Hospitals Without Walls Waivers are Working. Let’s Make Them Permanent.

For years, healthcare slowly marched into the future. Telehealth and alternative sites of care steadily gained acceptance and improved experiences, outcomes, and bottom lines, but failed to break into the mainstream. That changed in 2020 and the march became a sprint. 

The COVID-19 pandemic limited hospital beds and in-person care meant risking disease transmission. Acute care delivery in the home transitioned from an advancement into a necessity. 

Needing to act quickly, The Centers for Medicare and Medicaid Services (CMS) introduced Hospitals Without Walls in March of 2020, allowing healthcare systems to provide services in locations beyond their existing walls. Today, the waivers have helped nearly eighty health systems expand where they can provide care.  

In November 2020, the agency went a step further and announced that it would cover hospital-level care at home for Medicare fee-for-service patients at approved sites, giving roughly 38 million beneficiaries the opportunity to receive hospital-level care at home. This launched healthcare into the future, benefitting patients, providers, and payers alike, and it’s a future from which we can’t turn back. Now, we must embrace it and bring government policy in line with the realities of care. 

Patients have overwhelmingly embraced hospital-level care at home. Contessa’s partners across markets report an opt-in rate of 90 percent and an average patient satisfaction rate of more than 90 percent. And once patients start acute in-home care, the story gets even better: improved outcomes, a comfortable care environment and, ultimately, significant cost savings. 

The benefits go beyond patients. Providers have noted this change created a healthier work environment, while administrators appreciated the cost savings of the evolved model. Healthcare providers have proven to be among our most essential workers, and hospitals are crucial community institutions. Their collective continued wellbeing is vital to the health of our nation. 

While there’s tremendous upside to making these waivers permanent, the downside to inaction may be even greater. We know patients, to a degree, are now well-accustomed to staying home. Patients (dare we say, consumers) now expect goods and services to be conveniently available. If hospitals cannot innovate and evolve to meet patients where they are, it can lead to diminished population health, poor outcomes, and more expensive care. 

We’ve laid the groundwork and the need for this type of care has been proven to still exist ongoing. Now, let’s build upon that success and make these regulatory changes permanent, allowing healthcare systems to provide their patients with acute care at home when practical and necessary. Anything less would turn back the monumental progress we’ve achieved in the last year and defy the will of patients and providers alike. 

Editor’s note: This post has been adapted to reflect the landscape as of October 2021 and reposted to emphasize its timeliness and importance.