Nancy Gin, MD, FACP, leads a vibrant panel discussion for The Permanente Journal on the evolution, merits, and challenges of value-based care.
Stephen Parodi, MD, associate executive director of The Permanente Medical Group, commented on the impact of the impending expiration of a waiver granted by the Centers for Medicare & Medicaid Services (CMS) in a recent Healthcare Innovation article. According to Dr. Parodi and other physicians quoted in the article, losing the waiver, which provides acute care services in the home setting during the pandemic, could threaten innovative investments in hospital-at-home programs made by over 100 health systems.
Dr. Parodi discussed the need to extend the waiver, which expires after the COVID-19 public health emergency ends, to continue research that could inform a permanent framework for hospital-at-home programs throughout the country. He said that even though considerable research has been done on hospital-at-home programs in other countries, there’s a need to demonstrate success at scale in the United States.
“I think the big picture question is, ‘can this be done at a much larger scale?’ The waivers are kind of a patch,” said Dr. Parodi. “They allowed us to get off the ground. But you really are going to want a larger framework.” He added that an extension of CMS’ waiver can enable health systems to demonstrate what’s possible when it comes to both the quality and safety for patients, and that it could be taken to a larger scale considering the cost and affordability relative to a standard brick-and-mortar hospital.
Dr. Parodi also said that because hospital-at-home programs see people where they live, clinicians can more easily identify social issues impacting health care than they could with patients in the hospital setting.
“We’re at the ground level of actually developing a new part of the care delivery system, and we can deliberately weave in equity, inclusion, and diversity, which wasn’t the case with prior developments within the health care industry,” Dr. Parodi said.
Note: To read the entire article, visit the Healthcare Innovation website.