The Covid-19 pandemic has amplified interest in Hospital at Home (HaH) programs in the United States as an alternative care model for acutely ill patients. HaH describes a delivery paradigm where the entirety of an inpatient acute care episode is substituted with intensive at-home treatment enabled by digital technologies, multidisciplinary teams, and ancillary services, and has been implemented in countries such as Australia and piloted by select American health systems. However, HaH programs have struggled to scale in the United States — despite national endorsements. from the Physician-Focused Payment Technical Advisory Committee — due to gaps in reimbursement and the absence of standards for equity, quality, and safety. Although approximately 150 hospitals implemented HaH programs during Covid-19, it remains to be seen whether HaH is at a true inflection point. This paper examines policy and operational matters that must be addressed for HaH to define a path forward for successful implementation.
Read the full journal article in NEJM Catalyst.