Special Report: Five Successful Case Studies and Strategies in Hospital-at-Home Best Practices Friday September 19, 2025

 

5 Successful Case Studies and Strategies in Hospital-at-Home Best Practices

Situation

1. Momentum for U.S. Hospital-at-Home (HaH) remains strong as policymakers consider a multi-year extension: a current AHA brief summarizes CMS’ 2024 study (lower mortality, lower HACs) and active legislation to extend the waiver through 2030 — https://www.aha.org/fact-sheets/2024-08-06-fact-sheet-extending-hospital-home-program (aha.org)

2. CMS released its “Acute Hospital Care at Home Data Release Fact Sheet” detailing data from Nov 2020 through Mar 2023: number of home admissions, escalations, and unanticipated mortalities — https://www.cms.gov/newsroom/fact-sheets/acute-hospital-care-home-data-release-fact-sheet (cms.gov)

Background

1. Evidence over the last year reinforces HaH’s safety and experience benefits: the data release shows most HaH patients are treated under MS-DRGs for respiratory, circulatory, renal, and infectious disease conditions; beneficiary/caregiver experience was positive overall, though some differences in patient selection were observed. — https://www.cms.gov/newsroom/fact-sheets/acute-hospital-care-home-data-release-fact-sheet (cms.gov)

2. Programs increasingly use a hybrid model (in-home nurse/paramedic + virtual hospitalist + remote monitoring + rapid lab/pharmacy/ imaging) as detailed in the AHA market scan and lessons-learned pieces. — https://www.aha.org/aha-center-health-innovation-market-scan/2025-07-29-how-4-providers-successfully-launched-hospital-home-programs (aha.org)

Action (What leading systems are implementing now)

1. Stand up hybrid HaH models with twice-daily in-home clinical visits, daily virtual MD, continuous remote monitoring, rapid lab / imaging logistics — https://www.aha.org/aha-center-health-innovation-market-scan/2025-07-29-how-4-providers-successfully-launched-hospital-home-programs (aha.org)

2. Define standardized success metrics & eligibility criteria, as Cleveland Clinic has emphasized in its HaH implementation approach — https://www.beckershospitalreview.com/healthcare-information-technology/telehealth/definitions-matter-cleveland-clinics-approach-to-hospital-at-home/ (beckershospitalreview.com)

3. Use scaling playbooks that include technology platforms, logistics support, 24/7 clinical backup, and rapid escalation capacity — e.g. Mass General Brigham’s operational model — https://currenthealth.com/insights/studies/mass-general-brigham-case-study/ (currenthealth.com)

Results — Five U.S. Case Studies (all within the last 12 months)

1. Advocate Health (multi-state) — In 2024, HaH participants had a readmission rate of 0.93 vs 1.09 for comparable inpatient stays; patient satisfaction significantly higher; eligibility based purely on clinical appropriateness — https://www.aha.org/aha-center-health-innovation-market-scan/2025-07-29-how-4-providers-successfully-launched-hospital-home-programs (aha.org)

2. Mass General Brigham (MA) — Scaled HaH large-scale; 25,000+ bed-days saved, readmissions lower than inpatient care, no unexpected mortality reported in latest reporting period — https://currenthealth.com/insights/studies/mass-general-brigham-case-study/ (currenthealth.com)

3. Ohio State University Wexner Medical Center (OH) — HaH program achieved 6.5% readmissions in FY2024 and 9.2% in FY2025 among participants vs >15% in eligible but non-participating patients; 95% satisfaction — https://www.aha.org/aha-center-health-innovation-market-scan/2025-07-29-how-4-providers-successfully-launched-hospital-home-programs (aha.org)

4. Cleveland Clinic Florida (FL) — Retrospective acute heart failure HaH vs inpatient showed 30-day readmissions 12.4% vs 16.9%; 84% stayed entirely at home without escalation; high patient acceptance — https://consultqd.clevelandclinic.org/hospital-at-home-care-model-shown-safe-and-effective-in-heart-failure-management (consultqd.clevelandclinic.org)

5. Mayo Clinic (multi-site) — 2025 pragmatic RCT of hybrid HaH model: met non-inferiority vs brick-and-mortar for composite 30-day mortality/readmission; patient comfort 84.4% vs 60.9% inpatient — https://pubmed.ncbi.nlm.nih.gov/40400147/ (pubmed.ncbi.nlm.nih.gov)

Quality Metrics From These Case Studies

1. Advocate Health HaH readmission rate: 0.93 vs 1.09 inpatient baseline.

2. Mass General Brigham: 25,000+ bed-days saved; zero unexpected mortality in reporting period.

3. OSU Wexner: 6.5% / 9.2% readmissions (FY2024 / FY2025) vs >15% among eligible non-participants; patient satisfaction ~95%.

4. Cleveland Clinic Florida HF HaH: 30-day readmissions 12.4% vs 16.9%, 84% of patients stayed entirely at home without escalation.

5. Mayo Clinic RCT: composite mortality/readmission non-inferior; patient comfort ~84.4% vs ~60.9% inpatient.

6. From CMS Data Release: for many top MS-DRGs, 30-day Medicare post-discharge spending lower among AHCAH episodes vs brick-and-mortar inpatient episodes. — https://www.cms.gov/newsroom/fact-sheets/acute-hospital-care-home-data-release-fact-sheet (cms.gov)

7. AHA/AHCAH uptake: 366 hospitals participating as of late 2024, over 31,000 patients treated in home settings. — https://www.cms.gov/blog/lessons-cms-acute-hospital-care-home-initiative (cms.gov)

Leadership Project Plan (example dates assuming kickoff Monday, September 22, 2025)

1. Week of Sep 22, 2025 — Executive sponsor confirmed; define diagnoses for HaH pilot (respiratory, renal, infectious disease); establish eligibility criteria; legal/payer requirements review utilizing CMS AHCAH data release and CMS blog “Lessons.” — https://www.cms.gov/blog/lessons-cms-acute-hospital-care-home-initiative (cms.gov)

2. Week of Sep 29, 2025 — Design clinical model: hybrid in-home + virtual MD; RPM vendor selection; partner with lab/pharmacy/transport; build escalation / transfer protocols.

3. Week of Oct 6, 2025 — IT/EHR integration: orders, alerts, monitoring dashboards; staff training; simulate workflows (home admissions, visits, escalation).

4. Week of Oct 13, 2025 — Pilot launch: one region, limited diagnoses (e.g., respiratory, infectious); enroll small daily census; monitor patient experience and safety.

5. Week of Oct 20, 2025 — Analyze pilot outcomes: readmission rates, mortality, patient satisfaction, cost vs inpatient; refine eligibility, support logistics.

6. Week of Oct 27, 2025 — Scale to second region; extend diagnoses; optimize operational infrastructure (transport, supply, staffing).

7. Week of Nov 3, 2025 — Share results with board / payers; advocate waivers extension (if needed); publish early outcomes; plan for full HaH program integration.

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📍 Published at National Daily Hospital News

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