Government urged to fast-track hospital in the home reforms

Catholic Health Australia and Bupa have joined forces to call on the Federal Government to expand hospital in the home services and reform Medicare to give more Australians the option to receive clinically safe, high-quality care in their own homes.

The two healthcare organisations have worked collaboratively to identify what is needed to make the proposed hospital in the home reforms practical, affordable and sustainable for patients, doctors and hospitals.

Hospital in the home allows people who need acute care to be treated at home or in another non-hospital setting, rather than staying in hospital. These services are already well established in many countries and clinically proven, but access remains limited within Australia.

One of the biggest barriers to expanding hospital in the home is the current Medicare telehealth settings which prevent doctors from claiming Medicare for virtual consultations for patients receiving hospital-level care at home. This discourages referrals and reduces access to these programs even though virtual check-ins are now common and used by clinicians.

Data from Australian hospital in the home programs has demonstrated that it can be a safer, more appealing option than staying in hospital, with fewer deaths, fewer returns to hospital and patients saying they would choose to be treated at home again.

Catholic Health Australia and Bupa are recommending the adoption of five-point reform plan to make hospital in the home accessible for more Australians, including:

• Creating new Medicare telehealth items that allow specialists to support admitted hospital in the home patients while remaining responsible for their ongoing hospital care
• Prioritising services such as intravenous antibiotics, infection treatment, complex wound care and hospital-level palliative care, which are already operating successfully across Australia and are well suited to home-based care
• Ensuring Hospital in the home care is held to the same safety and quality standards as care delivered in a hospital, including national accreditation and reporting against recognised quality measures. Services should already meet these standards or be able to do so within 12 months, supported by hospital in the home specific guidance and audit tools to clearly demonstrate compliance
• Clear minimum service expectations are needed to ensure patients receive hospital quality care at home, including daily nursing, regular medical review, 24-hour escalation support and access to hospital level treatments when clinically required, including for palliative and end-of-life care
• Hospital in the home funding, including a default benefit, should cover the real costs of delivering safe care at home, including nursing, medical reviews, afterhours support, travel and consumables, with extra support for culturally appropriate care while major infrastructure costs remain funded through existing systems.

Catholic Health Australia Director of Health Policy Dr Katharine Bassett said: “We know our patients want more hospital in the home care. It allows them to stay in the comfort of their own homes and delivers better outcomes, while also taking pressure off the strained hospital system, which is vital as our population ages.

“Unfortunately, Australia is lagging well behind comparable nations such as the UK and Canada when it comes to offering care at home. The good news is the solutions are clear – the government must fix funding arrangements to allow hospital in the home care to thrive.”

Bupa Health Insurance Managing Director Kate Williams said with clinical approval and guidance, more Australians could safely receive hospital care in their own homes.

“It’s time to move forward and properly fund hospital in the home services which we know improve patient choice, deliver care that Australians increasingly want and expect, and importantly ease pressure on hospitals,” she said.

“These services are already delivering safe, high-quality outcomes and they should be supported with a clear framework to grow. Strong clinical oversight should remain central to any expansion to give patients real choice without compromising safety or quality.”