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.

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.”

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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.

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Fort Collins, Colorado – One doctor is prescribing ping pong for patients who have serious neurological diseases. 

Dr. Antonio Barbera, a former obstetrician-gynecologist who is now living with multiple sclerosis, is founder and CEO of Table Tennis Connections in Fort Collins, Colorado, which launched its NeuroPong program in 2021.

The group gathers every Tuesday, Thursday and Friday to play ping pong — also known as table tennis — inside the gym at the Council Tree Covenant Church in Fort Collins, Barbera told Fox News. 

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For each session, the doctor collects data to determine the effectiveness of the treatment. 

Players are evaluated on their performance over time and the results are sent to scientists nationwide. 

Barbera got the idea for the NueroPong program in 2021 after he received his MS diagnosis in 2016 and had to quit his job as a practicing doctor.

“I completely lost the right leg motion and sensation for about three months and had to re-learn how to walk,” he told Fox News.

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Thanks to a combination of medicine and table tennis, Barbera was able to make a full recovery, he said.

Now, the doctor said he’s inspired dozens of people who have also been diagnosed with neurodegenerative diseases, such as dementia and Parkinson’s disease, to join the NueroPong program. 

Barbera said he got the idea for the NueroPong program in 2021 after he received his MS diagnosis in 2016 and had to quit his job as an obstetrician-gynecologist. (Kennedy Hayes/Fox News)

“If the intervention of the paddle and a simple ball will improve the quality of our life, why not?” Barbera said. 

NueroPong members say the program has improved their symptoms in more ways than one.  

“There are so many things that Parkinson’s affects,” NeuroPong member Gil Wette told Fox News. 

“It’s not just tremors and stiffness and slow movements — it’s a lot of non-motor issues … the emotional part, like anxiety and depression.“

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Healthy lifestyle changes, including exercise, have been shown to help slow the progression of neurodegenerative diseases like multiple sclerosis, Alzheimer’s or Parkinson’s.

“It’s not just the physical activity, but the fact that people are engaging in social activities … and interacting with other people. [This] can be beneficial,” Dr. Ronald Petersen of the Mayo Clinic Alzheimer’s Disease Research Center in Rochester, Minnesota, told Fox News.

Players in the NeuroPong program are evaluated on their performance every few weeks. (Kennedy Hayes/ Fox News)

Since his Neuropong program started three years ago, Barbera said the organization has spread from several cities in Colorado to gyms in New Mexico, Utah and New York, and has partnered with universities in Florida, Texas and Illinois. 

Barbera said he has also worked with scientists at the University of Colorado School of Medicine. 

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“My goal is really to have gyms all over the place, where these people can go … where the neurologists can refer people and we can collect data to show the rest of the world that we are doing something good,” Barbera said. 

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Multiple sclerosis affects nearly one million people in the U.S., according to the National Multiple Sclerosis Society.

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While snow may be peaceful and pretty, removing it can be risky.

Snow shoveling is one of the most dangerous winter activities, with research showing that it leads to around 11,500 injuries and medical emergencies and 100 deaths each year.

The American Heart Association has identified snow shoveling as an activity that can put extra stress on the heart.

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Beyond cardiac events, other common injuries include broken bones, cuts, bumps and bruises from slipping and falling.

Two doctors shared with Fox News Digital their insights and recommendations about safe snow shoveling.

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Dr. Bradley Serwer, a cardiologist and chief medical officer at VitalSolution, an Ohio-based company that offers cardiovascular and anesthesiology services to hospitals nationwide, noted that there is an overall increased risk of cardiovascular morbidity and mortality during the winter months. 

“This is due to multiple factors including seasonal temperature, level of physical activity, air pollution, infections, stress levels and fluctuations in diet,” he told Fox News Digital.

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Physical inactivity is a major factor, Serwer noted, as during the winter months, people tend to be less active and thus are less prepared for the high physical demands of shoveling.

“It is often underestimated what kind of physical workload is required to shovel a substantial amount of snow,” Serwer said. “Shoveling snow can be a very strenuous activity, placing notable strain on the cardiovascular system.”

Frigid temperatures also increase the risk.

It’s safer to push the snow out of your path instead of lifting a heavy snow shovel over your head, said one doctor.  (iStock)

“Cold temperatures can cause peripheral blood vessels to constrict, which raises blood pressure and can put extra strain on the heart,” he said.

It’s also easy to become dehydrated while working in cold climates, as people tend to forget to replace fluids as needed, Serwer noted.

“It is also important to note that orthopedic injuries are very common due to falls from slick conditions,” he said.

Tips to reduce risk while shoveling snow

To ensure adequate protection from the cold, Serwer recommends dressing in layers — including coats, hats, scarves and gloves — to avoid overheating, shedding them as you warm up.

Sarah Lee, M.D., an emergency medicine physician at the University of Maryland Medical Center Midtown campus, warned people to watch out for signs of frostbite, particularly in the fingers, toes and nose.

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Some early symptoms of frostbite include severe cold, pain, swelling and discoloration. 

“If you experience these symptoms, it is recommended that you go to a warm place immediately,” Lee told Fox News Digital. “Be sure to change into warm and dry clothes once inside.”

It’s also important to stay hydrated and avoid alcohol and tobacco products while working, the doctor said.

When lifting heavy amounts of snow, it’s important to do the heavy lifting with your legs to prevent straining your back. (iStock)

Before getting started, experts recommend warming up with stretches. 

“Shoveling snow uses a lot of big muscle groups,” said Lee, who is also an instructor of emergency medicine at the University of Maryland School of Medicine. “Stretch before starting to warm up your muscles and joints.”

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When lifting heavy amounts of snow, it’s important to do the heavy lifting with your legs to prevent straining your back, added Lee.

For those who are not typically very active, it’s important to “take extra caution and know your limits,” Lee said.

“Try to avoid overexerting yourself and take plenty of small breaks if you are shoveling a large area,” she advised.

For those who are not typically very active, it’s important to “take extra caution and know your limits,” a doctor told Fox News Digital. (iStock)

To prevent slips and falls, Lee warned to watch out for black ice, which can be hard to detect. 

“The colder the weather, the more likely it will be that there will be frozen ice on the ground,” she noted.

Particularly for elderly people, Lee recommends keeping their cell phone in their pocket so they can call for help in the event of an emergency.

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When removing snow, Serwer said it’s safer to push the snow out of your path instead of lifting a heavy snow shovel over your head.

People with certain conditions or risks should consult with a doctor before shoveling, the doctors agreed.

To prevent slips and falls, a doctor warned to watch out for black ice, which can be hard to detect.    (Rachel Gibbons/The Daily News-Sun via AP)

“Generally, those who have any mobility-limiting conditions or those with high fall risks — those who are elderly, deconditioned or have a more sedentary lifestyle — should exercise extra caution,” said Lee.

People who have a history of cardiac problems should check with their doctor before any kind of strenuous exercise, she said.

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“Patients who take blood-thinning medications should also take special care to avoid falls,” Lee added.

For those who are at a high risk of cardiac events, the experts recommend hiring someone else to complete the task.

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