SHM Signs Multi-stakeholder Letter Urging Congress to Extend the Acute Hospital Care at Home (AHCAH) Program Waiver

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Dear Senate Majority Leader Thune, Minority Leader Schumer, and Speaker Johnson, and House Minority Leader Jeffries:

We are writing to thank you for temporarily extending the Acute Hospital Care at Home (AHCAH) waiver program until March, and strongly urge the inclusion of the full 5-year waiver in the March government funding package. The bill, renamed the Thomas Carper, Tim Scott, Brad Wenstrup, Earl Blumenauer Acute Hospital Care at Home bill, passed out of the Ways and Means Committee, Energy and Commerce Committee, and supported by the Senate Finance Committee, would allow the program to truly take root and further demonstrate advancements in patient care.

The AHCAH program has the rare combination of lower spending, shorter lengths of stay, high patient and caregiver satisfaction, and high quality. It deploys innovative technology and a workforce eager to treat patients where they live.

Americans want home to be the center of their health. Federal flexibilities such as the AHCAH waiver allowed hospitals to do just that. Another extension of the waiver effectively builds the bridge from demonstration to a more permanent model by giving more certainty to those hospitals currently on the sidelines waiting for regulatory clarity. The evidence is mounting, and another extension will continue the progress and expand participation.

• The Centers for Medicare and Medicaid Services report to Congress on the program found that patients in AHCAH had lower mortality rates, lower readmissions on many of the DRGs, lower spending post-discharge, and positive patient and provider experiences with the program.
• A study published in the Annals of Internal Medicine found that the mean cost was lower for hospital-at-home care ($5,081) than for acute hospital care ($7,480). The study reviewed whether treatment in a hospital-at-home model substituted for treatment in an acute care hospital. Not only was treatment efficacious, 69 percent of patients preferred hospital-at-home care. Patients treated in the hospital-at-home program also had a shorter length of stay.
• A Health Affairs study found achieved savings of 19 percent over costs for patients receiving care from hospital at home programs. These savings were from a lower average length-of-stay and use of potentially fewer unnecessary services.
• A study published in the Journal of the American Geriatrics Society found that a hospital-at-home program was almost $6,000 lower in costs than for inpatient patients.

Hospital at home is strongly supported by the evidence, the patients, caregivers and providers involved in the program. A long-term extension in March would solidify the evidence base, and allow more seniors to experience care at home. Please reach out to any of the signatories below with any questions.

Sincerely,