The Potential of the Home Hospital Model to Transform Acute Care Delivery

During the early months of the COVID-19 pandemic and later during the surge of the Omicron variant, hospitals around the country were at risk of running out of inpatient beds. In March 2020 the Centers for Medicare and Medicaid Services (CMS) announced a Hospitals Without Walls program, giving hospitals broad regulatory flexibility to provide services in locations beyond their facilities. In November 2020 CMS further expanded these efforts by announcing an Acute Hospital Care at Home waiver program, allowing authorized hospitals unprecedented flexibilities to treat eligible patients in their homes. The waiver program was developed to support models of at-home hospital care throughout the country. Given the right protocols, more than 60 acute conditions such as asthma, congestive heart failure, and pneumonia could be treated safely at home.

The CMS waiver broadened uptake of the Home Hospital model across the nation. After identifying a need for protocols and peer learning, The Duke Endowment began exploring ways to accelerate the adoption of the Home Hospital model in North and South Carolina.

The endowment was well positioned for this effort due to funding, in 2020, the creation of CaroNova, a two-state innovation center, through a partnership with the North Carolina Healthcare Association and the South Carolina Hospital Association.