During the pandemic, many aspects of our everyday lives transitioned into the home. Office work became remote, and meetings, both personal and business-related, found their way from cafes and corner offices to computer and smartphone screens.

This change was also evident in healthcare. As we have previously noted, telehealth saw a massive increase during the pandemic. Additionally, some hospitals began rolling out Hospital At Home programs, which allowed acute patients to undergo the majority of their recovery process at home while assisted by professionals.

The normal rules surrounding this at-home style of care required around-the-clock, on-site nurses for patients. However, CMS loosened these rules near the beginning of the pandemic, allowing Hospital At Home programs to be rolled out nationwide to 305 hospitals across 129 health systems in 37 states. Now, the data is in regarding this care — and to date, it’s been quite successful.

Last month, a study was published in the JAMA Health Forum that sought to assess patient outcomes during the initial 16 months of the Acute Hospital Care at Home initiative. As writer Anuja Vaidya explains, the study found that “patients receiving at-home hospital care under the Acute Hospital Care at Home waiver experienced a low mortality rate and minimal complications resulting in admission to brick-and-mortar hospitals.”

The study specifically states that, of the 11,159 patients admitted under the waiver since November 25, 2021, “the overall proportion of patients transferred from home back to the hospital was 7.20%.” Additionally, only 38 unexpected deaths occurred during this trial, accounting for about 0.34% of the participating population, and of those, 35 of them had been transferred back to a hospital prior to their passing. These deaths were largely attributable to complications resulting from COVID-19.

So why was this project so successful? To figure that out, we must first explain what Hospital At Home care involves.

To start, this is not simply bringing a patient home from a hospital early. Before a patient can be transferred back to their homes to recover as a part of this process, the environment must first be assessed to determine that it is a viable area in which recovery can occur. Then, once the patient has been transferred back home, professionals must frequently check in with them to ensure their recovery is going as planned.

“A minimum of two sets of in-person vital signs are required daily and remote monitoring should be consistent with existing hospital policies and standards of care,” reads the CMS website. “Remote monitoring can be continuous or intermittent, and the intensity should be appropriate to each patient’s management needs.” Furthermore, “Documentation should be consistent with existing hospital policies for inpatient admissions.”

A piece in NPR from April illustrates what this kind of monitoring can look like in real life: “Most hospital-at home programs provide in-person medical visits twice or three times a day – nurses or paramedics take patients’ vitals, replenish medications and supplies, and consult with a doctor via video conference, if necessary.”

When a patient is hospitalized at home, the specifics of their care varies, understandably, by the circumstances of the patient themselves. For example, in some cases, a patient may be more than capable of administering their own medication and are thus allowed to do so. In other cases, a medical professional may be required to administer such medications.

Naturally, there are risks to at-home care. A patient’s health can change dramatically in a matter of minutes, and without the quick and easy access to elevated care that a hospital provides, this patient could be at a greater risk of fatal outcomes.

That said, there are several efforts in place to prevent these issues. First, not all patients are selected for Hospital At Home care, and those at a greater risk of sudden changes in health status will likely continue to be treated in a hospital environment.

Second, individual hospitals have made efforts to mitigate any potential problems. As a Mayo Clinic worker told NPR, in summary, “there are safeguards in place to protect patients. Local paramedics and transportation are on call, in case a patient must be readmitted, for example. And at-home patients have 24-hour access to doctors on call with the touch of a button.”

Much like telehealth initiatives, these positive findings alone aren’t enough to keep Hospital At Home programs active. At the time of writing, these programs will only be allowed until the end of 2024. However, given the positive results shown in the JAMA Health Forum study, there is a chance that Hospital At Home care may be included as a standard option for treatment under CMS.

We will not know if this will be the case until next year — but given the strong results of the initial study, and the potential cost savings for those who are involved, there is a significant chance that something like Hospital At Home care could be incorporated into current treatment options.