Policy Impact Analysis - 117/HR/7053

Bill Overview

Title: Hospital Inpatient Services Modernization Act

Description: This bill extends the Acute Hospital Care at Home Program under Medicare until two years after the end of the COVID-19 public health emergency (the program allows hospitals to treat certain patients from emergency departments or inpatient hospital beds at home during the emergency period). It also requires an evaluation of this program and the Hospital Without Walls program (the program allowed hospitals to transfer patients to outside facilities, such as hotels, to continue treatment during the emergency period).

Sponsors: Rep. Wenstrup, Brad R. [R-OH-2]

Target Audience

Population: Medicare beneficiaries who may receive inpatient services at home or alternative settings

Estimated Size: 5000000

• The bill impacts the Acute Hospital Care at Home Program and the Hospital Without Walls program, both of which are extensions or modifications to traditional hospital care.
• The primary target population is Medicare beneficiaries, specifically those who receive acute hospital care and would be treated at home or in alternative settings rather than traditional inpatient settings.
• According to the Centers for Medicare & Medicaid Services (CMS), Medicare beneficiaries totaled over 63 million people in recent reports.
• Not all 63 million Medicare beneficiaries will be impacted. A subset of beneficiaries who require acute hospital care and can be treated at home or alternative settings will be directly impacted.
• The program was specifically designed to accommodate situations like the COVID-19 public health emergency, thus the bill language implies impact on those in a similar emergency need context.
• Hospitalized patients who meet certain clinical criteria and are suitable for at-home or at-facility care pathways are direct beneficiaries.

Reasoning

• The Acute Hospital Care at Home Program and the Hospital Without Walls program primarily target Medicare beneficiaries who can be treated in home settings or alternative facilities instead of traditional inpatient settings.
• With an estimated 5 million potential beneficiaries under this policy, we need to include a range of interviews to reflect different impacts: those highly impacted by being eligible for home care, moderately impacted, and those not directly affected.
• Budget considerations limit the program size; in year 1 the $270M budget cannot cover all 5 million potential beneficiaries extensively, so the impact will vary based on eligibility and location.
• The policy's impact will vary based on factors such as individual health conditions, geographical proximity to eligible hospitals, and current living circumstances.
• Hospitalized patients who can benefit from home care due to suitable living conditions and fewer complications will likely see a more significant impact in wellbeing scores.
• It's critical to include interviews from widespread geographic regions and both urban and rural settings as accessibility to services varies.
• The current understanding is that the policy should extend personal choice and potential comfort for eligible care while easing hospital burdens, which may reflect in increased wellbeing if implementation is smooth.

Simulated Interviews

Cost Estimates

Key Considerations

• The need for hospitals to adapt technology solutions for remote patient monitoring can increase initial costs.
• Potential cost savings in reducing conventional hospital stays must be weighed against the infrastructure investments required for at-home care.
• The availability of alternative facilities (e.g., hotels) for patient transfer under the Hospital Without Walls program will influence overall costs.
• The programs benefit Medicare specifically, limiting the broader applicability of the budget impacts.