SOURCE: John A. Hartford Foundation

Strategic Communications and Planning

November 13, 2014 10:00 ET

John A. Hartford Foundation Forges Public-Private Partnership With CMMI to Spread "Hospital at Home" Model of Care

Model Delivers Hospital-Level Care for Older Adults With Certain Chronic Conditions in Their Own Homes

NEW YORK, NY--(Marketwired - November 13, 2014) - To help improve the health of older adults, the John A. Hartford Foundation has formed a new public-private partnership with the Centers for Medicare & Medicaid Services (CMS) to support testing, delivery, and dissemination of the Mobile Acute Care Team. The Mobile Acute Care Team is a model of care that improves health outcomes for older adults with certain chronic conditions while lowering costs by bringing them hospital-level care in their own homes. It is a version of the program known as Hospital at Home.

Earlier this year, the Mobile Acute Care Team received a Health Care Innovation Award of $9.6 million from the CMS Innovation Center (CMMI) -- one of only 39 such Health Care Innovation Awards chosen in round two of this highly selective program. The Hartford Foundation grant will provide an additional $1.6 million over four years to evaluate the model and position it for widespread dissemination and implementation. The Foundation has a track record of collaborating on innovative health care projects with federal agencies ranging from the National Institute on Aging to the Corporation for National and Community Service.

"The Hospital at Home model is a very strong idea that was, in many respects, ahead of its time," said Christopher Langston, PhD, program director at the John A. Hartford Foundation. "CMS' investment in this version of the model -- the Mobile Acute Care Team -- has the potential to be a game-changer in terms of building recognition and enhancing credibility. We are pleased to be able to collaborate with CMS to help this model achieve the growth it deserves."

Providing an option for hospital-level care that does not require actually being admitted to the hospital is valuable because hospitals can be dangerous places for older adults. Hospital-acquired infections, delirium, medication mix-ups, and loss of function are just some of the problems that can leave older adults more frail than before they entered the hospital. The higher costs of providing care in a hospital are also well documented.

The Hospital at Home model addresses those problems by defining treatment protocols for older adults who meet certain criteria and have specific illnesses that are among the most common causes of hospital admission in Medicare beneficiaries: congestive heart failure, community acquired pneumonia, chronic obstructive pulmonary disease, and skin infections. A team of physicians, nurses, and others then provides older patients with hospital-level care at home, using mobile diagnostic technologies, intravenous medications, and supportive engagement of patients and family members.

The leaders of the Mobile Acute Care Team project are both based at Hartford Centers of Excellence in Geriatric Medicine and Geriatric Psychiatry: Al Siu, MD, professor and chairman of the Department of Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mount Sinai, and Bruce Leff, MD, professor of medicine in the Division of Geriatric Medicine at Johns Hopkins University School of Medicine. The Hartford Foundation has supported the Hospital at Home model since 1994, from its development by John Burton, MD, and later by Bruce Leff, MD, at Johns Hopkins, through multi-site testing and early dissemination.

"For two decades, we have seen the difference that Hospital at Home can make by providing older adults with patient-centric, individualized hospital-level care in a home setting," Dr. Leff said. "The support of the CMS Innovation Center and the Hartford Foundation will allow us to demonstrate the advantages of the model, and extend its reach to many more older Americans who need it."

The evaluation portion of the new Hartford award will enhance federally funded quantitative and qualitative evaluation of the program. It will fund the collection of clinical data in addition to the CMS' planned collection of administrative/claims data. It also will add a matched control group and review of medical records. The results will allow comparisons between the Hospital at Home model and usual care in such key areas as impact on caregivers' lives, medical complications such as falls, patients' functional outcomes, and health care provider satisfaction -- information that will prove valuable to potential adoption sites.

The Hartford award also will fund a qualitative analysis of the care model's implementation process, and, in collaboration with the Center to Advance Palliative Care (CAPC), develop the next generation of key technical assistance tools and Hospital at Home content experts to bolster future dissemination efforts.

About the John A. Hartford Foundation 
The John A. Hartford Foundation is a private philanthropy working to improve the health of older Americans. After three decades of championing research and education in geriatric medicine, nursing, and social work, today the Foundation pursues opportunities to put geriatrics expertise to work in all health care settings. This includes advancing practice change and innovation, supporting team-based care through interdisciplinary education of all health care providers, supporting policies and regulations that promote better care, and developing and disseminating new evidence-based models that deliver better, more cost-effective health care. The Foundation was established by John A. Hartford. Mr. Hartford and his brother, George L. Hartford, both former chief executives of the Great Atlantic & Pacific Tea Company, left the bulk of their estates to the Foundation upon their deaths in the 1950's. Additional information about the Foundation and its programs is available at

The project described was supported by Grant Number 1C1CMS331334 from the Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies.

Contact Information