Hospital at Home
Today’s Hospitalist, By Phyllis Macguire, August 2018
FOR THE PAST FIVE YEARS, Per Danielsson, MD, the executive medical director for Swedish Hospital Medicine in Seattle, has been on what he admits has been a “quixotic” and very frustrating quest.
What windmill does he keep tilting at? The fact that traditional Medicare and most private insurers won’t pay for hospital at home services. Dr. Danielsson first proposed launching a hospital at home program at Swedish in 2013. But even though several Swedish campuses are at capacity and even boarding ED patients in the winter, his market has very little capitated care.
And while he has read all the studies that indicate hospital at home produces better outcomes, “there is no payment mechanism in the fee-for-service world,” he points out. “You can make all the clinical arguments you want. But if there’s no payment, it’s not going to fly.”