The rise of technology has provided many benefits to society. Before 2020, the United States healthcare system was not taking full advantage of many technology tools, such as telehealth and at-home acute care services. Since the COVID-19 pandemic, healthcare companies, including insurances and hospitals, have made imperative technology changes and additions to their coverage.

cms expanding to cover at-home acute care patients

In March 2020, the Center for Medicare and Medicaid Services (CMS) launched CMS Hospital Without Walls. This program allowed hospitals flexibility to provide services outside of their walls. Since then, CMS has expanded its efforts more with the launch of the Acute Hospital Care at Home program and it details out how a hospital may participate in this program and what benefits the patient will receive.

So What will Acute Care at Home Provide to a Patient?

With this program, CMS states over 60 different acute conditions will be treatable, including asthma, congestive heart failure (CHF), pneumonia, and chronic obstructive pulmonary disease (COPD). Patients should expect to receive:

  • Admittance from the hospital (either from the emergency room or an inpatient hospital bed).
  • In-person physician evaluation before starting the program.
  • A registered nurse (RN) evaluation at least once daily either in-person or remotely.
  • Two in-person visits daily by either an RN or a mobile integrated health paramedic (based on the patient’s nursing plan and hospital policies).

What are the Benefits of Acute Care at Home?

Receiving a hospital-level of care at home services may seem impossible, but this is not the case in 2021. There have been successful programs throughout the country that report positive outcomes for patients. With over 90 hospitals in 24 states using Acute care at home, many benefits are being discovered including:

  • Gives eligible patients an option to receive care in the comfort of their home.
  • More availability at hospitals to allow for greater inpatient care when needed.
  • Increased virtual healthcare management decreases the risk for exposure to COVID-19 along with other viruses and bacteria.
  • Maximizes resources with the healthcare staffing.

How can a Hospital Apply to Participate?

CMS is requiring a waiver be completed by hospitals interested in participating in Acute Care at Home. Waiver requests are divided into two categories based on the hospital’s experience.

For hospitals with prior experience of at-home acute care to at least 25 patients, an expedited process will be allowed. This will allow the hospital to rapidly expand care to Medicare beneficiaries. Requirements with this waiver process include:

  • Hospital attestation to specific existing beneficiary protections.
  • Submitting monthly reports on different monitoring data.

For hospitals without prior experience or who have treated less than 25 patients, a more detailed waiver process must be completed. The waiver requirements during this process include:

  • Determining if internal processes are in place to provide successful at-home acute care.
  • Submitting weekly reports on the monitoring data.

What are the Requirements for a Hospital to Participate?

Several requirements must be met for a hospital to partake in Acute Care at Home. These include:

  • Screening protocols were completed assessing both the medical and social factors.
  • Daily evaluation by a physician (or an advanced practice provider) and RN either remotely or in-person.
  • Two in-person visits regularly by RN and/or by a mobile integrated health paramedic.
  • Ensuring patient has an on-demand, instantaneous remote audio connectivity that allows for a connection to physician or RN.
  • Must be able to respond within 30 minutes to a decompensating patient.
  • Tracking multiple safety metrics of patients with the weekly or monthly reporting system.
  • Reviewing patient safety data by a safety committee.
  • Utilizing an accepted patient-level screening process that ensures only patients requiring acute level care services are being treated.
  • During inpatient hospitalization, offering or contracting for other services.

Providers Serving Patients via Acute Care at Home

providers serving patients via acute care at-home

Before the COVID-19 pandemic, many physicians did not believe virtual and at-home care could match the safety and effectiveness of inpatient care. While at-home care is still new, the positive feedback and results are having some physicians think differently.

Home care business president at Humana Inc., Susan Diamond stated that “Physicians are embracing the delivery of hospital-level care and skilled nursing care services at home. Previously, physicians were more inclined towards referring a patient to a facility setting. Now, with the increased risks, physicians are introducing home-based models to more patients, which is delivering safe, effective care supporting home visits, remote monitoring technology, and virtual healthcare, which is often providing better health outcomes for patients.”

How can Mobisoft platforms assist?

For organizations using or interested in Acute Care at Home, Mobisoft offers two platforms to assist with communications and operations. These are:

Rainbow Care HouseCall Solutions

It is an all-in-one platform combining telemedicine, house-calls, and an in-clinic visit using a single sign-on. Administration may track house-call providers via GPS, which will display where the provider is located in real-time. Using this platform will help an organization:

  • Reduce the cost of having multiple platforms.
  • Scale operations via appointment booking and sending notifications of appointments.
  • Meet the Electronic Visit Verification (EVV) requirements.
  • Deliver safe and effective care leveraging home visits, virtual care, and remote monitoring technology.
  • Better provider-to-provider collaboration.
  • Patient engagement and better quality of care.
Non-Emergency Medical Transportation (NEMT)

It provides transportation services with a technology-first approach to patient transportation. The benefits to having this platform include:

  • Fast and reliable transportation.
  • Increased efficiency using the NEMT services platform.
  • Reduced costs with a better return on investment (ROI).
  • Address SDOH by providing transportations services to high-risk and vulnerable patients.

The essence of value-based care has expanded to Direct Contracting Entities, those who are providing efficient care services for Medicare beneficiaries

Bottom Line,

During the COVID-19 pandemic, it was clear the United States healthcare system was lacking in regards to technology. A few more technologically advanced hospitals with digital healthcare solutions had seen successful outcomes with both acute care and skilled nursing care at homes. Throughout 2020, CMS has worked to encourage at-home acute care and initiated a new reimbursable program called Acute Care at Home. The benefits to patients and hospitals are evident, and with time, more medical providers will likely support this new style of care.

Digitally integrated acute at-home care services ensures enhanced healthcare outcomes for patients Connect with us for more information

Author's Bio

Ayushi Patel Mobisoft Infotech

Ayushi Patel

Ayushi Patel is the Director of Strategy & Innovation at Mobisoft Infotech. She leads the strategic partnerships and initiatives in the healthcare division. Her experience includes healthcare administration, business development and sales, and customer success management.