PATHways investment program will support timely discharges to home, a contributing factor to increased lengths of stay and ED boarding
BOSTON — The Massachusetts Health Policy Commission (HPC) is soliciting proposals from acute care hospitals in Massachusetts to advance hospital-to-home programs, streamlining patient discharges to home care instead of skilled nursing facilities or other institutional settings.
Following a hospital stay, patients may face numerous barriers setting up the appropriate services to enable them to discharge directly home or to a community-based setting, even when these may be the most appropriate settings for their continued care. The Massachusetts Transitions from Acute Care to Post Acute Care (TACPAC) Task Force found that, each day, there are 2,000 patients on average that remain hospitalized despite being medically ready for discharge.
Along with patient care quality impacts, challenges discharging patients from inpatient care exacerbate capacity constraints that result in increased lengths of hospital stays and emergency department boarding. The HPC has found that lengths of stay of greater than 30 days are increasing as a proportion of hospital stays, and account for half of the growth in bed days since 2016.
The HPC has issued a Request for Proposals (RFP) for the new Promoting Appropriate Transitions to Home (PATHways) investment program to support hospitals in addressing this issue. This program provides an opportunity for both new and existing hospital-to-home programs, specifically through partnerships between Aging Services Access Points (ASAPs) and acute care hospitals in Massachusetts. PATHways has been designed to build on the Executive Office of Aging & Independence (AGE)-funded Hospital to Home Partnership Program, which supported partnerships between hospitals and ASAPs and ended in 2025.
ASAPs, organizations designed to connect residents over the age of 60 and their caregivers with programs and services to help them age in the community, are uniquely positioned to help residents access the services necessary to discharge directly home. PATHways aims to further bolster partnerships between hospitals and ASAPs to facilitate more hospital-to-home discharges, following the roadmap of AGE’s Hospital to Home Partnership Program.
“PATHways will continue the critical progress made by AGE to connect patients with the support they need to discharge from hospitals and receive care in their homes and communities – a mission that is more critical now than ever, with estimates that on average 2,000 residents ready for medical discharge remain hospitalized each day,” said HPC Executive Director David Seltz. “We look forward to partnering with hospitals and ASAPs across the Commonwealth on this program, pursuing our shared goals of decreasing health care cost growth, bolstering our hospitals’ capacity for patients who need that level of care, and ensuring that our residents are getting the care they need.”
“We are excited to collaborate with the Health Policy Commission as they launch the PATHways Investment Program, which builds on the foundation of AGE’s Hospital to Home Partnership Program,” said Aging & Independence Secretary Robin Lipson. “We learned that bringing the community resource expertise of ASAPs directly into the hospital setting and in the discharge planning process made a difference in more timely and satisfied discharges to community. I am pleased to see that strengthening connections between hospitals and ASAPs is being recognized as a critical step in smoothing the discharge path from hospital to home.”
“Given our hospitals’ ongoing capacity constraints, we are grateful to the Healey-Driscoll administration and the HPC for their responsiveness and support for the safe, efficient care transitions that patients deserve,” said Adam Delmolino, Senior Director of Virtual Care & Clinical Affairs at the Massachusetts Health & Hospital Association. “These are powerful partnerships. Following a successful pilot program in conjunction with Mass Aging Access, we are confident that the PATHways program will continue to allow hospitals and ASAPs to help patients recover in the comfort of their own homes, open up care beds for others, and provide people with a range of resources in their communities.”
Find the RFP on COMMBUYS and learn more about the PATHways investment program on the HPC’s website.
