Jiang Li, Ph.D., is the Founder and CEO of Vivalink, Inc.
Using advanced medical technologies for services such as medical monitoring, diagnostic testing, treatment and rehabilitation, hospital-at-home (HaH) programs are intended to bring the level of care found in hospitals directly to patients’ homes. Typically, HaH solutions cater to patients with acute conditions who can be safely managed outside a traditional hospital setting.
Home hospital services rely on advanced medical technologies to operate effectively. Remote patient monitoring (RPM), for example, allows healthcare providers to monitor patients’ vital signs, symptoms and health data in real time from a distance. Using devices like wearable sensors, patients securely transmit their health information to professionals, allowing for proactive and timely interventions.
An increasing number of healthcare facilities are expected to adopt HaH solutions over the next five years (paywall), driven by certain key factors leading to their widespread adoption. While technology plays a significant role, it’s not the only factor that enables at-home care.
The Reimbursement Landscape
Government reimbursement policies are essential for enabling and promoting the adoption of HaH solutions. These policies encourage healthcare organizations to invest in the infrastructure, personnel and technologies necessary for hospital-level care at home.
In the United States, for instance, the Centers for Medicare & Medicaid Services (CMS) introduced the Acute Hospital Care at Home (AHCAH) waiver in 2020. Under the waiver, participating facilities can receive reimbursement for acute care at home, just as they would for care provided in hospitals. The waiver has led to a significant expansion of at-home care programs. As of March 2023, 277 hospitals in 37 states have been approved to provide care under the waiver. The AHCAH initiative is set to end on December 31, 2024, and its future beyond that date is subject to congressional action.
The sustainability and growth of HaH programs are fueled by reimbursement support. Without the right incentives, healthcare organizations may be unable to maintain the infrastructure and resources needed for quality home care.
The Switch To Value-Based Healthcare
Under the value-based care model, providers are incentivized to focus on the quality of care, provider performance and patient experience. Unlike the fee-for-service model, where providers are paid based on the volume of services rendered, value-based care rewards quality of care rather than the quantity of services.
In the U.S., where the healthcare system has traditionally operated under a fee-for-service model, interest is growing in evaluating value-based care models. Both public and private groups have experimented with various approaches to assess the effectiveness of the model in enhancing care quality, controlling costs and improving patient outcomes.
For example, CMS tested whether an “episode-based” payment system, which pays providers for all the services needed for a specific medical issue, could reduce costs without compromising quality. The shift to value-based care closely aligns with the goals of HaH initiatives, as both prioritize delivering high-quality care that enhances patient outcomes.
Value-based care models contribute to the increased adoption of HaH solutions by incentivizing healthcare providers to prioritize patient-centered care. Through RPM, for instance, value-based care enables healthcare providers to continuously monitor patients’ health, identify issues early and intervene promptly to avoid unnecessary hospital visits.
The Importance Of Government Support
Government support is also a key element of the growing use of HaH solutions. While the pandemic expedited their efforts, governments have long aimed to advance home-based care, with various initiatives at the federal, state and local levels focused on promoting the adoption and expansion of such services.
One example of a government initiative promoting at-home care is the Independence at Home (IAH) Demonstration program. Established by the Affordable Care Act, the program aimed to enhance care for chronically ill Medicare patients by offering primary care services at home. While only one site was participating as of January 2023, the IAH program demonstrated success in reducing hospital admissions and emergency room visits and improving patient satisfaction and health outcomes.
In countries with universal healthcare systems, government support for at-home care programs is especially vital. These governments understand the importance of offering post-acute care services in patient’s homes to efficiently serve a larger population at a lower cost. For instance, in the U.K., HaH models referred to as virtual wards, have gained significant traction. By employing these models, healthcare systems can reach more people, ensuring they receive care in a comfortable setting and easing the strain on traditional healthcare facilities.
Hospital-At-Home Adoption Challenges
To ensure successful care delivery, implementing HaH programs involves addressing various technological and infrastructure considerations.
Healthcare organizations must establish an effective virtual care infrastructure to support remote monitoring, virtual consultations and telemedicine visits is essential. One of the most fundamental and challenging components of such an infrastructure is a robust, real-time, continuous RPM solution. Signal quality, network delays and user errors can often disrupt the effectiveness of the monitoring, whether in real time or near real time. Organizations should have reliable telecommunication systems, secure data transmission protocols and user-friendly interfaces for smooth data connections between patients and providers.
Patient safety and quality of care are top priorities in at-home care solutions, as patients receiving acute-level care at home face potential risks. Healthcare organizations must ensure they can thoroughly assess patients, regularly monitor vital signs and symptoms and act quickly if their condition worsens. Providers must provide adequate training and supervision for staff and family members delivering care in patients’ homes and ensure clear communication channels for reporting safety concerns.
Conclusion
HaH solutions mark a significant change in healthcare delivery. With government backing, reimbursements and technological advancements, these programs can offer improved access to care and improved patient experiences. Embracing innovation, collaboration and a patient-centered approach, healthcare organizations can fully leverage the benefits of at-home care solutions.
Forbes Technology Council is an invitation-only community for world-class CIOs, CTOs and technology executives. Do I qualify?
