Healthcare groups urge Congress to extend Acute Hospital Care at Home waiver

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This week, Moving Health Home, a coalition of healthcare organizations advocating for improved access to home-based care, sent a letter to congressional leadership requesting that Congress extend the Acute Hospital Care at Home (AHCAH) waiver. 

The letter collected signatures from 48 stakeholder organizations, including health systems, home health agencies, value-based care companies, non-profit entities and home infusion groups, among others.

Many seniors who need acute-level care, as well as their caregivers, have been able to receive services at home during the pandemic. According to the groups that signed the letter, temporarily extending the AHCAH program will allow for additional data collection and inform lessons learned, as well as provide the necessary time for a legislative process to establish a permanent Acute Care at Home program for Medicare patients.

The groups pointed to the popularity of the AHCAH program: As of January 20, they said, there are 90 health systems and 197 hospitals in 34 states participating in the program.

"The success of the AHCAH waiver builds on decades of evidence generated by Acute Care at Home programs in the United States," the letter reads. "Research shows that these programs are at least as safe as facility-based inpatient care and result in improved clinical outcomes, higher rates of patient satisfaction, and reduced healthcare costs."

The waiver is set to expire at the end of the public health emergency without Congressional action. While the AHCAH waiver has expanded access to home-based care, the uncertainty over when the waiver will end may create barriers to entry for new participants, the groups said; health systems and providers have concerns about making significant investments in home-based care models if the program abruptly ends.

WHAT'S THE IMPACT

Care at home has proven popular with patients. In September 2021, a survey found that 85% of adults say it should be a high priority for the federal government to expand Medicare coverage for at-home health care. 

At the same time, a large majority of people who have received care in the home were satisfied (88%) and would be likely to recommend it to family and friends (85%). And according to a recent study, a bipartisan majority of adults (73% of Democrats and 61% of Republicans) say it should be a priority for the federal government to increase access to care in the home.

The letter's signers made the case that home-based models enabled by the AHCAH waiver contribute to health equity by expanding home care to historically disenfranchised communities, helping to reduce barriers such as access to transportation.

"Home-based care also promotes trust and communication between the patient and provider by removing institutional barriers and placing the interaction in a familiar setting," according to the letter.

The healthcare organizations have suggested to Congress that an extension of the waiver should be enacted by the end of the public health emergency declaration, which the groups said would limit gaps in care for Medicare beneficiaries while providing needed assurance for current and potential participants.

The groups are requesting that Congress extend the waiver as part of the next government funding package on February 18.

THE LARGER TREND

Just this week, two Florida-based healthcare providers, Lakeland Regional Health and BayCare HomeCare, joined forces to improve post-acute home care in Polk County, touting the potential benefits of this type of care coordination – including improved patient communications, reduced readmission rates and more effective discharge planning.

Several organizations have joined forces to advance home health initiatives. In November 2021, Jefferson Health and Bayada Home Health Care announced a joint venture for post-acute care at home for Jefferson patients in New Jersey and Pennsylvania.

Preliminarily referred to as "Jefferson Health at Home," the joint venture will leverage the employees of both organizations for healthcare services delivered at home. There will be an emphasis on care transitions and access to in-home and virtual care.

A month earlier, Detroit-based Henry Ford Health System said it was gearing up to offer hospital-level care in the home setting, thanks to a new partnership with Contessa.

The partnership will offer several home healthcare options, including acute care services, skilled nursing care and palliative care.

At-home hospital care has become more popular since the Centers for Medicare and Medicaid Services issued pandemic-related flexibilities for a number of health systems.

Since then, Humana announced plans to acquire One Homecare Solutions, or onehome, in an effort to grow its presence in the value-based home healthcare space. That followed the insurer's move to purchase the remaining share of Kindred at Home.

Additionally, both Mayo Clinic and Kaiser Permanente use Medically Home Group's at-home acute care services. The two health systems invested $100 million in the company earlier this year.

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com