Hospital at Home (HaH) is a health services innovation that delivers essential components of hospital inpatient services to select patients in their residence. This article provides a payer view of two payment models currently operating for HaH programs. Assuming payers use the Medicare reimbursement framework, we show how the bottom-up model costs payers significantly less than the top-down model, predominantly driven by lower acute reimbursement. Our analysis for the top-down model is based on the corresponding Medicare diagnosis-related-group inpatient payment, while the bottom-up approach relies on the Medicare home-health-related-group payment for home care.
The supplemental appendices for this report are available here.
This report was commissioned by AccentCare.
Hospital at home: Should payment models focus on the hospital or the home?
With hospital-at-home services, we found the bottom-up model cost payers about $7,000 less per episode than a top-down approach, assuming Medicare-like rates