In The News

The New Frontier of Healthcare: Bringing Hospital Care Home

Health Data Management | By Fred Bazzoli

Like many “new” trends in healthcare, the hospital at home movement is not new. The foundational research goes back nearly 30 years, to work by Bruce Leff, MD, of Johns Hopkins to flesh out the concept of providing acute-level care to patients in their own homes.

It seems to harken back to the notion of doctors carrying black bags into patients’ homes to do house calls, but multiple advances in technologies and trends in healthcare have thrust hospital at home programs to the forefront.

When those pressures converge, change happens. And providing hospital services in the home is gaining new attention.

Provider Realities

From the hospital side, several factors are forcing providers to get creative. Census levels are high nationwide, often near full capacity and beyond. Staff rolls are shrinking as growing numbers of clinicians quit because of burnout or unmitigated stress. There’s not enough money to build new brick-and-mortar facilities. And then, lordy, there was the pandemic – many organizations had a crash course in virtual care, forced by restrictions on in-person encounters, full COVID caseloads and nearly instantaneous changes in reimbursement policy that enabled virtual care.

And patients – well, they weren’t big fans of being in the hospital before. The pandemic opened their eyes to the possibility of virtual care, and nascent hospital-at-home programs revealed alternatives to traditional delivery of acute care services.

As one chronic care patient told Leff in his early formulation of a hospital at home strategy, “You run a great hospital, doc, but it’s a lousy hotel.” Factor in the risks of hospital-acquired infections, falls as unsteady patients exit unaccompanied from hospital beds, loneliness and disorientation in a strange clinical environment, harried hands-on caregivers managing multiple patients and … well, it’s clear that an alternative would be welcome.

And inpatient facilities are in no position to fix these ills. Capacity is strained at many hospitals, says Colleen Hole, vice president of clinical integration and chief nurse executive for Atrium Health Medical Group. “Our hospitals are running at 110 percent to 120 percent occupancy in this market,” she says. “And Charlotte is a growing market, and we really can’t afford nor spend the time to keep building brick-and-mortar beds to manage the growth. Money and time are precious, and it doesn’t make sense to keep building beds. But we can deliver hospital-level care in the home and with the same – or in some cases, better – outcomes.”…

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Revised Home Health Interpretive Guidelines- Chart 

On March 15, 2024, the Centers for Medicare & Medicaid Services (CMS) released revisions to the Medicare State Operations Manual, Appendix B, Also referred to as the Interpretive Guidelines for the home health Conditions of Participation(CoPs).

CMS has made conforming changes to the regulatory tags and interpretive guidelines based on several final rules that have amended the home health agency (HHA) CoPs.

See Attached


Health Plans Continue To Reduce Prior Authorization Burden For Home Health Providers

Home Health Care News | By Andrew Donlan
Yet another payer organization is removing certain prior authorization requirements for home health care services. 
Point32Health – the parent company of Harvard Pilgrim Health Care and Tufts Health Plan – announced Wednesday that it is removing prior authorization requirements for the first 30 days of home health care beginning on April 12. 
The changes will affect members in Point32Health’s commercial plans. 
“We continuously evaluate all our programs to ensure our members are receiving the highest quality of care and work closely with our provider partners to decrease their administrative burden wherever possible,” Dr. Hemant Hora, senior medical director at Point32Health, told Home Health Care News in an email. “We strive to offer a broad network of high-quality providers to our members. We welcome all home care providers interested in working with us to reach out.”
A nonprofit organization, Point32Health serves over 2 million members through a variety of health plans. 
Formerly, home health services required prior authorization after initial evaluations from Harvard Pilgrim and Tufts Health Plan plans. That will no longer be the case, though prior authorization will still be required after the initial 30 days for a continuation of services. 

Prior authorization requirements have long been one of the pain points for home health providers working with health plans outside of traditional Medicare. 
“Care delayed is care denied,” Intrepid USA CEO John Kunysz told Home Health Care News recently, regarding prior authorization woes in home health care
But there has been progress of late…

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Take Action: Tell Congress to Support Terminally-Ill Veterans!

Hospice Action Network | By Stephanie Marburger

Of the over 600,000 Veterans who die each year, 4 out of 5 will pass away outside of a VA facility. But for Veterans who choose to die at home under VA provided hospice care instead of a VA facility, they will be denied financial assistance in their greatest time of need. Veteran deaths that currently occur outside of a VA facility are ineligible for burial and funeral benefits. Tell Congress to support "Gerald's Law Act" (H.R.234 / S.1330) to end this injustice.

If passed, Gerald's Law would expand access to burial and funeral benefits for Veterans who die in non-VA settings while receiving VA hospice care. Veterans who choose to spend their last days at home surrounded by their loved ones deserve these benefits, earned through service and sacrifice to our country. Their end-of-life decisions should be based on comfort, not on cost.

We are proud to join the following supporters of Gerald's Law:
Department of Veterans Affairs (VA); Disabled American Veterans (DAV); Gold Star Wives of America; Tragedy Assistance Program for Survivors (TAPS); Veterans of Foreign Wars of the United States (VFW)

Share this action with your networks with the hashtag #HospiceAction!

Call on others to Sign Up to be a hospice advocate and join our cause today!

Thank you for being an advocate for hospice care. By supporting our efforts, you are helping policymakers and communities protect the future of hospice.


NAHC/HHFMA Medicare Advantage Survey – 2024

The National Association for Home Care & Hospice (NAHC), in conjunction with the Home Care & Hospice Financial Managers Association (HHFMA), has developed a survey to assess the current state of home health within Medicare Advantage (MA) plans.

We are asking home health providers that contract with MA plans to complete this survey, estimated at about 10-15 minutes. Thank you in advance for your participation.

Take the survey at

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