Integris Health @ Home is a multidisciplinary care model offering care for patients. Photos provided.

by Bobby Anderson, RN – staff writer

After launching on January 31, the Integris Health @ Home program has successfully discharged more than 100 patients who have received care in the comfort of their own homes.
But the future of the Integris offering and similar ones around the country are in doubt unless a government waiver allowing payment for treatment at home finally becomes law.
Lisa Rother, RN, is the system’s program director and says the services provided are offering cost effective treatment solutions for patients.
But that could go away.
“It’s pretty problematic not only for the providers who are operating under it but also those are allowing us to use the CMS waiver. They’re having to hedge on the uncertainty, too,” Rother said. (story continues below)

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Rother explained the program has the approval of the state’s Medicaid program and the Medicare Advantage Program offered through payor sources. Nationwide, some 200 health systems are operating similar programs under the waiver.
“The data has been very positive,” Rother said. “We’re showing improvements in patient experience with healthcare, reductions in readmissions from this model of healthcare and it definitely merits further exploration to determine if we should adopt this model of care post pandemic.”
Forty-six-year-old Rachael Martin had been in and out of the hospital multiple times due to congestive heart failure and respiratory issues. She was thrilled to learn there was an alternative option to the traditional brick and mortar hospital and wound up becoming the 100th successful discharge from the program.
“The hospital at home program is so much more convenient and comfortable,” says Martin. “There’s no place like home… and that’s truly where every patient would prefer to be if given the choice.”
Integris Health @ Home provides hospital-level care to patients in the comfort and convenience of their own homes. Patients receive a remote patient monitoring kit and other clinical equipment as needed for their particular diagnoses. Standard equipment includes a blood pressure monitor, pulse oximeter, cellular-enabled digital tablet and a digital scale. Other devices can be added based on the patient’s needs.
All the devices connect to a tablet through Bluetooth and transmit vital signs to a remote monitoring command center. The command center, staffed by INTEGRIS Health physicians and nurses, monitors patients 24/7 and responds immediately to a patient’s medical needs via video or telephone.
Daily in-home visits by community paramedics, nurses, nurse practitioners and other health care professionals are also part of the treatment plan. IV therapies, oxygen treatments, lab tests, mobile imaging like x-rays and ultrasound are all performed in the home. Other services provided include skilled nursing, medications, infusions, behavioral health, and rehabilitation.
In early August, the Federation of American Hospitals urged Heath and Human Services to extend the COVID-19 public health emergency (PHE) into 2023, stressing that hospitals across the country still rely on the accompanying regulatory waivers and flexibilities.
The program has been buoyed by a November 2020 waiver from the Centers for Medicare and Medicaid Services that pays hospital diagnosis-related group payment for hospital-at-home patients. The waiver is in place for the duration of the PHE. When the PHE ends, hospital-at-home will have a 60-day grace period and then the waivers will expire.
The current PHE is set to expire in October.
For CMS to make the program permanent, legislation is required. The only proposal that has come up that would fully continue the program, the Hospital Inpatient Services Modernization Act, went nowhere.
Fortunately, Congress is considering the Advancing Telehealth Beyond COVID–19 Act of 2022.
This bill would authorize Medicare to continue telemedicine until Dec. 31, 2024. The bill passed the House by a lopsided 416-12 vote. It now awaits a vote in the Senate.
On July 15, 2022, HHS Secretary Xavier Becerra renewed the PHE for an additional 90 days, as authorized under the Public Health Service Act. While there was some conjecture that this might be the last renewal, and that the PHE would permanently end in mid-October, signs are now pointing to at least one more renewal, through January 2023.
“The positive that has come out of this pandemic is it has allowed innovation to look at different ways of providing care for our patients,” Rother said. “(Feedback) has been fabulous, that’s why we would hate to stop it. So many of our patients have significant challenges with needing additional social support with their disease and diagnosis. We have been able to identify that earlier because we are in the home and see their environment.”
“We’re able to hopefully manage their chronic disease at home and better manage their health at home.”

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