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The publication discusses the Acute Hospital Care at Home (AHCAH) initiative launched by CMS in response to the COVID-19 pandemic, allowing approved hospitals to provide inpatient-level care in patients' homes. Over 11,000 patients were admitted under this waiver from November 2021 to March 2023, primarily utilizing Medicare fee-for-service. The study reveals positive outcomes, with a low mortality rate (0.34%) and a 7.20% transfer rate back to hospitals. Given the study limitations, the findings support the ongoing federal oversight and a comprehensive study to identify best practices for inpatient care at home.

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Broadly, this article underscores the delicate balance between fostering innovation, ensuring patient safety, and providing timely access to breakthrough technologies. The proposed suggestions of the authors and ongoing discussions aim to optimize the regulatory and reimbursement pathways, aligning them to better meet the needs of patients and healthcare providers. The evolving landscape discussed reflects the dynamic nature of medical innovation and the regulatory framework that governs it.

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The article discusses CMS commitment to modernizing its coverage pathways to deliver efficient, predictable, and transparent coverage of emerging medical technologies. We are equally committed to covering devices based on scientifically sound clinical evidence and with appropriate safeguards. The TCET pathway aims to accelerate national coverage where the evidence supports it but may offer transitional coverage for technologies that do not yet satisfy the reasonable and necessary standard when they first enter the market. By defining objective success criteria and dates for review in advance, CMS aims to increase predictability while reducing the burden of evidence development.

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