Healthy Days at Home

"Healthy Days at Home" is a new quality measure proposed by Harvard researchers and others. At first blush this appears to be an interesting measure in the acute care environment - i.e., the more healthy days at home, the better a person's health status (and, perhaps, days in hospice and other settings "count againt" the person).

But upon reflection, Healthy Days at Home could also translate into a useful hospice acuity / eligibility measure, too - i.e., the fewer healthy days at home, the higher a person's acuity and potential eligibility for hospice. This is something to watch... (Article summary per Hospice News Today, 3/27/20.)

New quality measure designed by researchers quantifies time spent at home in good health
MedCity News
March 25, 2020
Researchers at Harvard Medical School and the Harvard T.H. Chan School of Public Health in conjunction with the Medicare Payment Advisory Commission established a new measure, “Healthy Days at Home,” that attempts to quantify how well healthcare organizations keep people healthy and out of facility-based healthcare settings. The full study, published in Healthcare presents a novel population-based outcome measure that quantifies how much time Medicare beneficiaries spent away from in-patient stays and other acute-care services that could help providers tailor quality-improvement initiatives to address the needs of specific patient populations. … The measure, Healthy Days at Home (HDAH), was designed to reflect the quality of care provided and represent a health outcome of value to patients. … As designed, the measure represents an intimate understanding of the multidimensional nature of healthcare. HDAH is defined as the number of days spent alive and outside of institutional settings (inpatient psychiatry, ED visits, hospital stays) and analogs (home health visits). For example, a beneficiary who spent seven days in the hospital and visited the ED three times would have had 355 HDAH out of 365 calendar days. In this way, the measure captures both healthcare utilization and cost, while measuring value to patients in the form of time spent in good health. … HDAH has a myriad of uses. Individual organizations could measure HDAH across their patient populations and deliver healthcare in line with patient priorities. Beneficiaries may be able to use the measure to make more informed choices about how they choose to receive care. Ultimately, the HDAH measure represents a meaningful way to compare differences in outcomes across populations in a way that is easy for beneficiaries, policymakers, providers, and payers to understand. The full article, “Healthy Days at home: A novel population-based outcome measure” written by Laura G. Burke, E. John Orav, Jie Zheng and Ashish K. Jha was published in Healthcare: The Journal of Delivery Science and Innovation and can be found on ScienceDirect. [Editor’s Note: To read the study, click here.]