/ en Fri, 25 Apr 2025 22:49:44 -0500 Mon, 24 Mar 25 09:19:29 -0500 /role-hospitals-st-lukes-regional-medical-center-idahos-first-hospital-home-program-showing-promising-results <div class="container"><div class="row"><div class="col-md-9"><div class="row"><div class="col-md-6"><img src="/sites/default/files/inline-images/TTHS-St-Lukes-Regional-Medical-Center-Hospital-at-Home.jpg" data-entity-uuid="870e9f8a-ba45-4d6b-b28f-0d2f38f63a58" data-entity-type="file" alt="Idaho’s First Hospital-at-Home Program Showing Promising Results. A paramedic listens to a women's heartbeat using a stethoscope as part of hospital-at-home care in Idaho." width="700" height="532"></div><p>The St. Luke’s Hospital at Home program, launched in late 2024, provides hospital-level care to patients in the comfort of their homes. This initiative is especially timely given Idaho's rapid population growth, which has increased the demand for health care services. The program allows patients with conditions such as heart failure, infections requiring IV antibiotics, pneumonia or asthma to receive necessary treatments at home, reducing the strain on emergency departments.</p><p>Patients in the program are equipped with medical devices like scales, tablets, blood pressure monitors and IV pumps. Paramedics visit patients twice daily and are connected to doctors and nurses through a tablet, ensuring continuous care. This setup not only provides medical support but also allows health care providers to understand the patient's living environment and involve social work if needed, enhancing overall care</p><p>The program is supported by Medically Home and offers a cost-effective alternative to traditional hospital stays. St. Luke’s is the first hospital in Idaho to start the program, which has been around since the 1960s. “We have a type of care that is very comparable to the outcomes of a brick-and-mortar hospital,” said the program’s Medical Director Adam Balinger.</p><p>It also provides a healing environment where patients can be with their families and pets, which can aid in recovery. With Medicare authorizing billing for hospital care at home since 2021, programs like St. Luke’s Hospital at Home are becoming more viable and beneficial, especially during times when hospitals are overwhelmed, such as during the pandemic.</p><p><a class="btn btn-primary" href="https://www.idahopress.com/news/local/hospital-care-at-home-st-lukes-launches-hospital-at-home-program/article_e740f5ca-ea40-11ef-94d8-bbde4c8e5aba.html" target="_blank">LEARN MORE</a></p></div></div><div class="col-md-3"><div><h4>Resources on the Role of Hospitals</h4><ul><li><a href="/topics/promoting-healthy-communities">Supporting Public Health</a></li><li><a href="/roleofhospitals">All Case Studies</a></li></ul></div></div></div></div> Mon, 24 Mar 2025 09:19:29 -0500 Hospital at Home <div class="container"><div class="row"><div class="col-md-8"><p>In December, Congress passed a legislative package to fund the government through March 14 and extend key health care provisions through the end of March. Congressional action is needed once again to fund the government and ensure long-term stability for these critical health care programs. At the same time, House and Senate Republicans are planning a strategy to use the budget reconciliation process to accomplish some of their legislative priorities, and Congress must raise the debt ceiling in the coming months. As part of these strategies, they are considering proposals that would reduce funding for hospital care, including reductions to the Medicaid program, jeopardizing access to the 24/7 care and services that hospitals provide.</p><h2>Action Needed</h2><p><strong>Please ask your senators and representatives to prevent Medicaid disproportionate share hospital payment cuts from taking effect; extend enhanced low-volume adjustment and Medicare-dependent hospital programs that expand access to care in rural areas; and extend telehealth and hospital-at-home waivers. These policies are currently set to expire at the end of March and must be extended.</strong></p><p><strong>In your discussions with your legislators, please continue to share the valuable role your hospital or health system plays in the community they represent and urge them to reject cuts that would jeopardize access to hospital care and services that patients rely on.</strong></p><p>More details and resources to support your advocacy efforts on these important issues follow.</p><h2>Health Care Extenders</h2><p>Congress passed a legislative package in December that extended some key health care provisions through the end of March, but additional congressional action is needed.</p><ul><li><strong>Prevent Medicaid DSH Cuts.</strong> The Medicaid disproportionate share hospital (DSH) program provides essential financial assistance to hospitals that care for our nation’s most vulnerable populations — children, the impoverished, disabled and elderly. Without congressional action, billions in cuts would take effect April 1. <strong>See the </strong><a href="/system/files/media/file/2020/02/fact-sheet-medicaid-dsh-0120.pdf"><strong>Medicaid DSH fact sheet</strong></a><strong> for more details.</strong></li><li><strong>Extend Key Rural Programs.</strong> The enhanced low-volume adjustment and Medicare-dependent hospital programs provide rural, geographically isolated and low-volume hospitals additional financial support to ensure rural residents have access to care. Without congressional action, these programs will expire on April 1. <strong>See the </strong><a href="/fact-sheets/2022-08-30-fact-sheet-rural-hospital-support-act-s4009-assistance-rural-community"><strong>rural programs fact sheet</strong></a><strong> for more details.</strong></li><li><strong>Extend Telehealth and Hospital-at-Home Waivers.</strong> Congress has extended telehealth waivers and the hospital-at-home program through March 31, but additional action is needed. See the <a href="/advocacy/advocacy-issues/2024-10-31-advocacy-issue-telehealth-waivers">telehealth</a> and <a href="/fact-sheets/2024-08-06-fact-sheet-extending-hospital-home-program">hospital-at-home fact sheets</a> for more details.</li></ul><h2>Critical Issues for the 119th Congress</h2><p>Following our Feb. 5 advocacy update webinar for members, we are providing new fact sheets and primers on emerging issues of significant importance for hospitals and health systems. We will be providing updates, new resources and data on these and other issues to help your advocacy efforts throughout the year.</p><h3>Reject Cuts to Medicaid</h3><p>Republican leaders continue to have discussions about how to use reconciliation — a <a href="/issue-landing-page/2025-02-07-budget-reconciliation-process-resource-page">budget tool</a> that gives Congress a fast-track mechanism to avoid the Senate filibuster and pass legislation with a simple majority. House and Senate Republicans are expected to use the budget reconciliation process to try to pass key agenda items on taxes, energy and border security, and they may look to health program funding as a way to pay for this legislation. <strong>Such proposals could significantly reduce federal spending for the Medicaid program. Even a small portion of possible reductions could have wide-ranging negative consequences for the health and well-being of both Medicaid enrollees and the broader health care system.</strong></p><p>The AHA has developed a number of resources hospitals and health systems can use as part of their advocacy efforts, including the following:</p><ul><li><a href="/fact-sheets/2025-02-07-fact-sheet-medicaid">General Fact Sheet on Medicaid</a></li><li><a href="/fact-sheets/2025-02-07-fact-sheet-medicaid-provider-taxes">Fact Sheet on Medicaid Provider Taxes</a></li><li><a href="/fact-sheets/2025-02-07-fact-sheet-medicaid-hospital-payment-basics">Fact Sheet on Medicaid Hospital Payment Basics</a></li><li><a href="/fact-sheets/2025-02-07-fact-sheet-capita-caps-medicaid-program">Medicaid Per Capita Caps</a></li></ul><h3>Extend Enhanced Premium Tax Credits</h3><p>The federal government offers enhanced premium tax credits (EPTCs) to help eligible individuals and families purchase coverage on the health insurance marketplaces. These policies are scheduled to expire at the end of 2025. <strong>Congress should extend the EPTCs before the end of the year</strong> as they have increased access to health care coverage and high-quality care for patients and communities served by hospitals, health systems and other providers. <strong>Download the AHA fact sheet, which includes new data on the negative impact of not extending the </strong><a href="/fact-sheets/2025-02-07-fact-sheet-enhanced-premium-tax-credits"><strong>EPTCs</strong></a><strong>.</strong></p><h3>Reject Site-neutral Payment Cuts</h3><p>Congress is considering several bills that would impose billions in Medicare site-neutral payment reductions for services provided in hospital outpatient departments. <strong>Congress should reject site-neutral proposals</strong> because they would reduce patient access to vital health care services, particularly in rural and other medically underserved communities. <strong>See AHA resources on the detrimental impact of </strong><a href="/advocacy/advocacy-issues/2023-09-11-advocacy-issue-site-neutral-payment-proposals"><strong>site-neutral policies</strong></a><strong>.</strong></p><h3>Protect the 340B Drug Pricing Program</h3><p>For more than 30 years, the 340B Drug Pricing Program has provided financial help to hospitals serving vulnerable communities to manage rising prescription drug costs. However, some in Congress and the pharmaceutical industry want to see the program scaled back. <strong>Congress should protect the 340B program</strong> for all providers and ensure the program continues to help stretch limited resources and provide more comprehensive services to more patients. <strong>Download the AHA fact sheets on the </strong><a href="/340b-drug-savings-program"><strong>340B program</strong></a><strong>.</strong></p><h2>Further Questions</h2><p>Visit the <a href="/advocacy/action-center">AHA Action Center</a> for more resources on these issues and other priorities important to hospitals and health systems. Watch for more Action Alerts and resources from the AHA to assist your advocacy efforts. If you have further questions, please contact AHA at 800-424-4301.</p></div><div class="col-md-4"><p><a href="/system/files/media/file/2025/02/Contact-Your-Lawmakers-and-Urge-Them-to-Extend-Key-Health-Care-Policies-Set-to-Expire-Next-Month.pdf" target="_blank" title="Click here to download the Action Alert ACTION NEEDED: Contact Your Lawmakers and Urge Them to Extend Key Health Care Policies Set to Expire Next Month PDF."><img src="/sites/default/files/inline-images/Page-1-Contact-Your-Lawmakers-and-Urge-Them-to-Extend-Key-Health-Care-Policies-Set-to-Expire-Next-Month.png" data-entity-uuid="2dd3d759-0b56-4a54-8cdb-d635ee169360" data-entity-type="file" alt="Action Alert: ACTION NEEDED: Contact Your Lawmakers and Urge Them to Extend Key Health Care Policies Set to Expire Next Month page 1." width="696" height="900"></a></p></div></div></div> Fri, 07 Feb 2025 15:04:02 -0600 Hospital at Home /fact-sheets/2024-08-06-fact-sheet-extending-hospital-home-program <div class="container"><div class="row"><div class="col-md-8"><h2><span>The Issue</span></h2><p>The hospital-at-home (H@H) model — where patients receive acute level care in their homes, rather than in a hospital — has emerged as an innovative and promising approach to provide high quality care to patients in the comfort of their homes. Since the start of the program, Congress has extended the waivers twice, first in 2022 (Consolidated Appropriations Act of 2023) for two years and then again in 2024 (H.R. 10545 the American Relief Act) for 90 days. Both extensions received no score from the Congressional Budget Office. The waivers were extended until Sept. 30, 2025, as part of the continuing resolution passed earlier in the year.</p><h2>AHA Take</h2><p>The AHA supports the Hospital Inpatient Services Modernization Act to extend the H@H waiver for five years.</p><p>Hospitals and health systems see H@H programs as a safe and innovative way to care for patients in the comfort of their homes. This kind of care is well suited for medium acuity patients who need hospital level care but are considered stable enough to be safely monitored from home. Rather than staying three days or longer in the hospital, these patients can be treated safely by their doctor and a team of medical professionals along with the patient’s support system at home.</p><p>A long-term extension will not only provide additional time to continue gathering data on quality improvement, cost savings, and patient experience, but will also provide much needed stability for new programs and may ease state concerns about updating Medicaid policies to allow for coverage of these services.</p><h2><span>Background</span></h2><p>To allow hospitals and health systems the ability to respond to the COVID-19 pandemic effectively and efficiently, the Centers for Medicare & Medicaid Services (CMS) provided a number of waivers and flexibilities that eased several Medicare restrictions and requirements. These included waivers to certain conditions of participation for approved H@H programs.</p><p>To receive approval to participate in the H@H program, hospitals must submit an individual waiver request to CMS. The request specifically asks CMS to waive §422.23(b) and (b)(1) of the Medicare Conditions of Participation, which require nursing services to be provided on premises 24 hours a day, seven days a week, as well as the immediate availability of a registered nurse for the care of any patient. Once the waiver request is received, CMS divides the applications into two categories, allowing more-experienced hospitals a quicker approval process so they can rapidly expand their H@H program; less-experienced hospitals have to demonstrate they are capable of meeting the requirements associated with the provision of H@H services.</p><p>As of November 2024, 378 hospitals, across 140 systems and 39 states, have been approved to provide H@H services to patients. Other health systems and hospitals have indicated they are interested in standing up H@H programs but are hesitant to do so without a long-term extension from Congress. In October 2024, CMS released a report that adds to the growing body of literature which demonstrates that H@H is a safe, effective program. Specifically, CMS found that generally H@H patients had lower mortality rates, lower readmission rates, and lower spending in the 30-days post-discharge. But the benefits went beyond quality and costs as patients and caregivers also expressed predominantly positive experiences with the program. While the report found that AHCAH patients were more likely to be white and live in an urban location and less likely to receive Medicaid or low-income subsidies, this can in part be attributed to the variability in state Medicaid coverage of H@H<br>programs. As of June 2024, only 12 states provide Medicaid coverage for H@H.</p></div><div class="col-md-4"><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/system/files/media/file/2024/07/Fact-Sheet-Extending-the-Hospital-at-Home-Program-20240719.pdf" target="_blank" title="Click here to download the Fact Sheet: Extending the Hospital-at-Home Program PDF.">Fact Sheet PDF</a></div><a href="/system/files/media/file/2024/07/Fact-Sheet-Extending-the-Hospital-at-Home-Program-20240719.pdf"><img src="/sites/default/files/2025-04/fact-sheet-extending-the-hospital-at-home-program-april-2025.png" data-entity-uuid data-entity-type="file" alt="Fact Sheet Image" width="682" height="882"></a><p> </p></div><div class="col-md-4"><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/system/files/media/file/2024/08/understanding-the-hospital-at-home-program-infographic.pdf" target="_blank" title="Click here to download the Infographic: Understanding the Hospital At Home Program PDF.">Infographic PDF</a></div><a href="/system/files/media/file/2024/08/understanding-the-hospital-at-home-program-infographic.pdf"><img src="/sites/default/files/inline-images/understanding-the-hospital-at-home-program-infographic-jan-25.png" data-entity-uuid data-entity-type="file" alt="Infographic Image" width="NaN" height="NaN"></a></div></div></div> Sun, 26 Jan 2025 16:08:20 -0600 Hospital at Home <div class="container"><div class="row"><div class="col-md-8"><p>The House by a vote of 366-34 Dec. 20 passed the American Relief Act <a href="https://docs.house.gov/billsthisweek/20241216/ARA%2012.20.pdf">(H.R. 10545)</a>, a bill to fund the government through March 14, 2025, provide disaster relief and farm aid, and extend for three months a number of critical programs for hospitals and health systems. The Senate early Dec. 21 passed the bill on an 85-11 vote. </p><div class="panel module-typeC"><div class="panel-heading"><h2>Key Highlights</h2><p>The bill contains provisions: </p><ul><li>Preventing cuts in Medicaid Disproportionate Share Hospital payments.</li><li>Extending critical rural Medicare programs.</li><li>Extending telehealth and hospital-at-home programs</li></ul></div></div><h2>AHA TAKE</h2><p>The AHA appreciates the bipartisan effort to fund the government and extend these critical health care policies for three months to support hospitals’ efforts to care for patients and communities. We thank Congress for their support and look forward to our continued work to ensure hospitals and health systems have the resources they need to advance health for patients and communities. </p><h2>MEDICAID AND MEDICARE </h2><p><strong>Medicaid Disproportionate Share Hospital (DSH) Relief. </strong>The bill eliminates the Medicaid DSH cuts through April 1, 2025.   </p><p><strong>Medicare Rural Extenders. </strong>The bill will extend the enhanced low-volume adjustment and the Medicare-dependent hospital programs through April 1, 2025. They were set to expire Dec. 31, 2024<strong>.</strong></p><p><strong>Medicare Telehealth and Hospital-at-home Extensions. </strong>The bill will extend key telehealth waivers and the hospital-at-home program through March 31, 2025. They were set to expire Dec. 31, 2024<strong>.</strong> </p><p><strong>Extension of the Work Geographic Index Floor under the Medicare Program. </strong>The bill will extend a 1.0 floor on the work Geographic Practice Cost Index (GPCI) through April 1, 2025. This was scheduled to expire Dec. 31, 2024. </p><p><strong>Medicare Rural Ambulance.</strong> The bill will extend add-on payments for ambulance services through March 31, 2025. These add-on payments support rural, “superrural,” and urban ambulance services. They were set to expire Dec. 31, 2024. </p><h2>OTHER ITEMS OF INTEREST </h2><p><strong>PAYGO Sequester. </strong>Under PAYGO requirements, Congress must pay for any legislative package, either by reducing entitlement spending or increasing revenue. The legislation would waive PAYGO reductions by “wiping the scorecard clean,” preventing a 4% Medicare sequester cut from taking effect in January. </p><p><strong>Disaster Relief. </strong>The bill provides $29 billion to the Federal Emergency Management Agency Disaster Relief Fund. <strong> </strong></p><h2>OFFSETS</h2><p>The health care portion of the bill includes the following offset. </p><p><strong>Medicare Improvement Fund. </strong>The bill reduces the amount of funding in the Medicare Improvement Fund from $3.197 billion to $1.241 billion. </p><h2>FURTHER QUESTIONS</h2><p>If you have further questions, please contact the AHA at 800-424-4301.</p></div><div class="col-md-4"><a href="/system/files/media/file/2024/12/congress-passes-bill-funding-government-current-levels-to-march-extending-key-health-care-provisions-bulletin-12-21-2024.pdf" target="_blank" title="Special Bulletin PDF"><img src="/sites/default/files/inline-images/cover-congress-passes-bill-funding-government-current-levels-to-march-extending-key-health-care-provisions-bulletin-12-21-2024..png" data-entity-uuid="48d278a2-1930-4eb3-93be-3a57b8fbcbd7" data-entity-type="file" alt="Special Bulletin Cover Image" width="679" height="878"></a></div></div></div> Sat, 21 Dec 2024 09:54:45 -0600 Hospital at Home <p>The House by a vote of 366-34 today passed the American Relief Act (<a href="https://docs.house.gov/billsthisweek/20241216/ARA%2012.20.pdf" target="_blank" title="docs.house.gov: H.R. 10545">H.R. 10545</a>), a bill to fund the government through March 14, 2025, provide disaster relief and farm aid, and extend for three months a number of critical programs for hospitals and health systems. The Senate is expected to vote on the bill later tonight. In light of the overwhelming bipartisan support and signals of support from the Administration, it is highly likely the Senate will favorably consider the package. The AHA will provide updates accordingly.</p><h2>Key Highlights</h2><p>The bill contains provisions:</p><ul><li>Preventing cuts in Medicaid Disproportionate Share Hospital payments.</li><li>Extending critical rural Medicare programs.</li><li>Extending telehealth and hospital-at-home programs.</li></ul><h2>AHA Take</h2><p>The AHA appreciates the bipartisan effort to fund the government and extend these critical health care policies for three months to support hospitals’ efforts to care for patients and communities. We thank Congress for their support and look forward to our continued work to ensure hospitals and health systems have the resources they need to advance health for patients and communities.</p><h2>Medicaid and Medicare</h2><h3>Medicaid Disproportionate Share Hospital (DSH) Relief</h3><p>The bill eliminates the Medicaid DSH cuts through April 1, 2025.</p><h3>Medicare Rural Extenders</h3><p>The bill will extend the enhanced low-volume adjustment and the Medicare-dependent hospital programs through April 1, 2025. They were set to expire Dec. 31, 2024.</p><h3>Medicare Telehealth and Hospital-at-home Extensions</h3><p>The bill will extend key telehealth waivers and the hospital-at-home program through March 31, 2025. They were set to expire Dec. 31, 2024.</p><h3>Extension of the Work Geographic Index Floor under the Medicare Program</h3><p>The bill will extend a 1.0 floor on the work Geographic Practice Cost Index (GPCI) through April 1, 2025. This was scheduled to expire Dec. 31, 2024.</p><h3>Medicare Rural Ambulance</h3><p>The bill will extend add-on payments for ambulance services through March 31, 2025. These add-on payments support rural, “super-rural,” and urban ambulance services. They were set to expire Dec. 31, 2024.</p><h2>Other Items of Interest</h2><h3>PAYGO Sequester</h3><p>Under PAYGO requirements, Congress must pay for any legislative package, either by reducing entitlement spending or increasing revenue. The legislation would waive PAYGO reductions by “wiping the scorecard clean,” preventing a 4% Medicare sequester cut from taking effect in January.</p><h3>Disaster Relief</h3><p>The bill provides $29 billion to the Federal Emergency Management Agency Disaster Relief Fund.</p><h2>Offsets</h2><p>The health care portion of the bill includes the following offset.</p><h3>Medicare Improvement Fund</h3><p>The bill reduces the amount of funding in the Medicare Improvement Fund from $3.197 billion to $1.241 billion.</p><h2>Further Questions</h2><p>If you have further questions, please contact the AHA at <a href="tel:1-800-424-4301">800-424-4301</a>.</p> Sat, 21 Dec 2024 08:06:22 -0600 Hospital at Home <div class="container"><div class="row"><div class="col-md-8"><p>Following the elections, lawmakers are returning to Washington, D.C., to tackle key funding issues, including Medicaid disproportionate share hospital (DSH) payment reductions and support for rural programs. They also will consider site-neutral payment proposals, oversight of health plans, continuation of telehealth and hospital-at-home waivers, and the prevention of violence against health care workers.</p><p>Before the lame-duck session ends and the 118th Congress adjourns, it is essential that federal lawmakers understand the challenges hospitals and health systems face and what is at stake for the patients and communities they represent. With several programs facing expiration at the end of this year, quick action is needed to preserve necessary funding and support for the nation’s health care organizations.</p><p>Here are the issues AHA leaders are <a href="/2024-11-12-aha-urges-congress-act-key-priorities-lame-duck-session" target="_blank" title="Issues AHA Leaders are calling on Congress to reinforce">calling on congressional leaders</a> to reinforce. Following is an overview of the issues and what you can do to assist these advocacy efforts.</p><h2>SUPPORT MEDICAID DSH DEAR COLLEAGUE LETTER</h2><p>At the beginning of the year, billions of dollars will be cut from the Medicaid DSH program, severely jeopardizing hospitals’ finances and threatening communities’ access to care. Contact your representative(s) and ask them to sign on to the bipartisan <a href="/system/files/media/file/2024/11/congress-dear-colleague-letter-to-stop-medicaid-disproportionate-share-hospital-dsh-payment-cuts-11-13-2024.pdf" target="_blank" title="House Dear Colleague Letter">House Dear Colleague letter</a> being circulated by Reps. Dan Crenshaw, R-Texas, Yvette Clarke, D-N.Y., Gus Bilirakis, R-Fla., and Diana DeGette, D-Colo., calling for Medicaid DSH cuts to be addressed. <a href="https://www.votervoice.net/AHA/Campaigns/118959/Respond">Click here</a> to send a message to your representatives.</p><h2><strong>LEGISLATIVE ACTION NEEDED</strong></h2><p><strong>Address the Medicaid</strong> <strong>DSH Payment Reductions. </strong>The <a href="/fact-sheets/2023-03-28-fact-sheet-medicaid-dsh-program" target="_blank" title="Medicare DSH Program Information">Medicaid DSH program</a> provides essential financial assistance to hospitals that care for our nation’s most vulnerable populations — children, impoverished, disabled and elderly. The fiscal year 2025 Medicaid DSH payment reductions are scheduled to be implemented on Jan. 1, 2025, when $8 billion in reductions take effect. The AHA calls on Congress to continue to provide relief from the Medicaid DSH cuts.</p><p><strong>Protect Rural Communities’ Access to Care.</strong> The AHA urges Congress to continue the <a href="/advocacy/advocacy-issues/2024-10-31-advocacy-issue-rural-mdh-and-lva-programs" target="_blank" title="Medicare-dependent Hospitals and Low-volume Adjustment programs">Medicare-dependent Hospitals and Low-volume Adjustment programs</a>. These programs provide rural, geographically isolated and low-volume hospitals additional financial support to ensure rural residents have access to care. These programs expire on Dec. 31, 2024. Congress should also enact a technical correction to remove barriers for Rural Emergency Hospitals to receive hospital-level reimbursement for outpatient services under Medicaid<strong>.</strong> </p><p><strong>Reject Site-neutral Payment Proposals.</strong> The AHA strongly opposes efforts to expand <a href="/advocacy/advocacy-issues/2023-09-11-advocacy-issue-site-neutral-payment-proposals" target="_blank" title="Site-neutral payment cuts information">site-neutral payment cuts</a> to include essential drug administration services furnished in off-campus hospital outpatient departments (HOPDs). Current Medicare payment rates appropriately recognize that there are fundamental differences between patient care delivered in HOPDs compared to other settings. HOPDs have higher patient safety and quality standards, and, unlike other sites of care, hospitals take important additional steps to ensure drugs are prepared and administered safely for both patients and providers. </p><p>The AHA also calls on Congress to reject legislative efforts requiring each off-campus HOPD to be assigned a separate unique health identifier from its provider as a condition of payment under Medicare or group health plans. Hospitals are already required to be transparent about the location of care delivery. This requirement would be duplicative and impose unnecessary and onerous administrative burdens and costs by needlessly requiring the overhaul of current billing practices and systems.</p><p><strong>Hold Commercial Health Plans Accountable.</strong> Certain health plan practices, such as inappropriate care denials and delayed payments, threaten patient access to care. These practices also contribute to clinician burnout and add excessive administrative costs and burdens to the health care system. The AHA urges Congress to pass the<a href="/lettercomment/2024-06-12-aha-support-house-improving-seniors-timely-access-care-act" target="_blank" title="Improving seniors timely access to care"> Improving Seniors Timely Access to Care Act</a> (H.R. 8702/ S. 4532), bipartisan legislation supported by more than half of the members of the House and Senate. The bill would streamline the prior authorization process in the Medicare Advantage program by eliminating complexity and promoting uniformity to reduce the wide variation in prior authorization methods that frustrate both patients and providers.</p><p><strong>Extend </strong><a href="/system/files/media/file/2024/05/fact-sheet-2024-telehealth-advocacy-agenda.pdf" target="_blank" title="Telehealth information"><strong>Telehealth</strong></a><strong> and </strong><a href="/system/files/media/file/2024/07/Fact-Sheet-Extending-the-Hospital-at-Home-Program-20240719.pdf" target="_blank" title="Hospitals-at-home information"><strong>Hospital-at-home</strong></a><strong> Waivers.</strong> During the COVID-19 public health emergency, Congress established a series of waivers expanding access for millions of Americans and increasing convenience in caring for patients. Telehealth provides a tremendous ability to leverage geographically dispersed provider capacity to support patient demand. The AHA calls on Congress to permanently adopt telehealth waivers and expand the telehealth workforce. </p><p>The AHA also urges Congress to pass the <a href="/lettercomment/2024-05-23-aha-support-house-bill-hospital-inpatient-services-modernization-act-2024" target="_blank" title="Hospitals Inpatient Services Modernization Act">Hospital Inpatient Services Modernization Act</a> (H.R. 8260/S. 4350), extending the hospital-at-home waiver for five years through 2029. Congressional action will reassure hospitals and health systems that are interested in developing such programs for their communities. </p><p><strong>Prevent Reimbursement Cuts for Physicians. </strong>Congress should take action to mitigate the scheduled physician reimbursement cuts for 2025 and to continue its work on broader reform for sustainable physician payment. Physicians have dealt with over two decades of conversion factor decrements, as well as significant staffing shortages and rising inflation in recent years. The scheduled 2.8% payment reduction in the 2025 Physician Fee Schedule would result in a significant risk to patients’ access to care.</p><p><strong>Protect America’s Health Care Workers.</strong> The AHA calls on Congress to enact the <a href="/system/files/media/file/2022/09/Fact-Sheet-Workplace-Violence-and-Intimidation-and-the-Need-for-a-Federal-Legislative-Response.pdf" target="_blank" title="SAVE Act information">Safety from Violence for Healthcare Employees (SAVE) Act</a> (H.R. 2584/S. 2768). This bipartisan bill would provide federal protections from workplace violence for hospital workers, similar to the protections in current law for airport and airline workers.</p><h2>FURTHER QUESTIONS</h2><p>Visit the <a href="/advocacy/action-center" target="_blank" title="AHA Action Center">AHA Action Center</a> for more resources on these issues and other priorities important to hospitals and health systems.</p><p>If you have further questions, please contact AHA at 800-424-4301.<br> </p></div><div class="col-md-4"><a href="/system/files/media/file/2024/11/aha-asks-congressional-leadership-to-fund-hospitals-protect-health-care-workers-alert-11-13-2024.pdf"><img src="/sites/default/files/inline-images/cover-aha-asks-congressional-leadership-to-fund-hospitals-protect-health-care-workers-alert-11-13-2024.png" data-entity-uuid="40f68d4b-dfe5-4e56-af78-6f8af97f13ca" data-entity-type="file" alt="Action Alert Cover Image" width="640" height="834"></a></div></div><p> </p></div> Wed, 13 Nov 2024 14:05:33 -0600 Hospital at Home /advocacy/advocacy-issues/2024-11-01-advocacy-issue-hospital-home-waivers <div class="container"><div class="row"><div class="col-md-8"><h2><span>The Issue</span></h2><p>The hospital-at-home (H@H) model — where patients receive acute level care in their homes, rather than in a hospital — has emerged as an innovative and promising approach to provide high quality care to patients in the comfort of their homes. Since the start of the program, Congress has extended the waivers twice. First in 2022 (Consolidated Appropriations Act of 2023) for two years and then again in 2024 (H.R. 10545 the American Relief Act) for 90 days. Both extensions received no score from the Congressional Budget Office. Congressional action is needed to extend the waivers for this program, which are now set to expire March 31, 2025.</p><h2><span>AHA Position</span></h2><p>The AHA supports the Hospital Inpatient Services Modernization Act to extend the H@H waiver for five years.</p><p>Hospitals and health systems see H@H programs as a safe and innovative way to care for patients in the comfort of their homes. This kind of care is well suited for medium acuity patients who need hospital level care but are considered stable enough to be safely monitored from home. Rather than staying three days or longer in the hospital, these patients can be treated safely by their doctor and a team of medical professionals along with the patient’s support system at home.</p><p>A long-term extension will not only provide additional time to continue gathering data on quality improvement, cost savings, and patient experience, but will also provide much needed stability for new programs and may ease state concerns about updating Medicaid policies to allow for coverage of these services.</p><h2><span>Key Resources</span></h2><ul><li><a href="/fact-sheets/2024-08-06-fact-sheet-extending-hospital-home-program">Fact Sheet: Extending the Hospital-at-Home Program</a></li><li><a href="/infographics/2024-08-06-infographic-understanding-hospital-home-program">Infographic: Understanding the Hospital At Home Program</a></li><li><a href="/news/perspective/2024-10-18-taking-action-extend-telehealth-and-hospital-home-programs">Perspective: Taking Action to Extend Telehealth and Hospital-at-home Programs</a></li><li><a href="/action-needed-contact-lawmakers-important-issues-facing-hospitals-and-health-systems">ACTION NEEDED: Contact Lawmakers on Important Issues Facing Hospitals and Health Systems</a></li><li><a href="/news/headline/2024-10-01-cms-report-finds-hospital-home-program-safe-effective">CMS report finds hospital-at-home program safe, effective</a></li></ul></div><div class="col-md-4"><p><div class="views-element-container"> <section class="top-level-view js-view-dom-id-15f58d1647ce338450d54e9ec05a9da0c6d5eaf50120a2e880a0d0ae06559acc resource-block"> <h3>Latest Hospital-at-Home Advocacy and News</h3> <div class="resource-wrapper"> <div class="resource-view"> <div class="article views-row"> <div class="views-field views-field-field-access-level"> <div class="field-content"> <div class="meta custom-lock-position"> <div class="views-field-access-level access-type-member-non-fed" data-toggle="tooltip" data-placement="bottom" title="Members only"><a href="/taxonomy/term/280" hreflang="en">Member Non-Fed</a></div> </div></div> </div><div class="views-field views-field-title"> <span class="field-content"><a href="/action-alert/2025-02-07-contact-your-lawmakers-and-urge-them-extend-key-health-care-policies-set-expire-next-month" hreflang="en">Contact Your Lawmakers and Urge Them to Extend Key Health Care Policies Set to Expire Next Month</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2025-02-07T15:04:02-06:00">Feb 7, 2025</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <span class="field-content"><a href="/fact-sheets/2024-08-06-fact-sheet-extending-hospital-home-program" hreflang="en">Fact Sheet: Extending the Hospital-at-Home Program</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2025-01-26T16:08:20-06:00">Jan 26, 2025</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-field-access-level"> <div class="field-content"> <div class="meta custom-lock-position"> <div class="views-field-access-level access-type-member" data-toggle="tooltip" data-placement="bottom" title="Members only"><a href="/taxonomy/term/279" hreflang="en">Member</a></div> </div></div> </div><div class="views-field views-field-title"> <span class="field-content"><a href="/special-bulletin/2024-12-21-congress-passes-bill-funding-government-current-levels-march-extending-key-health-care-provisions" hreflang="en">Congress Passes Bill Funding Government at Current Levels into March, Extending Key Health Care Provisions to Expire</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2024-12-21T09:54:45-06:00">Dec 21, 2024</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-field-access-level"> <div class="field-content"> <div class="meta custom-lock-position"> <div class="views-field-access-level access-type-member-non-fed" data-toggle="tooltip" data-placement="bottom" title="Members only"><a href="/taxonomy/term/280" hreflang="en">Member Non-Fed</a></div> </div></div> </div><div class="views-field views-field-title"> <span class="field-content"><a href="/special-bulletin/2024-12-21-house-passes-bill-funding-government-current-levels-march-extending-key-health-care-provisions-due" hreflang="en">House Passes Bill Funding Government at Current Levels into March, Extending Key Health Care Provisions Due to Expire at End of Year</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2024-12-21T08:06:22-06:00">Dec 21, 2024</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-field-access-level"> <div class="field-content"> <div class="meta custom-lock-position"> <div class="views-field-access-level access-type-member" data-toggle="tooltip" data-placement="bottom" title="Members only"><a href="/taxonomy/term/279" hreflang="en">Member</a></div> </div></div> </div><div class="views-field views-field-title"> <span class="field-content"><a href="/action-alert/2024-11-13-aha-asks-congressional-leadership-fund-hospitals-protect-health-care-workers" hreflang="en">AHA Asks Congressional Leadership to Fund Hospitals, Protect Health Care Workers</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2024-11-13T14:05:33-06:00">Nov 13, 2024</time> </span> </div></div> </div> </div> <div class="more-link"><a href="/topics/hospital-home">More on Hospital at Home</a></div> </section> </div> </p></div></div></div>.meta.custom-lock-position { position: relative; top: 0px; right: inherit; display: block; float: right; } Fri, 01 Nov 2024 08:57:06 -0500 Hospital at Home /news/perspective/2024-10-18-taking-action-extend-telehealth-and-hospital-home-programs <p>People want medical care that is safe, convenient and accessible. Hospitals deliver that every day within their walls — and increasingly, outside of their walls as well, to the benefit of patients everywhere.</p><p>Improved technology has made telehealth services available for some time, providing increased access and convenience for patients. The regulatory waivers implemented during the pandemic allowed broader portions of the population to experience the benefits of virtual care. The expansion of telehealth services has transformed care delivery, expanded access for millions of Americans and increased convenience in caring for patients, especially those with transportation or mobility limitations, and those in rural communities.</p><p>Many of the same things can be said about the hospital-at-home model, where medically appropriate patients receive acute-level care in the comfort and familiarity of their homes, rather than in a hospital. It has emerged as an innovative and promising approach to providing high-quality care in a setting that many patients would choose as an option if available. </p><p>Hospital-at-home programs get a thumbs up not only from a majority of patients, but from care providers too, according to a recent <a href="https://www.cms.gov/newsroom/fact-sheets/fact-sheet-report-study-acute-hospital-care-home-initiative#_ftn1" target="_blank" title="CMS Report">report</a> from the Centers for Medicare & Medicaid Services that found patients and caregivers overall had positive experiences in the program.</p><p>Both of these innovative approaches to patient care have proven their worth. However, the waivers that have supported their expansion are scheduled to expire at the end of this year unless Congress acts.</p><p><strong>That is why the AHA has made making these flexibilities permanent or extending them a top advocacy priority when Congress returns for a post-election lame-duck session.</strong></p><p><strong>Telehealth Advocacy</strong>. The AHA continues to work with Congress and the Administration to enact telehealth reform so that providers can use these services to benefit patients on a permanent basis. We are urging Congress to lift geographic and originating site restrictions, allow Rural Health Clinics and Federally Qualified Health Centers to serve as distant sites, expand practitioners who can provide telehealth, remove in-person visit requirements for behavioral health and allow the continuation of audio-only telehealth services. We also are seeking provisions that would support telehealth for underserved areas; expand the telehealth workforce; and ensure fair and adequate telehealth reimbursement.</p><p><strong>Extend the Hospital-at-home Program. </strong>More than 300 hospitals offer hospital-at-home programs, and many other hospitals and health systems are interested in developing programs for their communities but are reluctant to do so without more certainty from Congress. The AHA strongly urges lawmakers to protect and expand this important program by passing the <a href="/lettercomment/2024-05-23-aha-support-senate-bill-hospital-inpatient-services-modernization-act-2024?" target="_blank" title="Hospital Inpatient Services Modernization Act (H.R. 8260/S. 4350) ">Hospital Inpatient Services Modernization Act (H.R. 8260/S. 4350)</a>  which would extend the hospital-at-home waiver for five years through 2029.</p><p>As the health care model continues to transform moving into the future, protecting and expanding the opportunities for great patient care via telehealth and hospital-at-home capabilities is paramount.</p><p>The AHA has developed <a href="/system/files/media/file/2024/05/fact-sheet-2024-telehealth-advocacy-agenda.pdf" target="_blank" title="Telehealth factsheets">fact sheets</a> on telehealth and the <a href="/system/files/media/file/2024/07/Fact-Sheet-Extending-the-Hospital-at-Home-Program-20240719.pdf" target="_blank" title="Hospital-at-home programs">hospital-at-home programs</a> that you can use in your advocacy efforts. Please reach out to your lawmakers and urge them to extend or make permanent these waivers as they are an important part of our efforts to deliver convenient and accessible care as we work to advance health in America. And please see our recent <a href="/action-needed-contact-lawmakers-important-issues-facing-hospitals-and-health-systems" target="_blank" title="Action Alert">Action Alert</a> for more on these issues and our other advocacy priorities for Congress’ post-election lame-duck session.</p> Fri, 18 Oct 2024 08:54:41 -0500 Hospital at Home /news/headline/2024-10-01-cms-report-finds-hospital-home-program-safe-effective <p>The Centers for Medicare & Medicaid Services Sept. 30 released a <a href="https://www.cms.gov/newsroom/fact-sheets/fact-sheet-report-study-acute-hospital-care-home-initiative#_ftn1">report</a> on the hospital-at-home program, which found that patients and caregivers overall had positive experiences in the program. Patients in the H@H program were more likely to be white, urban-living and less likely to receive Medicaid or low-income subsidies. The report does not provide insight into the criteria participating hospitals use to identify patients suitable for H@H care, but does note that hospitals used evidence and an awareness of their own capacity to support care in the home to establish their criteria. Patients were most commonly treated for respiratory, circulatory and renal conditions, as well as infectious diseases. The study also found that H@H patients had a lower mortality rate than those in brick-and-mortar facilities but had a slightly longer length of stay.</p> Tue, 01 Oct 2024 15:18:02 -0500 Hospital at Home <div class="container"><div class="row"><div class="col-md-8"><p>Lawmakers have returned to their districts for October after passing a continuing resolution that will keep the government funded through Dec. 20. Following the November election, lawmakers will return to Washington for a busy lame-duck session when key funding issues, including Medicaid disproportionate share hospital (DSH) and rural programs, will be on the agenda.</p><p>Now, while lawmakers are in their district, it is important for the field to engage with members of Congress to remind them of the importance of preserving access to care by continuing to fund vital programs and avoiding harmful policies such as site-neutral payments. It is essential that federal lawmakers understand the challenges hospitals and health systems face and what is at stake for the patients and communities they represent.</p><p>While AHA makes the case in Washington, D.C., we also continue to increase our efforts to engage the field with their lawmakers. It is important that hospital and health system leaders reinforce these messages back home. Your legislators listen to you because you live, work, vote and provide care in their communities. Lawmakers need to hear how congressional support is necessary to ensure hospitals can provide the 24/7 access to care patients and communities depend on.</p><h2>WHAT YOU CAN DO</h2><ul><li><strong>Contact</strong> your lawmakers and arrange conversations about the challenges your organization is facing and why additional support is needed.</li><li><strong>Invite</strong> your elected officials to visit your organization to show them firsthand the important service you provide to their communities.</li><li><strong>Explain</strong> to your elected lawmakers how government funding programs such as Medicaid DSH, enhanced low-volume adjustment (LVA) and Medicare-dependent hospitals (MDH), and others impact your ability to provide care in your community, and what would happen if those programs were not extended.</li><li><strong>Share</strong> this alert with your government affairs and media relations staff, leadership team and governance board to ensure a cohesive narrative around issues impacting hospitals and health systems. Be prepared to give specific examples of what services could be at stake.</li></ul><h2>AREAS OF FOCUS</h2><p><strong>Prevent damaging cuts to hospitals. </strong>The <a href="/fact-sheets/2023-03-28-fact-sheet-medicaid-dsh-program">Medicaid DSH program</a> provides essential financial assistance to hospitals that care for our nation’s most vulnerable populations — children, impoverished, disabled and elderly. The Medicaid DSH payment reductions are scheduled to be implemented on Jan. 1, 2025, when $8 billion in reductions take effect. <u>Congress should provide relief from the Medicaid DSH cuts.</u></p><p>In addition, <a href="/fact-sheets/2022-08-30-fact-sheet-rural-hospital-support-act-s4009-assistance-rural-community">MDH and LVA programs</a> provide rural, geographically isolated and low-volume hospitals additional financial support to ensure rural residents have access to care. These programs are set to expire Dec. 31, 2024. <u>Congress should extend or make these critical rural programs permanent.</u> AHA member hospitals participating in the MDH and/or LVA programs received an Alert with data on the impact on their organization if these programs expire.</p><p><a href="/issue-landing-page/2023-09-11-advocacy-issue-site-neutral-payment-proposals"><strong>Reject so-called site-neutral payment proposals.</strong></a><strong> </strong>When Congress returns from recess, AHA expects to see continued efforts to push proposals that would enact additional site-neutral payment cuts. <u>Urge your lawmakers to oppose any site-neutral payment proposal</u> as they would impose billions of dollars in additional Medicare payment cuts for services provided by hospital outpatient departments. It’s important to emphasize that these proposals would reduce patient access to vital health care services, particularly in rural and other medically underserved communities.</p><p><strong>Hold commercial health plans accountable. </strong>Certain health plan practices threaten patient access to care, contribute to clinician burnout and add excessive administrative costs and burden to the health care system. Regulators should increase their oversight of health plans<strong> </strong>and implement a comprehensive simplification agenda, beginning with streamlining prior authorization requirements and processes and monitoring for abusive payment delays and denials. <u>Urge Congress to pass the </u><a href="/lettercomment/2024-06-12-aha-support-house-improving-seniors-timely-access-care-act">Improving Seniors Timely Access to Care Act</a><u> — bipartisan legislation that would streamline the prior authorization process in the Medicare Advantage program.</u></p><p><strong>Permanently adopt </strong><a href="/system/files/media/file/2024/05/fact-sheet-2024-telehealth-advocacy-agenda.pdf"><strong>telehealth</strong></a><strong> and </strong><a href="/system/files/media/file/2024/07/Fact-Sheet-Extending-the-Hospital-at-Home-Program-20240719.pdf"><strong>hospital-at-home</strong></a><strong> waivers. </strong>During the public health emergency, Congress established a series of waivers expanding access for millions of Americans and increasing convenience in caring for patients. Telehealth holds tremendous potential to leverage geographically dispersed provider capacity to support patient demand. <u>Congress should permanently adopt telehealth waivers and expand the telehealth workforce</u>.</p><p>Hospital-at-home programs are a safe, innovative way to care for patients in the comfort of their homes. With over 300 hospitals with hospital-at-home programs, many other hospitals and health systems indicate they are interested in developing programs for their communities but are reluctant to do so without congressional action. <u>Urge</u> <u>Congress to pass the Hospital Inpatient Services Modernization Act (</u><a href="/lettercomment/2024-05-23-aha-support-house-bill-hospital-inpatient-services-modernization-act-2024">H.R. 8260</a><u>/</u><a href="/lettercomment/2024-05-23-aha-support-senate-bill-hospital-inpatient-services-modernization-act-2024">S. 4350</a><u>), extending the hospital-at-home waiver for five years through 2029.</u> The current waiver is set to expire Dec. 31, 2024.</p><p><strong>Protect America’s health care workers. </strong>Enactment of the <a href="/action-alert/2024-06-07-urge-congress-protect-health-care-workers-violence-passing-save-act">Safety from Violence for Healthcare Employees (SAVE) Act</a> (H.R. 2584/S. 2768) is a top priority for the AHA and the hospital field. This bipartisan bill would provide federal protections from workplace violence for hospital workers, similar to the protections in current law for airport and airline workers. <u>Urge your lawmakers to cosponsor the bipartisan SAVE Act.</u></p><h2>RESOURCES</h2><ul><li><a href="https://www.senate.gov/legislative/resources/pdf/2024_calendar.pdf">Senate</a> and <a href="https://www.majorityleader.gov/uploadedfiles/2024_house_calendar_-_one_page_-_revised_april_2024.pdf">House</a> 2024 calendars.</li><li><a href="/2024-03-01-congressional-site-visits-during-and-after">Congressional Site Visits</a>: Before, During and After — AHA’s comprehensive resource to help you and your staff plan a lawmaker’s visit.</li><li><a href="https://youtu.be/T-RlDRPzJCE">Video </a>of Bruce White, CEO of Knox Community Hospital in Ohio, describing his experience hosting a site visit.</li></ul><p>See AHA’s additional tips and best practices to enhance your advocacy <a href="/advocacy/2023-03-07-advocacy-tips-and-best-practices">here</a>.</p><h2>FURTHER QUESTIONS</h2><p><strong>To support your efforts to communicate effectively with lawmakers and their staff, visit the </strong><a href="/advocacy/action-center"><strong>AHA Action Center</strong></a><strong> for more resources on these issues and other priorities important to hospitals and health systems. </strong></p><p>If you have further questions, please contact AHA at 800-424-4301.</p></div><div class="col-md-4"><a href="/system/files/media/file/2024/09/action-needed-contact-lawmakers-on-important-issues-facing-hospitals-and-health-systems-9-30-2024.pdf" target="_blank" action alert><img src="/sites/default/files/2024-09/cover-action-needed-contact-lawmakers-on-important-issues-facing-hospitals-and-health-systems-9-30-2024.png" data-entity-uuid data-entity-type="file" alt="Cover Action Alert: ACTION NEEDED: Contact Lawmakers on Important Issues Facing Hospitals and Health Systems" width="NaN" height="NaN"></a></div></div></div> Mon, 30 Sep 2024 13:20:55 -0500 Hospital at Home