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Feasibility and Outcomes of a Postpartum Hospital at Home Program
Journal article

Feasibility and Outcomes of a Postpartum Hospital at Home Program

Kristen Plastino, Bridget Sumner, Jennifer Todd, Charles Reed and Anna G. Taranova
Journal of Advanced Home Medicine, v 1(1)
02 Mar 2026
DOI: https://doi.org/10.64919/001c.2708448
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Abstract

Importance Care for acutely ill patients at home is one of the most traditional care models used worldwide; however, post the Medicare Act of 1966, it has not been widely adopted in the U.S., primarily due to the lack of fee-for-service reimbursement for care in that setting. A 16-study Cochrane Review comparing hospital at home (HaH) programs with inpatient hospitalization showed that patients who participated in HaH reported higher levels of patient satisfaction (27-40% increase)6, without statistically significant changes in morbidity and mortality.7 HaH has also shown a reduction in the cost to the patient8, 9 with total average costs reported to be 19% to 30% lower than traditional inpatient care. Objective To evaluate the feasibility and operational performance of implementing a postpartum Hospital-at-Home (HaH) program, with a focus on identifying potential cost savings and informing recommendations for program refinement and sustainability. Design This study focuses on program evaluation to review the clinical impacts and benefits when providing inpatient-level care for postpartum patients at home. Setting Large university-affiliated 716-bed, acute care tertiary facility designated a Level 4 maternity care facility. Participants Intervention/Exposure Patients were admitted to Labor and Delivery and on postpartum day 1 were transferred to their home on the HaH service. Patients received twice daily in-home nursing visits and daily video visits with an obstetrician. Results Forty-three patients were enrolled between July 2021 and August 2022 with average age of 26.4 years; 86% Hispanic. Over half the patients delivered vaginally with an average length of stay of 2.7 days. Seven participants presented to the Emergency Department within the six-week postpartum period. Outcomes The average direct cost per patient per day for the HaH patients was$2,027 less than the traditional brick and mortar patients. Conclusion The implementation of this county hospital’s innovative postpartum Hospital-at-Home (HaH) program successfully demonstrated operational feasibility and financial value. Over the 13-month study period, 43 postpartum patients were enrolled, with the majority identifying as Hispanic. The program enabled earlier discharge, helping to increase access to inpatient beds during the COVID-19 pandemic and allowing patients to recover at home with family support. Importantly, the HaH model resulted in an average direct cost savings of $ 2,027 per patient per day compared to traditional inpatient care, supporting its potential for sustainable integration into postpartum care delivery.

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