Hospital Inpatient Services Modernization Act
Officially: “Hospital Inpatient Services Modernization Act” Read the full text
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1Short title
This section says the Act may be called the Hospital Inpatient Services Modernization Act.
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1. Short title This Act may be cited as the Hospital Inpatient Services Modernization Act .
2Extending acute hospital care at home waiver flexibilities
This section would amend Section 1866G(a)(1) of the Social Security Act by changing a reference to the year 2025 to the year 2030, extending the acute hospital care at home waiver flexibilities under that provision for five more years.
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2. Extending acute hospital care at home waiver flexibilities Section 1866G(a)(1) of the Social Security Act ( 42 U.S.C. 1395cc–7(a)(1) ) is amended by striking 2025 and inserting 2030 .
3Requiring additional study and report on acute hospital care at home waiver flexibilities
This section would further amend Section 1866G of the Social Security Act, as already amended by section 2. It would rename the heading of subsection (b) from "Study" to "Initial study," and it would renumber the existing subsections (c) and (d) as subsections (d) and (e) to make room for a new subsection (c). The new subsection (c) would require the Secretary of Health and Human Services, not later than September 30, 2028, to conduct a study that analyzes, to the extent practicable, the criteria hospitals use under the Acute Hospital Care at Home initiative to decide which individuals may be given services under it, and that analyzes and compares, both within and between hospitals that participate in the initiative and relative to comparable hospitals that do not participate (for relevant parameters such as diagnosis-related groups): (i) the quality of care given to individuals with similar conditions and characteristics in the inpatient setting versus through the initiative, including health outcomes, hospital readmission rates (counting readmissions both within and beyond 30 days after discharge), hospital mortality rates, length of stay, infection rates, the composition of the care team (including the types of labor used, such as contracted labor), the ratio of nursing staff, transfers from the hospital to the home, transfers from the home back to the hospital (including their timing, frequency, and causes), transfers and discharges to post-acute care settings (including their timing, frequency, and causes), and patient and caregiver experience of care; (ii) the clinical conditions treated and the diagnosis-related groups of discharges from inpatient settings compared with discharges from the initiative; (iii) the costs the hospital incurs for care in inpatient settings compared with the costs it incurs for care through the initiative, including costs for staffing, equipment, food, prescriptions, and other services the Secretary identifies; (iv) the quantity, mix, and intensity of services (such as in-person visits and virtual contacts with patients, and how intensive those services are) given in inpatient settings compared with the initiative, and, to the extent practicable, the nature and extent of family or caregiver involvement; (v) socioeconomic information on individuals treated in comparable inpatient settings compared with the initiative, including racial and ethnic data, income, housing, geographic proximity to the brick-and-mortar facility, and whether such individuals are also eligible for benefits under Medicaid (title XIX); and (vi) the quality of care, outcomes, costs, quantity and intensity of services, and other relevant measures comparing individuals who entered the initiative directly from an emergency department with individuals who entered the initiative directly from an existing inpatient hospital stay. In conducting the study, the Secretary would have to, to the extent practicable, analyze and compare individuals who do and do not participate in the initiative while controlling for selection bias or other factors that could affect how reliable the data is. Not later than September 30, 2028, the Secretary of Health and Human Services would have to submit a report on this study to the Committee on Ways and Means of the House of Representatives and the Committee on Finance of the Senate.
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3. Requiring additional study and report on acute hospital care at home waiver flexibilities Section 1866G of the Social Security Act ( 42 U.S.C. 1395cc–7 ), as amended by section 2, is further amended— (3) in subsection (b), in the subsection heading, by striking Study and inserting Initial study ; (4) by redesignating subsections (c) and (d) as subsections (d) and (e), respectively; and (5) by inserting after subsection (b) the following new subsection: (c) Subsequent study and report (1) In general Not later than September 30, 2028, the Secretary shall conduct a study to— (A) analyze, to the extent practicable, the criteria established by hospitals under the Acute Hospital Care at Home initiative to determine which individuals may be furnished services under such initiative; and (B) analyze and compare (both within and between hospitals participating in the initiative, and relative to comparable hospitals that do not participate in the initiative, for relevant parameters such as diagnosis-related groups)— (i) quality of care furnished to individuals with similar conditions and characteristics in the inpatient setting and through the Acute Hospital Care at Home initiative, including health outcomes, hospital readmission rates (including readmissions both within and beyond 30 days post-discharge), hospital mortality rates, length of stay, infection rates, composition of care team (including the types of labor used, such as contracted labor), the ratio of nursing staff, transfers from the hospital to the home, transfers from the home to the hospital (including the timing, frequency, and causes of such transfers), transfers and discharges to post-acute care settings (including the timing, frequency, and causes of such transfers and discharges), and patient and caregiver experience of care; (ii) clinical conditions treated and diagnosis-related groups of discharges from inpatient settings relative to discharges from the Acute Hospital Care at Home initiative; (iii) costs incurred by the hospital for furnishing care in inpatient settings relative to costs incurred by the hospital for furnishing care through the Acute Hospital Care at Home initiative, including costs relating to staffing, equipment, food, prescriptions, and other services, as determined by the Secretary; (iv) the quantity, mix, and intensity of services (such as in-person visits and virtual contacts with patients and the intensity of such services) furnished in inpatient settings relative to the Acute Hospital Care at Home initiative, and, to the extent practicable, the nature and extent of family or caregiver involvement; (v) socioeconomic information on individuals treated in comparable inpatient settings relative to the initiative, including racial and ethnic data, income, housing, geographic proximity to the brick-and-mortar facility and whether such individuals are dually eligible for benefits under this title and title XIX; and (vi) the quality of care, outcomes, costs, quantity and intensity of services, and other relevant metrics between individuals who entered into the Acute Hospital Care at Home initiative directly from an emergency department compared with individuals who entered into the Acute Hospital Care at Home initiative directly from an existing inpatient stay in a hospital. (2) Selection bias In conducting the study under paragraph (1), the Secretary shall, to the extent practicable, analyze and compare individuals who participate and do not participate in the initiative controlling for selection bias or other factors that may impact the reliability of data. (3) Report Not later than September 30, 2028, the Secretary of Health and Human Services shall submit to the Committee on Ways and Means of the House of Representatives and the Committee on Finance of the Senate a report on the study conducted under paragraph (1). .
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In the House.