Hospitals across the country are bracing for a potential disruption in care as critical waivers allowing acute hospital care in patients’ homes are set to expire at the end of January. If Congress doesn’t act, facilities may be forced to relocate patients, a costly and potentially risky process.
A Programme on the Brink
The future of at-home acute care hangs in the balance as a key deadline approaches.
- The Acute Hospital Care at Home Program, launched during the COVID-19 pandemic, is temporarily authorized and requires congressional reauthorization.
- A government shutdown last fall caused a temporary lapse in the program, forcing hospitals to discharge patients from their homes.
- Providers are urging Congress to pursue a long-term solution rather than repeated short-term extensions.
- A bill passed by the House in December proposes a five-year extension of the waivers.
The Acute Hospital Care at Home Program was initially created by the centers for Medicare & Medicaid Services (CMS) in 2020, a time when hospitals were overwhelmed with patients during the height of the COVID-19 pandemic. The program aimed to alleviate capacity challenges by enabling hospitals to provide hospital-level care within the comfort of patients’ residences, and established a pathway for reimbursement of those services.
Currently, nearly 380 facilities in 37 states participate in the initiative, according to the CMS. But this program isn’t permanent; it relies on continued authorization from Congress. Similar to temporary expansions of telehealth coverage, the initiative has been repeatedly extended for short periods over the past year.It even experienced a complete lapse for several weeks during the government shutdown last fall.
Lawmakers’ spending plan that ended the shutdown onyl extended the hospital at home program through January 30. Should that deadline pass without congressional action, hospitals will once again have to move patients from their homes back to conventional facilities-a notable logistical undertaking and a potential safety concern for patients, experts warn.
“It takes enormous resources and coordination for health systems to be able to ensure that patient care is not sacrificed,” said Jeff Wurzburg,a partner at law firm Norton Rose Fulbright.
Resource Strain and Regulatory Risks
The looming expiration presents a host of challenges for health systems managing hospital at home programs, especially so soon after navigating a similar lapse during the recent government shutdown.
During the shutdown last fall, when the waivers expired, hospitals were compelled to “discharge” patients from their homes and readmit them to inpatient facilities, according to Cal Stein, a p
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