Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Care Delivery Models topic
No spam. Unsubscribe anytime.
HPC releases hospital‑at‑home brief and urges congressional reauthorization of Medicare waiver
Summary
The Health Policy Commission released a brief showing hospital‑at‑home discharges in Massachusetts rose from about 460 in 2020 to ~4,500 in 2024 and urged Congress to reauthorize the Medicare waiver that enables Medicare reimbursement for acute‑level hospital care delivered at home, which the brief said is scheduled to expire at month‑end.
The Health Policy Commission published a policy brief on Sept. 18 documenting the rapid expansion of hospital‑at‑home services in Massachusetts and flagging payment, data and equity issues tied to the model.
Executive Director David Seltz said Massachusetts has been an early adopter and that hospital‑at‑home discharges increased nearly ten‑fold from roughly 460 in 2020 to about 4,500 in 2024. He noted the programs remain a small share of total inpatient discharges (under 1%) but are concentrated among hospitals that have invested in the model.
Seltz warned the Medicare authority that enabled reimbursement for acute hospital‑at‑home services is subject to congressional reauthorization. "Currently the authorization for the Medicare approval of that program expires at the end of the month," he said, adding that the majority of hospital‑at‑home patients in the state are Medicare beneficiaries. Staff said Congress has reauthorized the waiver in past years but that the program's continuity is not guaranteed unless reauthorized again.
The brief highlights policy issues for state and federal policymakers: (1) ensuring appropriate admission criteria so hospital‑at‑home is used for clinically appropriate patients; (2) establishing standardized data collection and outcomes reporting to monitor safety and quality (including 30‑day readmission rates); and (3) addressing access and equity concerns for Medicaid populations, where use can be limited by coverage rules for services such as personal care attendants.
Staff recommended tracking federal reauthorization, standardizing data elements across providers to support evaluation, and exploring payment approaches that ensure equitable access for MassHealth beneficiaries. The report is available on the HPC website and staff urged the board to use the brief as part of the commission's November cost‑trends hearing.
