Medicare Reimbursement Reinstated for Hospital-at-Home Programs
Health systems across the United States are rapidly relaunching hospital-at-home programs following the restoration of Medicare reimbursement through the federal government’s reopening agreement. The resumption marks a critical recovery point for an innovative care model that faced unprecedented disruption during the recent government shutdown.
The Centers for Medicare & Medicaid Services (CMS) waiver enabling acute hospital care at home expired on October 1 during the government shutdown, triggering widespread program closures. President Donald Trump’s signing of the new federal spending package on November 12 provided the lifeline these programs desperately needed to resume operations and serve Medicare beneficiaries once again.
Impact of Government Shutdown on Care Delivery
The seven-week government shutdown created severe disruptions across the hospital-at-home landscape. According to the Hospital at Home Users Group, more than half of all hospital-at-home programs either temporarily or permanently ceased operations when Medicare reimbursement ended. The statistics paint a stark picture of the crisis:
- Daily admissions plummeted by 67% nationwide
- An additional 23% of programs pivoted to ambulatory care at home models
- Approximately 20% of health systems offered hospital-at-home services before the shutdown
- Thousands of patients required transfer to traditional brick-and-mortar facilities
The operational impact extended beyond patient care metrics. Health systems experienced record-high emergency department boarding numbers, extended lengths of stay, and significant strain on traditional hospital infrastructure. Staff members trained specifically for home-based acute care faced uncertainty and temporary reassignment to administrative roles during the shutdown period.
Major Health Systems Resume Hospital-at-Home Services
Cleveland Clinic Florida Leads Rapid Recovery
Cleveland Clinic Florida demonstrated remarkable responsiveness by resuming full hospital-at-home operations on November 13. Dr. Richard Rothman, Chief Medical Operations Officer of Cleveland Clinic Florida, confirmed that all five Florida region hospitals restarted services simultaneously. Within hours of reopening, the system admitted over 15 patients to receive acute hospital care in their homes, showcasing the pent-up demand for this care delivery model.
Mayo Clinic Restarts Multi-State Operations
Rochester, Minnesota-based Mayo Clinic also recommenced acute care at home services on November 13 across its Arizona, Florida, and Wisconsin locations. The health system’s preparation during the shutdown period proved invaluable for rapid resumption. Dr. Michael Maniaci, Chief Clinical Officer of Advanced Care at Home for Mayo Clinic, explained that maintaining the same Epic computer system setup for both inpatient and outpatient programs minimized technical transition challenges.
Mass General Brigham Plans Aggressive Ramp-Up
Somerville, Massachusetts-based Mass General Brigham announced plans to reopen its home hospital program on November 14 with ambitious expansion goals. The health system aims to reach capacity of 70 patients within several days, targeting 12 to 15 daily admissions. Staff had proactively begun identifying suitable candidates before the official reopening, demonstrating strategic planning during the uncertainty.
Additional Health Systems Join Recovery Effort
Newark, Delaware-based ChristianaCare, which maintained services for commercially insured patients during the shutdown, resumed accepting Medicare beneficiaries on November 13. Dr. Sarah Schenck, Executive Director of ChristianaCare’s Center for Virtual Health, emphasized the organization’s commitment to the innovative program based on improved patient outcomes, enhanced satisfaction, and reduced burden on traditional hospital infrastructure.
Marlton, New Jersey-based Virtua Health scheduled its acute hospital care at home reinstatement for November 17, after experiencing nearly doubled patient volumes in its post-discharge program during October. Worcester, Massachusetts-based UMass Memorial Health also planned a November 17 restart date.
Operational Challenges and Recovery Efforts
Health system leaders acknowledge that resuming hospital-at-home programs requires significant coordination beyond simply flipping a switch. Dr. Constantinos “Taki” Michaelidis, Medical Director of UMass Memorial Health Hospital at Home, outlined the complex recovery process involving weeks of planning, staff redeployment cycles, and extensive stakeholder communication.
The human impact of the shutdown cannot be understated. Mass General Brigham’s Dr. Stephen Dorner noted the strain on care teams who had to pivot to different roles during the closure. While excited to return to direct patient care delivery, these specialized professionals experienced disruption to their clinical routines and career trajectories.
Some programs face uncertain futures. Kansas City, Missouri-based Saint Luke’s Hospital in Your Home closed on October 1 and provided no update on potential reopening plans as of November 13, raising concerns about permanent program losses in certain markets.
Patient Benefits and Program Advantages
Hospital-at-home programs deliver measurable benefits across multiple dimensions of healthcare delivery. These innovative care models provide acute-level hospital services in patients’ residences, offering clinical outcomes comparable or superior to traditional inpatient care while enhancing patient satisfaction and experience.
The programs reduce strain on overcrowded emergency departments and inpatient units, freeing capacity for patients requiring facility-based interventions. During the shutdown period, Mass General Brigham experienced some of its highest boarding numbers in recent years, demonstrating how hospital-at-home capacity relieves pressure on traditional hospital infrastructure.
Patient outcomes consistently show favorable results, with lower readmission rates, reduced hospital-acquired infections, and improved patient satisfaction scores. The home environment provides familiar surroundings that can accelerate recovery while maintaining the intensive monitoring and treatment capabilities of hospital-level care.
Future Outlook and Legislative Concerns
Despite the welcome resumption of hospital-at-home programs, healthcare leaders express significant concerns about long-term sustainability. The new federal spending agreement expires on January 30, creating the distinct possibility of another shutdown and subsequent program disruption in just weeks.
The House Ways and Means Committee passed a five-year hospital-at-home extension in September, providing a potential path toward permanent authorization. However, the legislation requires full Congressional approval to provide the stability these programs need for sustainable growth and investment.
Dr. Michaelidis articulated the healthcare industry’s position clearly: “We do need Congress to provide an infusion of confidence in the model aligned with the scale of the very strong quality, safety and capacity wins that HAH generates, and we’re hopeful this will occur soon with a longer extension.”
The coming weeks will prove critical for determining whether hospital-at-home programs can achieve the legislative certainty necessary to fulfill their promise of transforming acute care delivery across the United States.
Discover the latest Provider news updates with a single click. Follow DistilINFO HospitalIT and stay ahead with updates. Join our community today!
Leave a Reply