The health system, one of the first to launch an acute care at home platform, has received federal and state approval to treat patients from three more hospitals in their own homes.
Mass General Brigham has received federal and state approval to expand its Hospital at Home program to include patients from three more hospitals.
Health system officials have announced that Newton-Wellesley Hospital, Salem Hospital, and Brigham and Women's Faulkner Hospital will join the Home Hospital program, which was launched by both Massachusetts General Hospital and Brigham and Women's Hospital in 2016 and consolidated in 2020 when the two hospitals merged.
"We are incredibly proud of the impact that Home Hospital has had on its patients, as well as our care teams across Mass General Brigham,” Heather O’Sullivan, MS, RN, A-GNP, president of Mass General Brigham Healthcare at Home, said in a news release issued earlier this month. “This expansion is an exciting opportunity to provide greater access to the integrated, high-quality care we offer to even more patients in our surrounding communities."
Acute care at home and the CMS-approved Acute Hospital at Home programs enable hospitals to provide care for patients in their own homes instead of the hospital setting. The platform combines remote patient monitoring and telehealth technology with scheduled daily in-person visits. Health systems that follow the CMS model must adhere to strict guidelines to qualify for Medicare reimbursements.
The concept gained momentum during the pandemic as a means of helping overcrowded and workforce-thin hospitals care for COVID-19 patients at home, reducing the risk of infection. During the pandemic, CMS activated special waivers to enable more hospitals to qualify for its Hospital at Home program, and more than 220 health systems have followed that model. Those waivers are scheduled to end with the 2024 calendar year, though supporters are lobbying to make them permanent.
Many health systems – including Mass General Brigham, which has treated more than 3,000 patients at home, including nearly 1,000 this year, and is considered to have one of the oldest programs in the country – have developed their own protocols to treat a wider variety of patients at home, including those with chronic care needs.
“Being able to have that kind of vantage point, you can ensure greater health and safety of a patient as you’re tailoring their care plan to their personal environment,” Stephen Dorner, MD, MPH, MSc, chief clinical and innovation officer for Mass General Brigham Healthcare at Home, said in the release.
According to David Levine, MD, MPH, clinical director of research and development at Mass General Brigham Healthcare at Home, the program has shown benefits in a number of clinical outcomes, which Levine and his colleagues have reported on in studies. Levine says those outcomes include clinical quality measures, "enhanced patient and employee experiences, and increased capacity and access to inpatient care, [as well as] greater visibility into a patient’s socioeconomic needs and offers additional resources to support their care."
Mass General Brigham's program includes daily in-person or virtual visits from a nurse practitioner, physician assistant, or physician, as part of a larger care team that includes paramedics, nurses, therapists, and home health aides. According to the press release, "services provided include intravenous fluids and medications, laboratory testing, oxygen, radiology studies, electrocardiograms, and ultrasounds directly in the home. All of this is supported by a 24/7 continuous remote patient monitoring platform that transmits a patient’s vital sign readings to their clinicians as well as a two-way text and video communication pathway that ensures continual access to a patient’s clinical team."
The health system currently is approved to care for 33 patients at home and is expanding to serve up to 45 patients. Officials say they expect to shift 10% of inpatient care at Mass General, Brigham and Women's, Newton-Wellesley, Salem and Women's Faulkner to the home setting within the next five years.
Eric Wicklund is the associate content manager and senior editor for Innovation, Technology, and Pharma for HealthLeaders.
The acute hospital at home program combines remote patient monitoring and telehealth platforms with daily in-person visits to treat patients at home who would otherwise be hospitalized. A CMS model sets rigid guidelines in order to qualify for Medicare reimbursement.
Massachusetts General Hospital and Brigham and Women's Hospital were two of the first hospitals to launch the program in 2016, and they merged in 2020. The program will now include patients from Newton-Wellesley Hospital, Salem Hospital, and Women's Faulkner Hospital.
Officials say the program improves clinical outcomes because patients recover more quickly at home than in a hospital, and it also reduces costs, improves hospital capacity and access to inpatient care, and allows providers to better understand how a patient's home environment affects care.