The Acute Care Hospital at Home model (ACHAH) provides traditional hospital inpatient acute-level services at home. Prior to the pandemic a Centers for Medicare and Medicaid pilot study yielded positive results with respect to hospital readmission rates and follow-up emergency department visits. The ACHAH model appears to be a feasible alternative to traditional inpatient acute care that can improve quality of care and patient satisfaction. What was previously a trickle of interest turned into a wave of necessity as the pandemic overwhelmed hospitals and the health care system in 2020. In response to the pandemic, CMS began to provide hospital with broad regulatory flexibility to implement the ACHAH model.
In November of 2020 as part of their “Hospitals Without Walls” waiver, CMS introduced a set of temporary emergency rules to allow healthcare systems and hospitals to provide services and increase bed capacity by providing acute care at a patient’s home. The ACHAH waiver provided pathways for hospitals experienced in the ACHAH model and for inexperienced hospitals to adopt the model. Hospitals and health systems across the country made use of the waiver with 92 health systems and 203 hospitals across 34 states participating. Barring Congressional action, this waiver is set to expire at the end of the Public Health Emergency, which CMS recently indicated would be in July 2022.
The market trends show that some healthcare systems are joining forces with home care providers by entering into ACHAH joint ventures or purchasing home care business as an investment for future expansion of the ACHAH model. A survey in September 2021 showed that patients who received ACHAH care were highly satisfied (88%) and were likely to recommend it to friends and family (85%). The ACHAH model seems to have the proper blend of efficiency, improved patient care outcomes, and demand that could be one of the most important trends for healthcare systems and hospitals in the post-pandemic world.
As part of an ongoing discussion about the future of the ACHAH model, we will be posting a series of articles that discuss the proposed legislation making the ACHAH model permanent, the federal regulatory pitfalls of healthcare systems and hospitals entering the ACHAH space, and the state regulations that also impact how hospitals and health care systems implement the ACHAH model.
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