Headline
Mixed outcomes for hospital at home services implemented for North Carolina Medicaid enrollees.
Background
North Carolina Medicaid has allowed hospitals participating in the Acute Hospital Care at Home initiative to be reimbursed for hospital at home services. The state partnered with an external quality review organization to evaluate the outcomes of Medicaid enrollees who received these services, as compared to a matched group that received inpatient hospitalization services from a health system in 2021 and 2022.
Findings
Individuals receiving hospital at home services had significantly higher rates of follow-up primary care visits, and similar average rates of hospital stays as the comparison group. However, the hospital at home group had higher (but not statistically significant) rates of 30-day readmissions and follow-up emergency department visits. The authors suggested that more evidence is needed to inform selection of hospital at home patients among Medicaid enrollees, given that most research and implementation of these programs has focused on Medicare enrollees.
Policy/Program Takeaways
This evaluation reported outcomes for Medicaid enrollees participating in the Acute Hospital Care at Home initiative — outcomes that were less positive than other studies of hospital at home services. The authors reported that North Carolina Medicaid leadership is exploring follow-up analyses with more robust data and examining the role of virtual monitoring. For Medicaid enrollees with health-related social needs and limited in-home supports, traditional inpatient care may yield better outcomes than hospital at home services.