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Hospital at home: Should payment models focus on the hospital or the home?

ByPamela Pelizzari, Bruce Pyenson, Matthew Emery, and Anna Loengard
24 May 2022

Hospital at Home (HaH) is a health services innovation that delivers essential components of hospital inpatient services to select patients in their residence. This article provides a payer view of two payment models currently operating for HaH programs. Assuming payers use the Medicare reimbursement framework, we show how the bottom-up model costs payers significantly less than the top-down model, predominantly driven by lower acute reimbursement. Our analysis for the top-down model is based on the corresponding Medicare diagnosis-related-group inpatient payment, while the bottom-up approach relies on the Medicare home-health-related-group payment for home care.

The supplemental appendices for this report are available here.

This report was commissioned by AccentCare.


About the Author(s)

Matthew Emery

Anna Loengard

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