What Congress’ New Healthcare Legislation Means for Contessa’s Care at Home

On Tuesday, long-awaited legislation that impacts healthcare at home in 2023 and beyond was unveiled by Congress. With the passage of the new omnibus spending package, Congress has taken another step to recognize the importance of the innovation in healthcare spurred by COVID-19, specifically around policies like the hospital-at-home model and the expanding use of telehealth.   

Here at Contessa, together with our parent company, Amedisys, Inc., we are proud to have unveiled our Comprehensive Care at Home model in 2022. This full continuum of care in the home sets the industry standard for this modality of care. And we’re thrilled to see that Congress agrees: supporting hospital-level care in the home and telehealth with this new legislation means more patients will have access to the high-quality care at home that they are increasingly demanding. 

A look at the new legislation and its impact 

There are two key parts of the new healthcare provisions in the omnibus bill that positively impact healthcare at home: an extension of Medicare’s hospital-at-home reimbursement for two more years, and an extension of the flexibilities around telehealth that were initiated during the COVID-19 pandemic.  

This gives further support to programs which Contessa has already proven are financially scalable, safe and effective. During the era of Medicare’s successful Hospitals Without Walls waivers, which were set to expire early next year if Congress had not acted, we fully realized a robust hospital-at-home program with Recovery Care at Home.  

This approach was an asset in bringing acute care home for patients grappling with overcrowded hospitals during the COVID-19 pandemic, such as Mount Sinai Health System in New York. With the support of the waiver, we launched our Completing Hospital at Home (CHaH) program, which brought stabilized patients home for the final 1-2 days of hospitalization. By pivoting to address this critical need, we could decant hospital beds during a time of unprecedented demand for inpatient beds.  

The new healthcare provisions are similarly poised to impact home-based medical care in some exciting ways: 

• Hospital at home reimbursement: when CMS announced the waiver program in 2020, they also indicated that there were at least 60 different acute conditions that could be treated at home. Contessa’s work with our hospital-level care at home partners has continued to illustrate that this potential indeed exists, with the result of reduced readmissions, low rates of care complications, and high patient satisfaction. Continued reimbursement will allow continued expansion of this model of care in the home.

• Telehealth flexibility: the pandemic accelerated access to telehealth services, creating a 63-fold increase in Medicare fee-for-service (FFS) utilization of telehealth. This included improved access to care for those whose social determinants of health (SDOH) make access to care, especially in rural areas, more challenging. Thanks to the ongoing support for telehealth backed by the omnibus bill, these services will continue to be readily available to patients. Organizations tasked with offering telehealth services in the home to their patient population will be looking for leaders in the field like Contessa to support their programs. 

Why did Congress move forward with this legislation? 

We’ve long been arguing that hospital-at-home has a bright future, with or without the CMS waiver program. This is attributable to the success we have seen in our hospital-at-home care and subsequent work with Medicare Advantage Plans to create a viable reimbursement structure. It is also reflected in our expansion beyond Recovery Care at Home to include strong offerings in Rehabilitation Care at Home, in lieu of skilled nursing facility care and Palliative Care at Home to support patients with complex chronic illnesses.  

Our partners and participating payers agree that these services improve outcomes, decrease costs, and that there is growing patient and provider demand for these models of care. With an aging population, as well as challenges in healthcare fragmentation at play, we see a future where Comprehensive Care at Home answers many challenges in the delivery of healthcare. A McKinsey & Company survey of providers predicted that $265 billion worth of Medicare services could move home by 2025 alone- in just the two years covered by provisions in this bill.  

All these factors contribute to a demonstrable need for exactly the kind of fiscal healthcare support of hospital-at-home programs outlined in the legislation. With Congress’ endorsement of hospital-at-home and telehealth, medical care at home is receiving the boost it needs to continue to grow as a viable solution to move healthcare forward in coming years and avert growing crises like the skilled nursing facility bed shortage. 

More work remains to be done 

As discussed above, the legislation tackles current challenges in funding hospital-at-home programs and remote care by extending the current programs for two years until December 31, 2024. There is more to be done as we move forward, however. Thanks to this vote of confidence from Congress, the foundation Contessa has built for healthcare at home with our Comprehensive Care at Home model can continue the challenging work of reshaping the future of healthcare. As we enter 2023, we are excited to be able to leverage our expertise to continue building high-quality, effective care at home.