Health
Home hospital care brings ‘phenomenal’ benefits to patients and providers, study finds
A growing number of patients and providers are heralding the benefits of bringing hospital care into private homes — but a lack of permanent federal funding could put such programs at risk.
The shift to in-home care began with the onset of COVID in March 2020, when the Centers for Medicare and Medicaid Services (CMS) launched its Acute Hospital Care at Home waiver program in response to a shortage of beds.
The program enables hospitals to receive the same reimbursement for home care as they would for patients who are treated in actual facilities.
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Since the program’s launch, hundreds of hospitals in 37 states have implemented home care for thousands of patients.
One of those is the Mass General Brigham (MGB) network in downtown Boston, which launched its Healthcare at Home program in 2016.
A growing number of patients and providers are heralding the benefits of bringing hospital care into people’s homes, though a lack of permanent federal funding could put such programs at risk. (Mass General Brigham)
MGB’s Home Hospital is one of the largest in the country, serving 66 neighborhoods from five of its facilities.
Since its launch, the program has had over 2,400 home hospital admissions, translating to more than 12,700 acute care bed days saved, according to a press release from the hospital.
Dr. Stephen Dorner, chief clinical and innovation officer at MGB Healthcare at Home, talked to Fox News Digital about the program’s growth and goals, as well as the benefits for patients and providers.
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“In January 2022, we had an average census of nine patients — today, we have an average census of 36 patients with an overall capacity for 40,” he said in a Zoom interview.
“We will continue to grow that in the months and years ahead until we ultimately shift at least 10% of current inpatient volume out of hospitals and into patients’ homes.”
Dorner sees home-based care as a viable solution for the “massive capacity crisis” facing the nation’s hospitals.
Patients are “more willing to accept home hospital care because they spend so much time dealing with their chronic illness and they’d like to be able to spend more time at home,” said one doctor. (Mass General Brigham)
“Health care just costs too much money,” he said. “And especially as we look at the aging baby boomer generation and the amount of care they’re going to need — particularly as longevity increases — we have to find new, lower-cost ways to do things.”
The ability to deliver acute inpatient care in people’s homes is a “phenomenal” way to improve overall access to care and reduce medical costs, Dorner noted.
Patients’ demand for home care
While home hospital care isn’t for everyone, many patients are more than willing to receive it.
“The patients who are most willing to accept home hospital care are those who are most in tune and aware of what their medical needs are,” Dorner told Fox News Digital.
“Health care just costs too much money … We have to find new, lower-cost ways to do things.”
That typically includes patients with chronic conditions that may lead to frequent hospitalizations, such as heart failure or chronic obstructive pulmonary disease, he noted.
“They’re more willing to accept home hospital care because they spend so much time dealing with their chronic illness and they’d like to be able to spend more time at home,” the doctor said.
MGB has also had “great success” in admitting patients with new, acute issues that they’ve never dealt with before, such as cellulitis, kidney infection or pneumonia, Dorner added.
The corporate offices of Massachusetts General Brigham hospitals is pictured in Assembly Square in Somerville, Massachusetts, on Jan. 27, 2022. Mass General Brigham launched its Healthcare at Home program in 2016. (Getty Images)
“Folks want to have the creature comforts of being in their own bed, eating their own food, petting their dog as they’re recovering, being able to have loved ones come and visit, and not having to trek into the city and pay for parking and all of those things,” he said.
Patients enjoy the personalized nature of in-home care, Dorner also said.
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“About 60% to 70% of our visits are actually conducted in the home, not virtually,” he said. “So we’re sending physicians, nurse practitioners and physician assistants into the homes of our patients to be able to see them firsthand, which gives them a unique vantage point of understanding the patients’ home environment.”
He added, “Many of the patients tell us they never want to receive hospital-based care again. They want to know how they can get all of their care from the comfort of their own home.”
“The patients who are most willing to accept home hospital care are those who are most in tune and aware of what their medical needs are,” the chief clinical and innovation officer at MGB Healthcare at Home told Fox News Digital. (Mass General Brigham)
The program also has the potential to alleviate provider burnout.
“We’ve heard from our clinicians that the time they spend in home hospital care delivery is among the most meaningful encounters they’ve had in their entire careers,” Dorner said.
That doesn’t mean that all care can be brought into the home, however.
“We’re not building ICUs in the home, and we’re not looking to conduct surgeries in anybody’s living room,” Dorner said.
“But in the right conditions, we’d like to be able to build a complement in the home-based environment.”
“We’re not building ICUs in the home, and we’re not looking to conduct surgeries in anybody’s living room.”
Dr. Shana Johnson, a physical medicine and rehabilitation physician in Scottsdale, Arizona, also voiced her support of the home hospital model.
“With appropriate patient selection, acute hospital care at home is an important care model to continue,” said Johnson, who is not involved with MGB’s program or research.
Researchers found that the patients who received home care had low rates of mortality (0.5% during hospitalization and 3.2% at 30 days). (Mass General Brigham)
“For certain medical conditions, the quality of care and outcomes appear equal to or better than in-hospital care,” she added.
“In particular, some studies have found fewer complications from inactivity, such as pressure sores, reduced need for skilled nursing facilities, and lower hospital readmission rates.”
Proven benefits
To measure the outcomes of its Home Hospital program, MGB researchers recently conducted a study that was published in Annals of Internal Medicine.
The team analyzed the outcomes of 5,858 U.S. patients who received home hospital care between July 1, 2022, and June 30, 2023.
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The patients in the study had “medically complex conditions,” including 42.5% with heart failure, 43.3% with chronic obstructive pulmonary disease, 22.1% with cancer and 16.1% with dementia, the researchers noted.
The five most common discharge diagnoses were heart failure, respiratory infection (including COVID), sepsis, kidney/urinary tract infections and cellulitis.
The researchers found that the patients who received home care had low rates of mortality (0.5% during hospitalization and 3.2% at 30 days). Only 62.2% of them were “escalated” to the hospital.
Within 30 days of discharge, 2.6% of patients used a skilled nursing facility and 15.6% were readmitted, the MGB researchers found. (iStock)
Within 30 days of discharge, 2.6% used a skilled nursing facility and 15.6% were readmitted, numbers the researchers described as lower than expected.
“Home Hospital is serving very complex and acutely ill patients — these are not ‘cherry-picked’ patients,” study co-author David Michael Levine, M.D., clinical director for research and development for MGB’s Healthcare at Home, told Fox News Digital.
“This is the first time we’ve been able to show the true complexity and acuity of patients cared for in this model on a national basis.”
The researchers also concluded that Home Hospital delivers “equitable care across traditionally underserved populations,” Levine said.
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“We know that traditional hospital care has large disparities in outcomes across underserved groups, and we don’t see that with Home Hospital.”
Johnson, who reviewed the findings of MGB’s study, said she found them to be consistent with previous research.
“This study of acute hospital care at home showed low rates of mortality, hospital escalation and skilled nursing facility use,” she told Fox News Digital. “These positive outcomes were seen for socially vulnerable patients as well.”
Providers are concerned that the Acute Hospital Care at Home program is still a temporary payment mechanism, as the waiver is set to expire in Dec. 2024. (iStock)
The study was limited, however, as it was based on observational data and did not have the capability to compare the numbers to in-hospital patients.
“Comparing home hospital patients to traditional hospital patients takes a lot of additional research,” said Levine. “We wouldn’t want to compare home hospital patients to, say, surgical patients or labor and delivery patients.”
He added, “If you simply look at all hospitalizations, yes, these numbers are better — but that is not a worthwhile comparison. We are currently undertaking this more advanced analysis.”
Barriers to home hospital care
Providers are concerned that the Acute Hospital Care at Home program is still a temporary payment mechanism.
The waiver is set to expire in Dec. 2024 unless Congress takes action to extend it or make it permanent.
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“A permanent payment mechanism is critical in order for more people to have access to Home Hospital care,” Levine told Fox News Digital.
“We wanted to conduct this national analysis so there would be more data for policymakers and clinicians to make an informed decision about extending or even permanently approving the waiver to extend opportunities for patients to receive care in the comfort of home.”
The shift to in-home care began with the onset of COVID in March 2020, when the Centers for Medicare and Medicaid Services launched its Acute Hospital Care at Home waiver program in response to a shortage of beds. (iStock)
When contacted for comment, the American Hospital Association (AHA) provided a statement.
“Emerging evidence suggests hospital care at home is safe, effective and useful to many patients. The AHA supported last year’s congressional extension of the regulatory flexibilities that have enabled hospitals to continue their hospital at home programs, and is working to ensure this innovative model of care remains available to patients and communities.”
Fox News Digital reached out to the Centers for Medicare and Medicaid Services (CMS) requesting comment on the potential extension of the Acute Hospital Care at Home waiver program.
For more Health articles, visit www.foxnews.com/health.
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A potentially deadly disease known as “the white plague” has been rising in the U.S. since the pandemic, health officials have warned.
Tuberculosis (TB) gets its nickname from the pale appearance of those affected with the disease.
After a dip in 2020 with the onset of COVID – likely due to underdiagnosis and reduced screenings, according to health experts – cases of TB have increased every year since.
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More than 10,600 cases were confirmed in 2024, which is around three people for every 100,000, per the latest available data from the Centers for Disease Control and Prevention.
This marks the third consecutive annual increase, and the total 2024 case count is the highest annual number since 2013.
After a dip in 2020 with the onset of COVID, cases of tuberculosis have increased every year since. (iStock)
Despite the recent increase, TB rates in the U.S. remain relatively low compared to many parts of the world, as the global average is about 131 cases per 100,000, per the World Health Organization. That’s approximately 40 times higher globally compared to the U.S.
TB is a curable bacterial infection that targets the lungs, but can also infect other organs, according to Johns Hopkins. It is spread through airborne particles released when an infected person coughs, speaks or sneezes.
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Renuga Vivekanandan, M.D., professor at Creighton University School of Medicine and VP and CMO of CHI Health Physician Enterprise Midwest, said the rise in tuberculosis cases in the U.S. is concerning, but noted that it was foreseeable.
“The COVID-19 pandemic effectively disrupted TB surveillance and treatment programs across the country,” the doctor, who is board-certified in internal medicine and infectious diseases, told Fox News Digital.
TB is a curable bacterial infection that targets the lungs, but can also infect other organs, according to Johns Hopkins. (Getty)
“What we’re seeing now is largely a rebound effect – latent TB infections that went undetected or untreated during the pandemic are now activating.”
Another factor is a return to international travel and increased migration from countries where TB is more prevalent, according to Vivekanandan.
The uptick has also strained healthcare systems. “Local and state public health TB programs became understaffed during the pandemic, and that capacity hasn’t fully recovered,” the doctor said.
Symptoms of disease
While around 25% of people have likely been infected with the TB bacteria, about 5% to 10% will go on to develop active disease, according to health agencies.
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A person with a latent infection has been infected with the tuberculosis bacteria, but the bacteria are inactive in the body. While latent-stage TB is not contagious, it can develop into active disease in 5% to 10% of people.
Only people with active TB disease in the lungs or throat can spread the infection.
While around 25% of people have likely been infected with the TB bacteria, about 5% to 10% will go on to develop active disease. (iStock)
Those who get sick with TB may experience mild symptoms, including coughing, chest pain, fatigue, weight loss, weakness, fever and night sweats, per the CDC. In some cases, however, the disease can also affect the kidneys, spine, skin and brain.
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“TB can affect any organ of the body, but it causes disease in the lung in over 80% of cases,” Masae Kawamura, M.D., a former TB control director in San Francisco and a tuberculosis clinician, previously told Fox News Digital. “This is dangerous because it causes cough, the mechanism of airborne spread.”
“TB can affect any organ of the body, but it causes disease in the lung in over 80% of cases.”
In more severe cases, patients may cough up blood, noted Kawamura, who serves on the board of directors of Vital Strategies, a global public health organization.
“Often, there are minimal symptoms for a long time, and people mistake their occasional cough with allergies, smoking or a cold they can’t shake off,” she added.
Risk factors, treatment and prevention
“The good news is that TB is both preventable and treatable,” Vivekanandan said.
“People who are at higher risk – including those born in or traveling frequently to high TB-burden countries, individuals living in crowded conditions, or those who are immunocompromised – should speak with their doctor about TB testing.”
“People who are at higher risk – including those born in or traveling frequently to high TB-burden countries, individuals living in crowded conditions, or those who are immunocompromised – should speak with their doctor about TB testing,” one doctor noted. (iStock)
Other high-risk groups include people who have diabetes, are malnourished, use tobacco and/or drink excess amounts of alcohol. Babies and children are also more vulnerable to the disease.
Doctors typically use a skin or blood test to detect TB infection, followed by imaging or sputum (mucus) testing to confirm active disease, per the CDC.
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The disease is treated with antibiotics that are taken every day for four to six months, the CDC states. Some of the most common include isoniazid, rifampicin, pyrazinamide and ethambutol.
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Failure to take the complete course of medications can cause the bacteria to become drug-resistant, which means it does not respond to standard antibiotics. Drug-resistant TB is more difficult and costly to treat and requires longer, more complex medication regimens, according to experts.
If TB goes untreated, it is fatal in about half of its victims.
“Latent TB, which causes no symptoms and is not contagious, can be treated and cured before it ever progresses to active TB, which is infectious,” the doctor pointed out. (iStock)
“Latent TB, which causes no symptoms and is not contagious, can be treated and cured before it ever progresses to active TB, which is infectious,” Vivekanandan said.
“Identifying and treating latent infection is one of the most powerful tools we have for protecting both individual patients and the broader community.”
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The U.S. Preventive Services Task Force recommends screening only for populations at increased risk rather than for the general population.
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For women struggling with weight gain after menopause, a new study suggests that adding hormone therapy to a popular obesity drug may lead to greater weight loss.
Postmenopausal women lost about 35% more weight when using menopausal hormone therapy alongside tirzepatide — a GLP-1-based, Food and Drug Administration-approved drug for the overweight and obese — compared to those taking the drug alone, according to a Mayo Clinic study.
The findings, published in February in The Lancet Obstetrics, Gynaecology, & Women’s Health, highlight a possible new strategy for addressing weight gain after menopause, when hormonal shifts can increase the risk of obesity, cardiovascular disease and Type 2 diabetes.
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“This study provides important insights for developing more effective and personalized strategies for managing cardiometabolic risk in postmenopausal women,” Dr. Regina Castaneda, the study’s first author, said in a statement.
A new study found that postmenopausal women lost more weight when combining hormone therapy with a GLP-1-based drug. (iStock)
Researchers analyzed 120 postmenopausal women who were overweight or obese who took tirzepatide for at least 12 months, including 40 who also used hormone therapy and 80 who did not.
Hormone therapy is commonly used to treat menopause symptoms like hot flashes and night sweats, while tirzepatide helps regulate appetite and blood sugar.
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Women in the hormone therapy group lost an average of 19.2% of their body weight, compared to 14.0% in the non-hormone group — about 35% greater relative weight loss — with more women reaching significant weight-loss thresholds, according to the study.
Despite the results, researchers emphasized that the study was observational and cannot prove cause and effect.
Hormonal changes after menopause can increase weight gain and health risks. (iStock)
“Because this was not a randomized trial, we cannot say hormone therapy caused additional weight loss,” said Dr. Maria Daniela Hurtado Andrade, an endocrinologist at Mayo Clinic and senior author of the study.
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Outside experts agree that the findings must be interpreted cautiously.
“As with all observational studies, we need to interpret this study with a grain of salt,” Dr. Gillian Goddard, a board-certified endocrinologist, told Fox News Digital.
Goddard, who is also an adjunct assistant professor of medicine at the NYU Grossman School of Medicine, noted that the findings show a link but do not prove that hormone therapy, which usually includes estrogen, directly caused the additional weight loss.
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“There may be important differences between the two groups,” she added. “For one thing, the group taking estrogen may be healthier than the groups that didn’t take estrogen. … Healthier people are more likely to eat a healthy diet and exercise in addition to taking tirzepatide. That could lead to more weight loss.”
Tirzepatide, a GLP-1-based drug, may be more effective for weight loss when paired with hormone therapy, according to researchers. (iStock)
Symptom relief from the therapy may have also improved sleep and well-being, making it easier for the group to maintain diet and exercise routines, Hurtado Andrade noted.
Researchers also pointed to a possible biological explanation. Preclinical data suggest estrogen may enhance the appetite-suppressing effects of GLP-1-based medications like tirzepatide, according to the study.
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Goddard said that theory is plausible but unproven.
Hormone therapy may ease menopause symptoms and help women stay on track with diet and exercise. (iStock)
“The other possibility is that estrogen interacts with tirzepatide in some way that makes it more potent,” she said. “We will need randomized studies to get a better handle on that.”
As for safety, experts say using the two together appears safe for most women. However, hormone therapy is not recommended for all patients, especially those with a history of certain cancers, blood clots or other underlying health risks, according to the Mayo Clinic.
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Researchers say future randomized trials will aim to confirm the findings and explore whether the combination also improves broader cardiometabolic health outcomes, according to the study.
Experts say more research is needed to confirm whether hormone therapy directly boosts weight loss results with GLP-1 drugs. (iStock)
“If confirmed, this work could speed the development and adoption of new, evidence-based strategies to reduce this risk for millions of postmenopausal women navigating this life stage,” Hurtado Andrade said.
Fox News Digital has reached out to the study authors for comment.
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