SHM Converge Scientific Abstract ePoster Gallery-Hospitalists at Home: An Alternative to Hospital Admission

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The document describes a “Hospital at Home” model designed and led by hospitalists to deliver advanced, hospital-level care safely in patients’ homes. It notes that while these models have existed in the U.S. for over 20 years, renewed interest has been driven by the push for value-based care, better technology, the pandemic, and CMS attention. Despite benefits such as lower readmissions, fewer hospital-acquired harms, higher patient satisfaction, and lower costs, widespread adoption has been limited by logistical complexity, supply chain challenges, workforce coordination, and payment barriers.<br /><br />The goal of the program is to scale a reliable model for hospitalists to provide high-quality acute care at home. The approach uses DispatchHealth’s existing in-home medical infrastructure to identify suitable patients and deliver care. The program relies on standardized protocols and centralized support to manage imaging, medications, oxygen, durable medical equipment, and skilled services like nursing and therapy.<br /><br />Reported value goals include avoiding unnecessary ED visits, hospital admissions, and post-acute facility use, while also improving patient and family experience, supporting goal-concordant care, and reducing deconditioning and hospital-acquired conditions.<br /><br />Outcomes reported include a 6% 30-day readmission rate, 6% escalation to the ED during the high-acuity phase, 0% unexpected mortality, intervention on at least one social determinant of health barrier in 67% of episodes, about $5,000 in medical cost savings per episode compared with brick-and-mortar admission, a patient NPS of 98, and PCP NPS of 100.<br /><br />The model launched in Denver in 2019 and has expanded to more than 50 U.S. markets. Growth accelerated substantially, with episode growth of 67% in 2021, 360% in 2022, and a projected 120% in 2023.

Asset Subtitle

Manuel J. Diaz

Meta Tag

Author List Lindsay McGuiness, Manuel J. Diaz, Megan Faga, Patrick P. Kneeland

Category Innovations

Concept Home-Based Acute Care

Concept Advanced Care at Home Program

Concept Traditional Hospital Admission

Concept Value-Based Care

Concept Management Challenges

Distinguished Finalist

Presenter Organization DispatchHealth

Presenting Author Manuel J. Diaz

Track Value in Hospital Medicine

Keywords

Hospital at Home

hospitalist-led care

acute care at home

value-based care

DispatchHealth

readmission rate

patient satisfaction

medical cost savings

social determinants of health

home-based hospitalization

Home-Based Acute Care

Advanced Care at Home Program

Traditional Hospital Admission

Value-Based Care

Management Challenges