Then coming out of COVID, there was the Medicare waiver for hospital-at-home programs, and we said, ‘Well, now, where does this rank?’ We got to the point where we felt like we had to move forward with this program.”
On its end, the UMass Memorial is a nonprofit health care system located in central Massachusetts. Its network consists of more than 14,000 employees and 1,700 physicians.
The Centers for Medicare & Medicaid Services (CMS) launched its “Acute Hospital Care at Home” waiver amid the public health emergency (PHE). It gave health systems and hospitals the opportunity — if accepted — to provide hospital-level care in the home and be reimbursed for it.
As of June 4, there were 133 hospitals and 59 health systems in 32 states that had been accepted to participate in the waiver program.
The primary goal of the program was to fix an issue that UMass Memorial had experienced both before and during the pandemic: overcrowding in hospitals. What made the formation of a hospital-at-home program easier was that the health system had set up alternate sites to deal with overcrowding earlier on in the COVID-19 crisis.
The logistics behind forming those new sites wasn’t all that different than the logistics for setting up hospital-level care at home, Dickson said.
It also had long recognized the fact that patients fare better in the home than they do elsewhere.
“The best part of all of this is patients actually do better in their homes than they do in hospitals, as long as you can provide that care,” Dickson said. “So we’re really excited about the emergence of home care, remote care and moving things from the hospital and the clinic to the home setting generally.”
At the outset of the program, Dickson hopes UMass Memorial can serve five to 10 patients in the home. He hopes to extend that number to about 50 in the next 12 to 18 months.
As is the case with many hospital-at-home programs, the health system has a list of conditions that it feels comfortable treating in the home.
To help deliver care, UMass Memorial enlisted Current Health, which is a remote care management platform that has increasingly aided providers in their efforts to treat patients at home. The company recently raised $43 million in Series B funding.
Boston-based Current Health will help UMass Memorial detect signs of patient deterioration, identify patients in need of immediate in-person care and coordinate in-home visits with the health system’s clinicians.
“Dr. Dickson and his team share our vision for improving system operations and patient outcomes through home-based care, and we’re eager to partner on the launch of their new Hospital at Home program,” Dr. Adam Wolfberg, the CMO at Current Health, said in a press release.
Expanding the program as Dickson wants to is obviously contingent on continued support from CMS. A mechanism for reimbursement brought the hospital-at-home idea to the top of UMass Memorial’s priority list, and it’s hoping it can remain an initiative with proper support from the agency.
Currently, CMS’s Acute Hospital Care at Home waiver is in line with the PHE’s timeline, which has been officially extended through mid-July. It is likely that that declaration will extend to the end of 2021, though.
Still, providers involved with the program are hoping CMS allows a version of the program to last longer than the PHE.
“What’s happening is … all of that stuff you’re doing in the hospital, you’re starting to be able to do in the home,” Dickson said. “And we think this is part of an overall movement of care moving from hospitals to other settings.”