Evaluating the Acute Hospital Care at Home (AHCAH) Initiative

Evaluating the Acute Hospital Care at Home (AHCAH) Initiative

The Centers for Medicare & Medicaid Services (CMS) has released a report on the Acute Hospital Care at Home (AHCAH) initiative, a program allowing select Medicare-certified hospitals to provide inpatient-level care within patients’ homes.

Originally launched to address hospital capacity challenges during the COVID-19 pandemic, the initiative has continued under the Consolidated Appropriations Act of 2023 (CAA), which extended the program’s flexibilities until Dec. 31, 2024. The recent report fulfills a mandate from the CAA to evaluate AHCAH and analyze its impact across multiple areas, including patient demographics, quality of care, and cost-effectiveness.

The study found that participating hospitals used a range of criteria to identify eligible AHCAH patients. These criteria, based on established hospital-at-home literature, ensure that selected patients are clinically appropriate for home care, and that their home environments are safe and conducive to receiving such care.

The report also highlighted demographic differences between AHCAH patients and traditional inpatients, showing that AHCAH patients were more likely to be white, live in urban areas, and have higher incomes, with fewer receiving Medicaid or low-income subsidies.

The report found that AHCAH primarily treated patients with a relatively small set of conditions, including respiratory and circulatory conditions, renal conditions, and infectious diseases. By grouping these conditions under MS-DRGs, CMS was able to compare treatment outcomes in AHCAH versus traditional inpatient settings. The findings provided insight into the types of cases that were most suitable for home-based acute care, suggesting that AHCAH may be particularly effective for certain known manageable conditions.

The CMS report also examined the quality of care provided under the AHCAH initiative. It assessed metrics like 30-day mortality rates, 30-day readmission rates, and the occurrence of hospital-acquired conditions (HACs). The findings indicate that AHCAH patients generally had lower mortality rates than their hospital-based counterparts.

Readmission rates, however, varied by condition, with AHCAH patients showing significantly higher rates for some conditions and lower rates for others; however, these specific conditions were not mentioned in the publicly released fact sheet. HAC rates were lower for AHCAH patients, although differences were not statistically significant.

When evaluating cost and utilization, the report focused on factors like length of stay, Medicare spending after discharge, and hospital service use, including telehealth services. AHCAH patients typically had longer lengths of stay, but incurred lower Medicare spending, in the 30 days following discharge. While these findings suggest cost benefits, the complex nature of AHCAH’s patient selection and clinical conditions makes it difficult to draw definitive conclusions about overall savings compared to inpatient hospital settings, according to CMS.

CMS hosted virtual listening sessions to gather feedback from patients and caregivers involved in AHCAH. The responses were generally positive, with patients appreciating the convenience and personal nature of home-based care. Clinicians, too, reported favorable experiences, which aligned with broader hospital-at-home research indicating high satisfaction rates among patients receiving care at home.

The report concluded with a need for further research and development, including refining cost, quality, and utilization metrics.

With the AHCAH initiative set to expire at the end of 2024, its continuation depends on future congressional action.

Programming note:

Listen to senior healthcare executive Tiffany Ferguson report this story live today during Talk Ten Tuesday with Chuck Buck and Dr. Erica Remer at 10 Eastern.

Facebook
Twitter
LinkedIn

Tiffany Ferguson, LMSW, CMAC, ACM

Tiffany Ferguson is CEO of Phoenix Medical Management, Inc., the care management company. Tiffany serves on the ACPA Observation Subcommittee. Tiffany is a contributor to RACmonitor, Case Management Monthly, and commentator for Finally Friday. After practicing as a hospital social worker, she went on to serve as Director of Case Management and quickly assumed responsibilities in system level leadership roles for Health and Care Management and c-level responsibility for a large employed medical group. Tiffany received her MSW at UCLA. She is a licensed social worker, ACM, and CMAC certified.

Related Stories

I am Just a Bill

I am Just a Bill

Today is election day.  I wanted to talk about the process by which laws are passed and regulations created in healthcare. Recently, the fall of

Read More
Washington Carries On

Washington Carries On

As the November elections neared, you might have expected Washington to slow to a crawl amidst campaigning and uncertainty about the future. However, the show

Read More

Leave a Reply

Please log in to your account to comment on this article.

Featured Webcasts

Comprehensive Inpatient Clinical Documentation Integrity: From Foundations to Advanced Strategies

Comprehensive Outpatient Clinical Documentation Integrity: From Foundations to Advanced Strategies

Optimize your outpatient clinical documentation and gain comprehensive knowledge from foundational practices to advanced technologies, ensuring improved patient care and organizational and financial success. This webcast bundle provides a holistic approach to outpatient CDI, empowering you to implement best practices from the ground up and leverage advanced strategies for superior results. You will gain actionable insights to improve documentation quality, patient care, compliance, and financial outcomes.

September 5, 2024
Advanced Outpatient Clinical Documentation Integrity: Mastering Complex Narratives and Compliance

Advanced Outpatient Clinical Documentation Integrity: Mastering Complex Narratives and Compliance

Enhancing outpatient clinical documentation is crucial for maintaining accuracy, compliance, and proper reimbursement in today’s complex healthcare environment. This webcast, presented by industry expert Angela Comfort, DBA, RHIA, CDIP, CCS, CCS-P, will provide you with actionable strategies to tackle complex challenges in outpatient documentation. You’ll learn how to craft detailed clinical narratives, utilize advanced EHR features, and implement accurate risk adjustment and HCC coding. The session also covers essential regulatory updates to keep your documentation practices compliant. Join us to gain the tools you need to improve documentation quality, support better patient care, and ensure financial integrity.

September 12, 2024

Foundations of Outpatient Clinical Documentation Integrity: Best Practices for Accurate Coding and Compliance

This webcast, presented by Angela Comfort, DBA, RHIA, CDIP, CCS, CCS-P, a recognized expert with over 30 years of experience, offers essential strategies to improve outpatient clinical documentation integrity. You will learn how to enhance the accuracy and completeness of patient records by adopting best practices in coding and incorporating Social Determinants of Health (SDOH). The session also highlights the role of technology, such as EHRs and CDI software, in improving documentation quality. By attending, you will gain practical insights into ensuring precise and compliant documentation, supporting patient care, and optimizing reimbursement. This webcast is crucial for those looking to address documentation gaps and elevate their coding practices.

September 5, 2024
Preventing Sepsis Denials: From Recognition to Clinical Validation

Preventing Sepsis Denials: From Recognition to Clinical Validation

ICD10monitor has teamed up with renowned CDI expert Dr. Erica Remer to bring you an exclusive webcast on how to recognize sepsis, how to get providers to give documentation that will support sepsis, and how to educate to avert sepsis denials. Register now and become a crucial piece of the solution to standardizing sepsis clinical practice, documentation, and coding at your facility.

August 22, 2024

Trending News

Featured Webcasts

Post Operative Pain Blocks: Guidelines, Documentation, and Billing to Protect Your Facility

Post Operative Pain Blocks: Guidelines, Documentation, and Billing to Protect Your Facility

Protect your facility from unwanted audits! Join Becky Jacobsen, BSN, RN, MBS, CCS-P, CPC, CPEDC, CBCS, CEMC, and take a deep dive into both the CMS and AMA guidelines for reporting post operative pain blocks. You’ll learn how to determine if the nerve block is separately codable with real life examples for better understanding. Becky will also cover how to evaluate whether documentation supports medical necessity, offer recommendations for stronger documentation practices, and provide guidance on educating providers about documentation requirements. She’ll include a discussion of appropriate modifier and diagnosis coding assignment so that you can be confident that your billing of post operative pain blocks is fully supported and compliant.

October 24, 2024
The OIG Update: Targets and Tools to Stay in Compliance

The OIG Update: Targets and Tools to Stay in Compliance

During this RACmonitor webcast Dr. Ronald Hirsch spotlights the areas of the OIG’s Work Plan and the findings of their most recent audits that impact utilization review, case management, and audit staff. He also provides his common-sense interpretation of the prevailing regulations related to those target issues. You’ll walk away better equipped with strategies to put in place immediately to reduce your risk of paybacks, increased scrutiny, and criminal penalties.

September 19, 2024
Pediatric SDoH: An Essential Guide to Accurate Coding and Reporting

Pediatric SDoH: An Essential Guide to Accurate Coding and Reporting

This webcast, presented by Tiffany Ferguson, LMSW, CMAC, ACM, addresses the critical gap in Social Determinants of Health (SDoH) reporting for pediatric populations. While SDoH efforts often focus on adults, this session emphasizes the unique needs of children. Attendees will gain insights into the current state of SDoH, new pediatric Z-codes, and the importance of interdisciplinary collaboration. By understanding and applying pediatric-specific SDoH factors, healthcare professionals can improve data capture, compliance, and care outcomes. This webcast is essential for those looking to enhance their approach to pediatric SDoH reporting and coding.

August 8, 2024
Oncology and E/M Services: Compliance, Medical Necessity, and Reimbursement

Oncology and E/M Services: Compliance, Medical Necessity, and Reimbursement

Join Becky Jacobsen, BSN, RN, MBS, CCS-P, CPC, CPEDC, CBCS, CEMC, VP of CDM, for a webcast addressing oncology service coding challenges. Learn to navigate coding for infusions and injections alongside Evaluation and Management (E/M) services, ensuring compliance and accurate reimbursement. Gain insights into documenting E/M services for oncology patients and determining medical necessity. This webcast is essential to optimize coding practices, maintain compliance, and maximize revenue in oncology care.

July 30, 2024

Trending News

Prepare for the 2025 CMS IPPS Final Rule with ICD10monitor’s IPPSPalooza! Click HERE to learn more

Get 15% OFF on all educational webcasts at ICD10monitor with code JULYFOURTH24 until July 4, 2024—start learning today!

👻Spooky Sale is Back!👻 Get 31% off all three Medlearn brands, using code SPOOKY24.