SHM Converge Scientific Abstract ePoster Gallery-Physician Advisors Navigating Evolving Inpatient Landscape: Hospital at Home

Pdf Summary

Hospital at Home is an innovative care model that expanded during the COVID-19 era, especially after CMS authorized the Acute Hospital Care at Home initiative in 2020. Kent Hospital, working with major insurers and CMS, became a Rhode Island pioneer by delivering inpatient-level care in patients’ homes.<br /><br />The physician advisor plays a central role in this program. Their main responsibility is determining which patients truly need acute hospital-level care and which can safely transition to home care. Because the line between inpatient and outpatient care is less clear in this setting, physician advisors also help manage denial cases, including peer-to-peer reviews and decisions about appeals.<br /><br />Patient selection is critical. The program recruits patients early, often in the emergency room, to reduce hospital crowding and improve throughput. Eligible patients must have a safe home environment, reliable support from family or friends, and the ability to move around without high fall risk. At first, the diagnosis list was kept narrow and the service area localized to ensure patient safety and quick return to the hospital if needed.<br /><br />Physician advisors and the Hospital at Home team conduct daily multidisciplinary rounds to review eligibility and care level decisions. The program has shown strong outcomes, including an extremely low emergent readmission rate of under 1%, lower post-discharge readmissions than traditional hospitals, and similar lengths of stay. Reported safety outcomes are also favorable, with no mortalities or serious adverse events and only four falls, none causing injury.<br /><br />The program has been successful enough to expand its diagnosis list and explore broader insurance contracts, though insurance eligibility remains a major limitation. In 2022, about one-third of medically eligible patients could not participate because their insurance did not qualify.

Asset Subtitle

Erin Hogan

Meta Tag

Author List Erin Hogan, Yayra Musabek

Category Innovations

Concept Physician Advisor

Concept Eligibility

Concept Home-Based Acute Care

Concept Patient Selection Criteria

Concept Level of Care

Distinguished Non-Finalist

Presenter Organization Kent Hospital, Care New England

Presenting Author Erin Hogan

Track Other

Keywords

Hospital at Home

Acute Hospital Care at Home

CMS authorization

physician advisor

patient selection

inpatient-level care

peer-to-peer review

daily multidisciplinary rounds

readmission rates

insurance eligibility

Physician Advisor

Eligibility

Home-Based Acute Care

Patient Selection Criteria

Level of Care