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Stephen Parodi, MD, tells KevinMD many Americans will lose access to acute care at home services unless Congress acts


Unless Congress passes bipartisan legislation already introduced in both the House and the Senate, many in the United States will lose access to vital health care services in just a few short months, Stephen Parodi, MD, wrote in a recent opinion piece on KevinMD.

Dr. Parodi, executive vice president of External Affairs, Communications, and Brand for The Permanente Federation, wrote that Sens. Tom Carper (D-Del.) and Tim Scott (R-S.C.) and Reps. Earl Blumenauer (D-Ore.) and Brad Wenstrup (R-Ohio) have introduced the Hospital Inpatient Services Modernization Act, which extends for at least 2 years waivers allowing patients with acute illnesses to receive hospital-level care at home.

Dr. Stephen Parodi
Stephen Parodi, MD

The waivers are set to expire at the end of the COVID-19 public health emergency, most recently extended to July 15. More than 100 health care organizations have urged lawmakers to pass the bill.

“Since the waivers were instituted by the Centers for Medicare & Medicaid Services 2 years ago, more than 200 programs in 34 states have delivered high-quality, hospital level care in the homes of patients with serious conditions like congestive heart failure, strokes, and pneumonia,” wrote Dr. Parodi, who also serves as associate executive director of The Permanente Medical Group. “Acute care at home has been lifesaving for non-COVID patients when inpatient beds were full. It is a safe and viable care option, giving patients more flexibility in how and where they are treated.”

Patients who want or need to stay home could continue to access the same specialized care using a mix of telehealth and in-person visits, with constant monitoring and individualized care plans that meet patients’ needs and preferences, minimizing disruption to their family life.

Several leading health care organizations view the waivers as an opportunity to increase the equity of care they deliver within their integrated systems. “Many patients in acute-care-at-home programs live in underserved rural or urban communities or face transportation challenges that make a trip to the hospital less likely for the patient and their families,” Dr. Parodi wrote. “If Congress allows the waivers to expire, the most vulnerable among us would be again, disproportionately impacted.”

While data suggest patients are safer and achieve better outcomes with in-home hospital care, Dr. Parodi said in a subsequent interview on The Podcast by KevinMD that the proposed legislation is important because “it pushes CMS (Centers for Medicare & Medicaid Services) to do studies to look at the efficacy, the cost-effectiveness of the programs, the safety of these programs, and we definitely need more data.”

Note: Read the full blog post on the site, and listen to Dr. Parodi in conversation with Kevin Pho, MD, at The Podcast by KevinMD.

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