MyMichigan Health joining 80-plus health systems in expanding hospital at home program

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MyMichigan Health is now among 84 health systems in the U.S., and one of four in Michigan, offering a hospital at home program approved by the Centers for Medicare and Medicaid Services. The program allows for inpatient-level acute care in a patient's home.

MyMichigan began a pilot program in February 2021 to care for COVID-19 patients in two communities, Alma and Midland.

To date, 39 COVID-19 patients have completed the Hospital at Home (HaH) COVID Completion program, with officials reporting no adverse events. In May 2021, the pilot expanded to include COPD, pneumonia and sepsis patients, with 27 additional patients receiving care. The program is now expanding and placing extra emphasis on achieving an inpatient standard of care in the home.

WHAT'S THE IMPACT

Based on a program developed by University of Michigan Health, with which MyMichigan Health is affiliated, the program aims to manage select acute diagnoses safely inside a home setting, offering approaches beyond even the increased adoption of remote monitoring technologies.

The program touts evidence of higher-quality outcomes with HaH, and at a lower cost to patients compared to those with similar conditions admitted to acute care facilities. It also emphasized the removal of travel costs and transportation barriers.

For hospitals, the program is intended to reduce lengths of stay, lower rates of readmissions and admission costs, and ease the need for hospital beds when they're busy.

Hospital at home care includes remote patient monitoring, collaboration with a patient's primary care provider and virtual visits. Emergency departments, virtual and home care teams and hospitalists will work in concert to determine which patients would benefit from the HaH program and coordinate their care plan.

THE LARGER TREND

Hospital At Home is a name trademarked by Johns Hopkins Medicine in 2010.

CMS has an Acute Hospital Care at Home program that was created during the COVID-19 pandemic to help hospitals struggling with bed capacity. In November 2020, CMS released a waiver called the Acute Hospital Care at Home Waiver allowing for hospitals to bill for acute care services that patients receive at home.

Research has shown the programs are at least as safe as inpatient care and result in improved clinical outcomes, higher rates of patient satisfaction and reduced healthcare costs, according to Hackensack Meridian Health, which launched its own Hospital at Home program earlier this month.

Many hospitals have been adopting their own models. The hospital-at-home program has been in practice in some form since at least 2002. The concept is not new, but like telehealth, at-home hospital-level services became a necessity for all health systems when acute-care beds filled during the first surge of the COVID-19 pandemic.

During the COVID-19 public health emergency, CMS is reimbursing for hospital-at-home acute-level care and has a list of appropriate drug-related groups, or DRGs. In general, these are diagnoses that are medical in nature, with lower acuity, and not post-surgical care.

Yet post-surgical care is being provided at home. For instance, Medically Home is working with the Mayo Clinic for kidney and bone marrow transplant patients to recover at home.

Like telehealth, CMS is reimbursing for this care during the public health emergency; once the PHE ends, CMS will evaluate these services for the future.
 

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