Home Health & Hospice Week

Instead of bludgeoning the home care industry for fraud and abuse or other perceived misdeeds, the USA Today newspaper is praising innovative programs providing "hospital at home" care. In a handful of pilot programs across the country, a team of clinicians provides acute care at home, rather than the post acute care paid for under the Medicare model.

In a study of three experimental hospital-at-home programs published in 2005 in the Annals of Internal Medicine, Bruce Leff, director of geriatric health services research at Johns Hopkins School of Medicine in Baltimore, demonstrated that patient outcomes were similar or better, satisfaction was higher, and costs were 32 percent less than for traditional hospitalizations, USA Today reports.

In most programs, doctors examine the patient daily, and nurses and aides visit up to three times a day, often for extended periods. Patients are admitted for three to five days after being seen in the emergency room, referred by a physician, or discharged early from a hospital.

"It's a very successful model, and in five years, I think, it's going to be very common. But we're still in the early adoption phase," said Mark McClelland, an assistant professor at the Center for Health Care Quality at George Washington Uni-versity.

Obstacles: Right now Medicare and other payors are reluctant to cover the care. But participants are submitting for funding, including through CMS's Innovations program, the newspaper reports.