‘Hospital at Home’ waiver expires Dec. 31 unless congress intervenes : Shots

Shane McMahon arrived at his home in Walpole, Massachusetts, carrying a bag of medical equipment. He is a paramedic in the home hospital program run by General Brigham. His patient was 91-year-old Stephanie Joseph.

“How is she feeling today?” McMahon asked Joseph’s daughter, Ketrine Edouard, to translate for her mother, who speaks Haitian Creole.

“She says she feels better,” Edouard replied.

Joseph has diabetes and recently went to the emergency room due to high blood sugar. After spending the night there, she was given the option of joining Mass General Brigham’s “home hospital” program.

“My daughter says she feels much better and more comfortable at home,” Edouard said on behalf of her mother. “I feel much better than when I was in the hospital.”

There is now 378 hospitals in 39 states have such home-based programs.. These programs began during the pandemic when the federal government provided waivers to Medicaid and Medicare that allowed them to pay for hospital-level care in patients’ homes. The exemption period has been extended once. However, the current exemption is scheduled to expire on December 31st.

5 year extension Contains exemptions Elon Musk and President-elect Donald Trump encouraged Republicans to pull out of the deal Wednesday in a congressional spending deal announced this week to avert a government shutdown. It is not clear what will happen next with the stopgap spending measures.

Home health programs are different from traditional home health care. A typical home care model involves several visits a week for about a month. Hospital-at-home programs provide much more intensive treatment, typically about five days, including several visits a day and 24-hour virtual monitoring of patients by doctors, nurses, and paramedics.

Brigham’s home hospital program can care for up to 70 patients, expanding the hospital’s capacity, he said. Heather O’Sullivanthe person who runs the program.

“So if you think about the 70-bed hospital that we operate today, what would that look like in a traditional brick-and-mortar environment? How many floors, how many buildings, and the workforce required? ” said O’Sullivan.

The trade union National Nurses United raised some concerns About safety when caring for patients outside the hospital. but, study A study of home health programs conducted last year by the Centers for Medicare and Medicaid Services found that patients in these programs had lower mortality rates and higher satisfaction rates than those in brick-and-mortar hospitals. Other researchshowed The cost is similar to or lower than hospital treatment.

Dr. Konstantinos Michaelidis He is the medical director of the home hospital program at Massachusetts Memorial Medical Center in Worcester. He is worried about the exemption expiring.

“Inpatient admission rates are going to be even higher,” Michaelidis said. “Emergency departments will be inundated with more patients who need care but can’t get it in brick-and-mortar locations, and we’ll be back to a capacity crisis not seen since the coronavirus era. It will be.”

The American Hospital Association Lobbying Congress For expansion.

“We are proposing a five-year extension of the exemption to ensure stability within the program to signal to those currently running the program that the program is continuing. [and] We can build and grow over the next five years,” said Rachel Jenkins of the American Hospital Association.

The Medicare and Medicaid waivers that enable home hospital programs expire on December 31, 2024, but Congress could extend them. Stephanie Joseph’s daughter Ketline Edouard helps paramedic Shane McMahon care for her mother.

Craig Lemolt/GBH

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Craig Lemolt/GBH

And that would give other hospitals the confidence to start their own programs, she said.

Rep. Jim McGovern, D-Mass., said he hopes a five-year extension of the program will be the final version of the federal spending deal.

“I’m hopeful that it will be extended,” McGovern said, noting political hurdles in Congress. “This place isn’t run the way it should be run. I hate to say that, but it’s the reality. And you probably won’t know until the last moment.”

And the final moment is rapidly approaching.