Flexibility for both hospitals and patients

The federal Acute Hospital Care at Home initiative was originally launched in 2020 during the COVID-19 pandemic to offer hospitals some flexibility and help free up inpatient beds for the sickest patients.

Since then, about 147 health systems with over 400 facilities and departments nationwide have been approved to participate, according to the Centers for Medicare and Medicaid Services.

Good candidates for the program include people with COVID-19, pneumonia, skin infections, issues related to congestive heart failure, urinary tract infections and other conditions that can be stabilized and managed, Ortega said.

At Virtua Health, enrolled patients are monitored 24/7 with devices that record their vital signs. Data is then transmitted in real time to Virtua’s command center in Pennsauken, which is staffed by nurses and other health providers.

Virtua Health’s Hospital at Home program is staffed by physicians, nurses and other providers who track patients’ health and provide care remotely, using video visits and remote monitoring equipment, from a command center in Pennsauken, New Jersey. Nurses and clinicians also visit patients in person in their homes. (Virtua Health)

In some ways, Ortega said providers can learn even more about their patients at home compared to those staying in the hospital.

“We can see when a patient of ours is improving day by day, because we have this flow of continuous vitals from this technology,” he said. “So, I can tell now that, say, Mrs. Smith is no longer short of breath when she’s been walking around in her own home.”

People receiving care at home also receive at least two daily in-person visits from registered nurses who can draw blood, administer intravenous medications and perform electrocardiograms and X-rays. Patients see a doctor at least once a day, either in person or remotely through telehealth.

The program has had some early success. A 2024 federal report found that patients treated at home had overall lower mortality rates compared to their counterparts treated at the hospital.

The study also found that hospital-acquired infections were lower among patients in hospital-at-home programs, including the one at Virtua Health.

“Whether they have less hospital acquired infections, they have less falls, they have less episodes of confusion, which a lot of elderly folks get in the hospital, all that is much less when they are cared for at home,” Kashyap said.