The Centers for Medicare & Medicaid Services (CMS) has officially released comprehensive data from its Acute Hospital Care at Home (AHCAH) initiative, offering valuable insights into this innovative healthcare model. Starting January 16, 2024, this data, collected from November 27, 2020, through March 30, 2023, is accessible through the Research and Data Assistance Center (ResDAC). This release marks a significant step towards understanding the impact and scope of acute hospital care at home programs across the nation.
Understanding the Acute Hospital Care at Home Initiative
Launched in November 2020 during the peak of the COVID-19 pandemic, the Acute Hospital Care at Home (AHCAH) initiative was a response to the overwhelming challenges faced by traditional hospitals. Building upon the earlier “Hospital Without Walls” program, AHCAH allowed Medicare-certified hospitals to provide inpatient-level care to eligible patients within the comfort and safety of their own homes.
This innovative approach was made possible through waivers granted under section 1135 of the Social Security Act. These waivers temporarily adjusted certain Medicare regulations, specifically conditions of participation (CoPs) related to 24/7 on-site nursing services and immediate registered nurse availability in the hospital setting. Furthermore, physical environment and Life Safety Code requirements typically mandated for hospitals were also waived for care delivered in patients’ residences. It’s important to note that while some regulations were adjusted, hospitals participating in AHCAH remained accountable for upholding all health and safety standards not explicitly waived under the public health emergency authority.
Despite the official end of the COVID-19 public health emergency, the AHCAH initiative continues to operate. The Consolidated Appropriations Act, 2023, extended the waivers and flexibilities associated with AHCAH until December 31, 2024, demonstrating ongoing support for this care model.
Data Collection and Public Release via ResDAC
A crucial component of the Acute Hospital Care at Home initiative is the mandatory data reporting by participating hospitals to CMS. This data collection is essential for continuous monitoring of patient safety and program effectiveness. Hospitals submit data either weekly or monthly, depending on their participation level. The Consolidated Appropriations Act, 2023, further mandated specific data collection to facilitate in-depth studies analyzing various aspects of the AHCAH program.
Now, this wealth of data is being made available to the public. Researchers, healthcare analysts, and policy experts interested in delving into the details of acute hospital care at home can request access through ResDAC. The initial data release covers the period from November 27, 2020, to March 30, 2023. CMS anticipates a subsequent data release in 2025, incorporating data collected until the current AHCAH extension concludes on December 31, 2024. The future of the AHCAH initiative beyond 2024 will depend on further action from Congress.
Key Data Points for Analysis
The released dataset includes critical metrics for evaluating the AHCAH program. These data points encompass:
- New Patient Admissions: The number of patients newly admitted to receive acute-level care in the home setting.
- Patient Care Escalations: Instances where patients initially receiving care at home required transfer back to a traditional inpatient hospital setting for a higher level of care.
- Unanticipated Patient Mortality: Data on patient deaths that occurred during the period of hospitalization, including those whose care was escalated to a traditional hospital setting (excluding patients in hospice or palliative care).
Beyond these core metrics, the data release also incorporates claims aggregation and patient eligibility information for Medicare Fee-for-Service and non-managed-care Medicaid beneficiaries who have received acute home care through the AHCAH initiative. This comprehensive dataset offers a rich resource for experts to extract clinically significant and policy-relevant insights into this evolving care delivery model. Notably, the AHCAH initiative represents a pioneering payment model for this level of care within Medicare Fee-for-Service and non-managed-care Medicaid systems.
To facilitate effective utilization of this valuable data, CMS will also provide a user’s guide alongside the dataset. This guide will assist researchers in navigating the data and conducting thorough analyses.
For detailed information and to access the data, please visit the Research and Data Assistance Center (ResDAC) and explore the available resources. https://www2.ccwdata.org/web/guest/data-dictionaries.
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