Telehealth on hold: Acute Hospital Care at Home — a visionary program now on hold

The Acute Hospital Care at Home generally works well — and even may be visionary treatment for some patients. Now it’s on hold due to the expiration of flexibilities granted for payment under Medicare fee-for-service. Here is an explanation from Kyle Zebley, senior vice president, public policy of the American Telemedicine Association, and executive director of ATA Action, its advocacy affiliate.

Medical Economics: Regarding the Acute Hospital Care at Home program, why is that program so important for telehealth, and why is telehealth so important for that program?

Kyle Zebley: This program is extraordinarily important. It's an example of creative policymakers doing the exact right thing at the right time. This program allowed for patients that were on their recovery journey to open up a hospital bed, leave that hospital setting, get hospital-level care through the use of technology and hybrid care and some in-person visits from hospital health care teams. It gets them back home where they want to be, with their loved ones in the comfort of their own home, and allows for them to still receive clinically appropriate care. This is a visionary program that's the exact right direction that our healthcare system should be going. It opens up capacity, it increases patient satisfaction. It's done in a clinically appropriate way. What's not to like? But telehealth is intrinsic in the delivery of the program — synchronous video calls, remote physiologic monitoring devices, data that's produced by the patient that is being reviewed by the care team. It's done in hybrid care in a really effective way. So we think it's a very robust, appropriate program. We have over 400 participating hospitals in the program. It's worked. Unfortunately, we are in a situation now where it has been also, of course, caught up in these other broader dynamics that led to the shutdown of Medicare telehealth services. And like I had said, it's very cut and dry, the Office of Management and Budget has put forth guidance leading up to this shutdown, saying all patients need to either be discharged or brought back to a hospital setting effective 12:01 a.m., October 1. So it's a devastating impact for our community, and it's dragging us backwards prior to the onset of the pandemic, when all these positive advancements have been made and sustained.