Acute Hospital Care at Home in Medicare—Will a Pandemic Policy Be Sustained?

Adashi, Eli Y.; Cohen, I. Glenn

doi:10.1001/jamahealthforum.2022.2564

Cited by 8 publications

(8 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The Centers for Medicare and Medicaid Services AHCaH waiver that catalyzed the creation of many HaH programs is set to expire in late 2024 58 , and while we have highlighted the many promises of HaH programs, here we present the consistently cited challenges that need to be addressed before HaH programs can cement their role in care delivery.…”

Section: Challengesmentioning

confidence: 92%

The hospital at home in the USA: current status and future prospects

Pandit,

Pawelek,

Leff

et al. 2024

npj Digit. Med.

View full text Add to dashboard Cite

The annual cost of hospital care services in the US has risen to over $1 trillion despite relatively worse health outcomes compared to similar nations. These trends accentuate a growing need for innovative care delivery models that reduce costs and improve outcomes. HaH—a program that provides patients acute-level hospital care at home—has made significant progress over the past two decades. Technological advancements in remote patient monitoring, wearable sensors, health information technology infrastructure, and multimodal health data processing have contributed to its rise across hospitals. More recently, the COVID-19 pandemic brought HaH into the mainstream, especially in the US, with reimbursement waivers that made the model financially acceptable for hospitals and payors. However, HaH continues to face serious challenges to gain widespread adoption. In this review, we evaluate the peer-reviewed evidence and discuss the promises, challenges, and what it would take to tap into the future potential of HaH.

show abstract

Section: Challengesmentioning

confidence: 92%

The hospital at home in the USA: current status and future prospects

Pandit,

Pawelek,

Leff

et al. 2024

npj Digit. Med.

View full text Add to dashboard Cite

show abstract

“…When COVID-19 overwhelmed hospitals in 2020 and triggered the declaration of a public health emergency, officials from the Centers for Medicare & Medicaid Services (CMS) recognized the potential value of the HaH model and created a waiver allowing Medicare-certified hospitals to treat patients with inpatient-level care in their homes . Guided by the Johns Hopkins model, CMS criteria define which conditions are eligible (eg, congestive heart failure); whether the home environment is safe for home management (eg, air conditioning for someone with respiratory conditions); and how, when, and by whom care processes such as telemetry monitoring should be delivered, such as daily visits by nurses and physicians.…”

Section: Emergence Of Hospitalization At Home During Covid-19mentioning

confidence: 99%

Considering Caregivers’ Needs in Hospital at Home Programs

2022

View full text Add to dashboard Cite

show abstract

“…[16][17][18] In fact, in response to concerns that some states may misinterpret abortion bans to include ECs as abortifacients, the Food and Drug Administration updated product labeling for levonorgestrel to clarify it does not affect fertilization or implantation or terminate pregnancy. 19 Prior work has investigated the impact of federal and state restrictive abortion policies on access to contraception. [20][21][22][23][24] For example, the 2019 Title X Final Rule, which prohibited participating family planning clinics from offering abortion services, reduced the availability of Title X clinics, the provision of contraception services, and the use of contraceptives.…”

Section: Introductionmentioning

confidence: 99%

Use of Oral and Emergency Contraceptives After the US Supreme Court’s Dobbs Decision

Qato,

Myerson,

Shooshtari

et al. 2024

JAMA Netw Open

View full text Add to dashboard Cite

ImportanceThe US Supreme Court Dobbs v Jackson Women’s Health Organization decision allowed states to strengthen restrictions on abortion access, triggering the closure of family planning clinics and leading to confusion about the legality of emergency contraceptives (ECs).ObjectivesTo evaluate the association between the Dobbs decision and fills for oral and emergency contraceptives in states that enacted the most restrictive abortion policies after Dobbs.Design, Setting, and ParticipantsThis cohort study used data on contraceptive fills for women of reproductive age (15-49 years) in the US from IQVIA’s National Prescription Audit PayerTrak and data from the Guttmacher Institute were used to categorize changes in abortion restrictions in each state. A difference-in-differences analysis compared changes in monthly fill rates for daily oral contraceptive pills (OCPs) and ECs in states that became most restrictive (implemented a full abortion ban after Dobbs) and comparison states (kept a medium level of abortion restrictions after Dobbs) before (March 2021 to November 2021) and after (July 2022 to October 2023) the Dobbs decision.ExposureState-level abortion restrictions.Main Outcomes and MeasuresMonthly fills of OCPs and ECs per 100 000 women of reproductive age.ResultsBetween March 2021 and October 2023, 142.8 million prescriptions for OCPs and 904 269 prescriptions for ECs were dispensed at US retail pharmacies. Before Dobbs, trends in monthly fill rates were similar for OCPs and ECs between the most restrictive and comparison states. After the Dobbs decision, states that became the most restrictive experienced an additional 4.1% decline in OCP fills with 285.9 fewer fills per 100 000 (95% CI, −495.8 to −6.8; P = .04). In contrast to OCPs, fills for ECs increased during the first year after Dobbs (July 2022 to June 2023) in both groups of states. However, 1 year after Dobbs (July 2023 to October 2023), the most restrictive states experienced an additional 65% decrease in emergency contraceptive fills with 13.2 fewer fills per 100 000 (95% CI, −27.2 to −4.1; P = .01).Conclusions and RelevanceIn this cohort study of prescriptions filled at US pharmacies, the Dobbs decision was associated with declines in oral contraceptives, particularly ECs, in states enacting the most restrictive abortion policies. Given the important role of OCPs and ECs in preventing pregnancy and the need for abortion, efforts to improve access may be needed, especially in states where legal abortion is no longer an option.

show abstract

Acute Hospital Care at Home in Medicare—Will a Pandemic Policy Be Sustained?

Abstract: This Viewpoint discusses the genesis of the Acute Hospital Care at Home waiver program and the legislative odds of the program continuing.

Cited by 8 publications

References 5 publications

The hospital at home in the USA: current status and future prospects

The hospital at home in the USA: current status and future prospects

Considering Caregivers’ Needs in Hospital at Home Programs

Use of Oral and Emergency Contraceptives After the US Supreme Court’s Dobbs Decision

Contact Info

Product

Resources

About