Decreased imaging use among perks of CMS’ at-home inpatient care expansion, hospitals say

CMS recently granted hospitals expanded leeway to care for Medicare patients outside of their facilities, in a bid to free up capacity during the pandemic. But some note that this flexibility could have the added effect of reducing spending on imaging and other services.

The Centers for Medicare and Medicaid Services first announced its Acute Hospital Care at Home program on Wednesday, Nov. 25, granting “unprecedented regulatory flexibilities” to the field. Under the effort, eligible providers would be able to treat more than 60 different acute conditions—including congestive heart failure, pneumonia and COPD—in a home setting.  

Both the American Hospital Association and Mass General Brigham praised the announcement on Wednesday. The latter said it has almost five years of experience providing such acute services, producing a 40% lower cost of care, including a decreased use of radiology services.

“Coverage of home hospital services is an incredibly important step to help bring safe, convenient, and cost-effective care to our patients’ homes,” Gregg Meyer, MD, executive VP of value based care at the Boston-based institution said in a statement. “It is an essential part of our system’s work in value-based care and this coverage decision will accelerate our ability to deliver these services to our patients and our communities.”

The Brigham backed its claim with a study published last year in the Annals of Internal Medicine. In a randomized control trial that included 91 adults—with 48 treated in a hospital—a median of 14% required imaging in the home-based population, compared to 44% in the control group.

CMS’ recent action builds upon its Hospitals Without Walls first launched in March as the pandemic took hold. The agency noted that Medicare beneficiaries will only be admitted from ED and inpatient hospital beds, and an in-person physician evaluation is required beforehand.

It’s launched an online portal to streamline waiver requests, and already granted them to six health systems. Those include Brigham and Women’s, the Huntsman Cancer Institute in Utah, Massachusetts, General, Mount Sinai in New York city, Presbyterian Healthcare Services in New Mexico, and UnityPoint Health in Iowa.