Fact Sheets

Acute Hospital Care at Home Data Release Fact Sheet

A public release of the data submitted to CMS as part of the Acute Hospital Care at Home initiative will be available beginning on January 16, 2024. CMS plans to release data through the Research and Data Assistance Center (ResDAC), collected from November 27, 2020, through March 30, 2023. 

Background

In response to challenges faced by hospitals because of the spread of COVID-19, CMS launched the Acute Hospital Care at Home (AHCAH) initiative in November 2020, which allowed certain Medicare-certified hospitals to treat patients with inpatient-level care at home. Using waiver authorities under section 1135 of the Social Security Act (the Act), which permits the Secretary to waive certain facility standards during declared public health emergencies (PHEs) like the COVID-19 PHE, CMS initially launched the broader “Hospital Without Walls” initiative in March 2020. Expanding on the Hospital Without Walls initiative, the AHCAH initiative allowed hospitals to seek waivers of § 482.23(b) and (b)(1) of Medicare regulations know as conditions of participation (CoPs). These waivers suspended the requirements for nursing services to be provided on premises 24 hours a day, 7 days a week, and for a registered nurse to be immediately available, respectively.  In addition, under section 1135 of the Act, the Secretary waived hospital physical environment and “Life Safety Code” requirements for delivering care in the patients’ home. Hospitals providing care in patients’ homes continued to meet all health and safety requirements that were not waived through the public health emergency waiver authority under section 1135 of the Act. Even though the COVID-19 PHE has ended, this initiative continues because the Consolidated Appropriations Act, 2023 (CAA, 2023) extended the waivers and flexibilities associated with the AHCAH initiative until December 31, 2024. 

As a condition of hospital participation in the AHCAH initiative, a participating hospital must report data to CMS for ongoing monitoring of patient safety. The hospital agrees to report the data to CMS either weekly or monthly depending on their participation tier. In addition to data that has been collected since the beginning of the initiative, the CAA, 2023 provision requires specific data collection for the purpose of conducting a study to analyze certain factors with respect to the AHCAH initiative.

Section(s) Applicable for Announcement 

Individuals interested in obtaining the CMS data will need to request the available data through ResDAC with an approved Data Use Agreement. This data release consists of data from November 27, 2020, through March 30, 2023. An additional data release is expected in 2025, following the conclusion of the AHCAH initiative on December 31, 2024.  Continuation of the AHCAH initiative beyond December 31, 2024 is contingent on further Congressional action.

The data include the number of new patients admitted to the home setting, the number of patient escalations of care from the home to the hospital, and the number of unanticipated patient mortalities. CMS defines the number of “patient escalations” as the number of patients whose care involved a transfer to the traditional inpatient setting from the home for further care. CMS defines “unanticipated mortality” as the death of a patient which occurred during their hospitalization, including those whose care was escalated to the hospital (excluding those on hospice or receiving palliative care). 

Additionally, the data include claims aggregation and eligibility data on beneficiaries who have been provided acute care by hospitals across the country through the AHCAH initiative. This information could be further analyzed by experts in the field to glean important clinical and policy-focused information about this type of care model. The AHCAH initiative represents the first example of payment for this level of care for Medicare Fee-for-Service and non-managed-care Medicaid beneficiaries.

CMS will also release a user’s guide to accompany the data set to assist researchers in performing their analyses. 

For more information, please visit: https://www2.ccwdata.org/web/guest/data-dictionaries.

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