Hospitals in this state have been unable to solve the problem of boarding, which extends stays for patients due to the lack of post-release services.
That situation became particularly acute for those requiring behavioral-health care.
However, boarding isn’t unique to that population; it’s now common for patients in need of other post-hospitalization placements.
And now the state’s Health Policy Commission, in its effort to facilitate patient discharges to home care instead of skilled nursing facilities or other institutional settings, is currently soliciting proposals from acute-care hospitals.
Following a hospital stay, patients often face numerous bureaucratic hurdles in setting up appropriate services in a home or community-based setting — likely the most appropriate options for their continued care.
The Massachusetts Transitions from Acute Care to Post Acute Care Task Force found that there are 2,000 patients daily on average that remain hospitalized despite being medically eligible for discharge.
Along with patient care quality impacts, challenges discharging patients from inpatient care exacerbate capacity constraints that result in increased emergency department boarding.
The Health Policy Commission found that patient boarding greater than 30 days has increased as a proportion of hospital stays, and now account for 50% of the growth in that category since 2016.
To combat that trend, the Health Policy Commission, an independent state agency charged in part with monitoring health care spending growth, has launched a $1.47 million PATHways Investment Program to fund initiatives that facilitate the transfer of eligible hospital patients to a home setting.
The Health Policy Commission will award $210,000 each to the seven selected programs (totaling $1.47 million), with an additional $90,000 in-kind contribution from those hospitals.
The funding supports the placement of a Home and Community-Based Services liaison from local Aging Services Access Points — private nonprofit agencies contracted by the Executive Office of Aging and Independence — inside hospitals to coordinate timely discharges to community settings.
ASAPs, organizations designed to connect residents over 60 and their caregivers with programs and services to help them age in the community, are uniquely qualified to help access the services necessary for home care.
The PATHways program aims to alleviate the hospital capacity crisis by limiting the need for institutional settings.
This initiative acts as bridge funding for the Executive Office of Aging & Independence’s Hospital to Home Partnership Program, which was previously supported by federal ARPA dollars.
“We look forward to partnering with hospitals and ASAPs across the Commonwealth on this program, pursuing our shared goals of decreasing health care cost growth, bolstering our hospitals’ capacity for patients who need that level of care, and ensuring that our residents are getting the care they need,” said Health Policy Commission Executive Director David Seltz.
“We are excited to collaborate with the Health Policy Commission as they launch the PATHways Investment Program, which builds on the foundation of AGE’s Hospital to Home Partnership Program,” said Aging & Independence Secretary Robin Lipson.
“We learned that bringing the community resource expertise of ASAPs directly into the hospital setting and in the discharge planning process made a difference in more timely and satisfied discharges to community.”
This investment constitutes part of the Health Policy Commission’s broader work to enhance care efficiency, address social determinants of health, and improve health outcomes across the Commonwealth.
Learn more about the PATHways investment program on the Health Policy Commission’s website.
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