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CMS Announces Comprehensive Strategy to
Enhance Hospital Capacity Amid COVID-19 Surge
Agency
outlines flexibilities to maximize Acute Hospital Care at Home, Ambulatory
Surgical Centers to decompress hospitals treating COVID-19 patients Today, the Centers for Medicare & Medicaid Services (CMS)
outlined unprecedented comprehensive steps to increase the capacity of the
American health care system to provide care to patients outside a traditional
hospital setting amid a rising number of coronavirus disease 2019 (COVID-19)
hospitalizations across the country. These flexibilities include allowances
for safe hospital care for eligible patients in their homes and updated
staffing flexibility designed to allow ambulatory surgical centers (ASCs) to
provide greater inpatient care when needed. Building on CMS’s previous
actions to expand the availability of telehealth across the nation, these
actions are aimed at allowing health care services to be provided outside a
hospital setting while maintaining capacity to continue critical non-COVID-19
care, allowing hospitals to focus on the increased need for care stemming
from public health emergency (PHE). “We’re at a new level of crisis response with COVID-19 and CMS
is leveraging the latest innovations and technology to help health care
systems that are facing significant challenges to increase their capacity to
make sure patients get the care they need,” said CMS Administrator Seema
Verma. “With new areas across the country experiencing significant challenges
to the capacity of their health care systems, our job is to make sure that
CMS regulations are not standing in the way of patient care for COVID-19 and
beyond.” Acute Hospital Care at Home In March 2020, CMS announced the Hospitals Without Walls program, which
provides broad regulatory flexibility that allowed hospitals to provide
services in locations beyond their existing walls. Today, CMS is expanding on
this effort by executing an innovative Acute Hospital Care At Home program,
providing eligible hospitals with unprecedented regulatory flexibilities to
treat eligible patients in their homes. This program was developed to support
models of at-home hospital care throughout the country that have seen prior
success in several leading hospital institutions and networks, and reported
in academic journals, including a major study funded by a Healthcare
Innovation Award from the Center for Medicare and Medicaid Innovation (CMMI). The program clearly differentiates the delivery of acute
hospital care at home from more traditional home health services. While home
health care provides important skilled nursing and other skilled care
services, Acute Hospital Care at Home is for beneficiaries who require acute inpatient
admission to a hospital and who require at least daily rounding by a
physician and a medical team monitoring their care needs on an ongoing basis. To support these efforts, CMS has launched an online portal https://qualitynet.cms.gov/acute-hospital-care-at-home
to streamline the waiver request process and allow hospitals and healthcare
systems to submit the necessary information to ensure they meet the program’s
criteria to participate. CMS will also closely monitor the program to
safeguard beneficiaries by requiring hospitals to report quality and safety
data to CMS on a frequency that is based on their prior experience with the
Hospital At Home model. Ambulatory Surgical Center Flexibility As part of Hospital Without Walls, CMS also previously announced regulatory
flexibility that allowed ASCs – facilities that normally provide same-day
surgical care – the ability to be temporarily certified as hospitals and
provide inpatient care for longer periods than normally allowed, with the
appropriate staffing in place. ASCs are normally subject to a requirement
that patients only remain in their care for less than 24 hours or require
admission to a regular hospital. Today, CMS is announcing an update to that regulatory
flexibility, clarifying that participating ASCs need only provide 24-hour
nursing services when there is actually one or more patient receiving care
onsite. The program change provides ASCs enrolled as hospitals the ability to
flex up their staffing when needed and provide an important relief valve in
communities experiencing hospital capacity constraints, while not mandating
nurses be present when no patients are in the ASC. The flexibility is
available to any of the 5732 ASCs throughout the country seeking to
participate and will be immediately effective for the 85 ASCs currently
participating in the Hospital Without Walls initiative. CMS expects this
flexibility will allow these and additional ASCs enrolled as hospitals to
serve as an added access point that will allow communities to maintain
surgical capacity and other life-saving non-COVID-19, like cancer surgeries.
Allowing these types of treatments to occur in designated ASCs enrolled as
hospitals while hospitals are managing any surges of COVID-19 would allow
vulnerable patients to receive this needed care in settings without known
COVID-19 cases. Today’s announcement builds upon the critical work by CMS to
expand telehealth coverage to keep beneficiaries safe and prevent the spread
of COVID-19. CMS has expanded the scope of Medicare telehealth to allow
Medicare beneficiaries across the country to receive telehealth services from
any location, including their homes. CMS also added over 135 services such as
emergency department visits, initial inpatient and nursing facility visits,
and discharge day management services, that could be paid when delivered by
telehealth. The flexibilities announced today, and the aggressive action
taken by CMS to remove barriers to telehealth, ensure patients and providers
have options when receiving and providing care given the challenges and
additional stress placed on hospitals and the health care system during the
COVID-19 PHE. To view the Acute Hospital Care At Home initiative and
application, please visit: CMS’: https://qualitynet.cms.gov/acute-hospital-care-at-home
For more on the ambulatory surgical center flexibilities, please
see: https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/guidance-processing-attestation-statements-ambulatory-surgical-centers-ascs-temporarily-enrolling To view comments from health systems participating in the Acute
Hospital Care at Home, please visit: https://www.cms.gov/files/document/what-are-they-saying-hospital-capacity.pdf Link to FAQs: https://www.cms.gov/files/document/covid-acute-hospital-care-home-faqs.pdf |
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Wednesday, November 25, 2020
CMS Announces Comprehensive Strategy to Enhance Hospital Capacity Amid COVID-19 Surge
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