The Hospital at Home Programs are Here to Stay Worldwide

The concept of hospital at home – providing hospital-level care inside the patient’s home – is far from new, but the COVID-19 pandemic gave it new life…and for good reason. 

Beyond the benefits of cost savings up to 30%, lower lengths of stay, better clinical outcomes, less sedative and restraint use and higher levels of patient and family satisfaction along with less caregiver stress – it provided increased infection control during some of the most critical periods of the COVID-19 pandemic. It might be easy to assume that, as the pandemic has become more controlled, that we would see less use of hospital at home so it would have little impact on hospital billing services. But I don’t think this is going to be true. 

Revenue cycle leaders should prepare for a future where the concept evolves from a pandemic trend, and into one that will require permanent changes to hospital billing services and revenue cycle practices. This is for a few reasons. First, simply that people increasingly know it’s now possible. On top of this, aging Baby Boomers will require more care and hospital-at-home options address many challenges of a growing elderly population. But the most powerful driver comes in the form of government support. 

The $1.7 million omnibus spending bill that went into effect at the end of 2022 allows individual hospitals to seek waivers in operating hospital at home programs, as the programs will no longer be eligible for Medicare reimbursement once the public health emergency has been declared over. These waivers are only available for patients who enter the programs through a hospital’s inpatient service or ED. Hospitals are also required to identify criteria they use to make sure their services are only being provided to individuals who require inpatient level care. 

While this is a slow start, I think it’s an indicator of a much bigger shift, especially in hospital billing services. Yes, uptake has been slow largely because of clinician reluctance (reasonable, since they want to ensure they’re providing high levels of care) and spotty reimbursement, but I believe things will begin to turn soon. This means revenue cycle leaders will increasingly need to consider hospital-at-home lines of service in their decision-making. And as reimbursement shifts, I can see it becoming a core revenue driver and significant influence on hospital billing services once reimbursement and quality control practices catch up to patient needs and preferences.