A recently published study in JACC: Heart Failure highlights the effectiveness of Cleveland Clinic’s hospital-at-home (HaH) program for patients with acute heart failure (AHF). This research gives insight into the feasibility, safety, and quality of a virtual care model compared to a traditional hospital setting. By integrating elements of heart failure management at home, this program demonstrates a growing approach to addressing the needs of heart failure patients in a familiar environment.
The acute hospital-at-home program (HaH) is a healthcare approach in which patients receive acute care services in their homes rather than in a traditional hospital setting. Advances in medical technology, evolving healthcare delivery models, and a focus on patient-centered care have driven the development of HaH. Combining these programs with remote patient monitoring enables patients to automatically transmit daily vital sign readings to their physicians using remote monitoring devices.
Heart failure Management at Home with a Hospital-at-Home Program
The study evaluated 194 patients aged 18 and older with acute heart failure admitted to Cleveland Clinic’s HaH program between April 2023 and August 2024. A virtual command center managed care remotely, while community paramedics and nurses provided on-site services when necessary. Most patients (84%) completed treatment without requiring transfer to a hospital for additional imaging, procedures, or care escalation. The program demonstrated several notable outcomes for heart failure management at home.
First, the 30-day readmission rate for HaH patients was 12.4%, significantly lower than the 16.9% observed in traditional hospital patients. Death rates were comparable between HaH and traditional hospital patients. Additionally, both groups showed similar improvements in using guideline-directed medical therapy (GDMT) use. Vital signs, including blood pressure and heart rate, consistently improved from admission to discharge in both settings.
The Structure of the HaH Model
The Cleveland Clinic’s HaH program uses an integrated virtual command center staffed by hospitalists and nurses who oversee patient care remotely. Local healthcare professionals, including community paramedics and nurses, also provide in-person support services to address patients’ immediate needs at home. This hybrid approach balances high-quality care delivery with the convenience and comfort of managing their condition at home.
Incorporating heart failure management at home into the HaH model enhances patient outcomes and aligns with the growing personalized, patient-centered care trend.
Challenges in Heart Failure Management at Home
This study adds to the growing evidence supporting hospital-at-home models. As of late 2024, 378 healthcare providers across 39 states have adopted similar HaH models. CMS evaluations consistently show that HaH programs deliver care quality that is on par with or superior to traditional hospital settings. Benefits of HaH include lower mortality rates and improved patient satisfaction.
However, challenges remain. Current legislative changes, such as the American Relief Act of 2025, provide only a short-term extension for AHCAH flexibilities. Stakeholders continue to advocate for long-term support to ensure the scalability and sustainability of these programs.
Understanding Heart Failure Management at Home
Hospital-at-home models, including heart failure management at home, address critical challenges in traditional hospitalization approaches. The study’s researchers emphasize the need for further studies to refine patient selection criteria, optimize protocols, and evaluate the scalability of virtual care models.
As healthcare systems face increasing pressures to innovate while maintaining quality and cost-effectiveness, Cleveland Clinic’s approach to home heart failure management illustrates the efficacy of integrating advanced technology and personalized care strategies.
Managing and tracking symptoms remotely for patients with failure offers enhanced patient outcomes, reduced healthcare costs, and greater patient satisfaction. By embracing this model, healthcare systems can create a future where advanced care is accessible, efficient, and patient-centered.
