REPORT – The Future of Acute Hospital Care at Home: BPC recommends Congress reauthorization of AHCAH

August 7, 2024


• Categories: 01-Digital Health, CMS/HHS, Home Health, Hospital at Home, Policy, Reimbursement, Telehealth, Topic – Digital Healthcare Intelligence, Virtual Healthcare

The Bipartisan Policy Center issued a brief on Wednesday recommending Congressional reauthorization of the pandemic-era Acute Hospital Care at Home waiver for five years so more hospitals and patients can benefit.

The Brief states:

“The AHCAH model allows CMS-approved hospitals to deliver hospital-level inpatient care to eligible Medicare and Medicaid fee-for-service beneficiaries in their homes. CMS created this waiver in November 2020 to help overwhelmed brick-and-mortar hospitals during the COVID-19 pandemic. Although home-based hospital care has been available under managed care and other capitated payment structures since 1995, Medicare and Medicaid fee-for-service historically did not cover acute inpatient care in a home setting. The AHCAH model targets beneficiaries who would otherwise require acute inpatient care in a traditional hospital setting, making it distinct from Medicare’s traditional home health benefit.

Under current guidelines, providers admit qualifying, consenting patients to this voluntary model directly from the emergency department or inpatient beds. Each hospital establishes the inclusion and exclusion criteria, and CMS reviews and approves these criteria. After confirming that the patient needs an acute hospital level of care, providers offer the at-home option, and patients can decline it and receive their care in the traditional inpatient setting (see Figure 1). Although care takes place in the patient’s home, the model does not expect family caregivers to provide any supplemental care. Common primary diagnoses include mild infections and chronic diseases, such as respiratory infection and heart failure.”

Download the full brief