Hospital Executives Cite Barriers to Expanding In-Home Care in Survey

Posted December 14, 2022

McKnights Home Care

By: Diane Eastabrook

Hospitals and health systems want to move more care into the home, but they see workforce challenges, technology, and patient engagement as hurdles to doing so. Those are the findings of a new survey by healthcare technology platform Current Health.

In the poll of 100 hospital and health system executives last September, 95% cited staffing challenges as a pain point and feared moving care into the home through acute care programs, such as hospital-at-home, could exacerbate current worker shortages. Nearly two-thirds of respondents said finding the right workers to deploy into the home could be difficult and roughly half had concerns about patient engagement and in-home technology support.

“Two-thirds of health system leaders we surveyed have deployed care-at-home programs, demonstrating significant progress as it relates to making the home a setting for care, but building and sustaining these care models is challenging,” Current Health CEO Christopher McCann said in a statement.

Despite those challenges, the executives cited a number of advantages to moving more care into the home. Decreases in hospital readmissions, emergency room visits and hospitalizations topped the list of benefits. Nearly two-thirds of respondents also said they believed in-home care improved patient outcomes.

The COVID-19 pandemic spurred growth in hospital-at-home programs. In 2020, the Centers for Medicare & Medicaid Services established the Acute Hospital Care at Home waiver program, allowing hospitals and health systems to treat patients in their homes in order to free up beds during the pandemic. Approximately 370 hospitals and health systems in 37 states have established hospital-at-home programs.

Despite the popularity of hospital-at-home, the waiver program is set to expire at the end of the COVID-19 public health emergency. Last month, academics at New York University urged CMS to develop a demonstration project or funding model as the waiver program transitions out of the PHE. The Hospital Inpatient Services Modernization Act introduced in the Senate last year would also extend the waiver program beyond the end of the PHE.

Larger home care firms are expanding into hospital-at-home. Baton Rouge, LA-based Amedisys acquired hospital-at-home firm Contessa last year. Other firms are also considering possible joint ventures or acquisitions.

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