Using home hospital to drive innovation within TEAM

Area of Science:

• Health Policy
• Value-Based Care
• Surgical Innovation

Background:

• The Centers for Medicare and Medicaid Services (CMS) established the Transforming Episode Accountability Model (TEAM) for major surgical procedures to improve postoperative care and reduce healthcare spending.
• Home Hospital (HH) programs, operating under the Acute Hospital Care at Home (AHCaH) waiver (renewed until 2030), have shown potential for cost savings and high-quality patient outcomes.

Purpose of the Study:

• To propose the integration of Home Hospital (HH) programs into the Transforming Episode Accountability Model (TEAM).
• To explore how HH can serve as a novel pathway for delivering value-based surgical care.
• To advocate for expanding high-quality surgical care delivery beyond traditional inpatient settings.

Main Methods:

• This study presents a conceptual framework and policy recommendation.
• It analyzes the alignment between HH program capabilities and TEAM objectives.
• The argument is built on existing evidence of HH's cost-effectiveness and quality.

Main Results:

• Home Hospital programs align with and can advance the goals of the TEAM initiative.
• Integrating HH into TEAM offers a method to extend high-quality surgical care beyond hospital walls.
• This integration has the potential to further enhance postoperative coordination and reduce overall healthcare expenditures.

Conclusions:

• CMS should consider incorporating Home Hospital programs into the Transforming Episode Accountability Model.
• This integration represents a strategic opportunity to advance value-based surgical care and improve patient outcomes.
• Embedding HH within TEAM facilitates innovative, high-quality surgical care delivery models.