The Rise of Hospital at home Care

The benefits, both economically and for the patient, have worked so well that hospitals are pursuing the model beyond the pandemic. Hospital at Home, a trademarked name of Johns Hopkins Medicine, has been in practice in that health system's hospitals since at least 2002. The concept is not new, but, like telehealth, at-home hospital-level services became a necessity for all health systems when acute-care beds filled during the first surge of the COVID-19 pandemic. 

"A lot of hospitals were at capacity," said Mark Larson, principal of Sg2, a consulting and analytics firm and Vizient subsidiary. Hospital at home became a concept that found itself in the right place at the right time, he said. Hospitals saw that hospital at home worked so well, both for the patient and for the economic benefits, that the model is being pursued beyond the pandemic. There are many hospital at home services, from urgent care, to skilled nursing, to home infusion services. But acute care at home has received the lion's share of attention from health systems.

Hospital executives must first evaluate whether hospital at home for acute-level services is a good fit. Patients must be evaluated to determine if a support system exists in the home environment. At-home care may not be a good fit for patients who have social determinants of health issues or who live alone. Hospitals must already have, or be willing to invest in skilled nursing staffing, physician telehealth and other technologies to coordinate the delivering and sequencing of services, supplies such as oxygen, and nursing schedules. "Everything has to be delivered at the patients' doorstep at the right time," Larson said. "Hospitals have to become powerhouses. They need to have the tech and operational capacity."