,,ib ,union ,cal5d> ,no4 #caa #aai?     
,,congress  #a/ ,session  ,h4 ,r4 #dcac 
,report ,no4 #aai-cei ,,9 ,,! ,,h\se ,,(
 ,,repres5tatives  ,july #aj1 #bjbe,mr4 
,bu*anan 7= himself1 ,mr4 ,smuck]1 &    
,mr4 ,evans ( ,p5nsylvania7 introduc$ ! 
foll[+ bill2 :i* 0 ref]r$ to !          
,committee on ,ways & ,means  ,octob]   
#ca1 #bjbe;,additional sponsors3 ,ms4   
,t5ney1 ,mr4 ,c>ey1 ,mr4 ,simpson1 ,mr4 
,smi? ( ,nebraska1 ,mrs4 ,fis*ba*1 &    
,mr4 ,moore ( ,utah  ,octob] #ca1       
#bjbe,report$ ) an am5dm5t1 committ$ to 
! ,committee ( ! ,:ole ,h\se on ! ,/ate 
( ! ,union1 & ord]$ to be printed,strike
 out all aft] ! enact+ clause & ins]t ! 
"p pr9t$ 9 italic,for text ( introduc$  
bill1 see copy ( bill z introduc$ on    
,july #aj1 #bjbe  ,a ,,bill  ,to am5d   
title ,,xviii ( ! ,social ,security ,act
 to ext5d acute hospital c>e at home    
waiv] flexibilities1 & to require an    
additional /udy & report on su*         
flexibilities4  #a4 ,%ort title ,?is    
,act may be cit$ z ! ,hospital ,inpati5t

 ,s]vices ,mod]nization ,act4  #b4      
,ext5d+ acute hospital c>e at home waiv]
 flexibilities ,section #ahff;,g7a77#a7 
( ! ,social ,security ,act 7#db         
,u4,s4,c4 #acie;cc-#g7;a77#a77 is am5d$ 
by /rik+ #bjbe & ins]t+ #bjcj4  #c4     
,requir+ additional /udy & report on    
acute hospital c>e at home waiv]        
flexibilities ,section #ahff;,g ( !     
,social ,security ,act 7#db ,u4,s4,c4   
#acie;cc-#g71 z am5d$ by section #b1 is 
fur!r am5d$-- 7#a7 9 subsection         
7a77#c77;,e7-- 7,a7 9 clause 7ii71 by   
/rik+ ! /udy describ$ 9 subsection 7b7 &
 ins]t+ ! /udies describ$ 9 subsections 
7b7 & 7c72 &  7,b7 by add+ at ! end !   
foll[+ new flu% s5t5ce3 ,! ,secret>y may
 require t su* data & in=mation be      
submitt$ ?r\gh a hospital's co/ report1 
?r\gh su* survey in/rum5ts z ! ,secret>y
 may develop1 ?r\gh m$ical record       
in=mation1 or ?r\gh su* o!r means z !   
,secret>y det]m9es appropriate4 2  7#b7 
9 subsection 7b71 9 ! subsection head+1 
by /rik+ ,/udy & ins]t+ ,initial /udy2  

7#c7 by r$esignat+ subsections 7c7 & 7d7
 z subsections 7d7 & 7e71 respectively2 
&  7#d7 by ins]t+ aft] subsection 7b7 ! 
foll[+ new subsection3  7c7 ,subsequ5t  
/udy & report  7#a7 ,9 g5]al ,n lat] ?an
 ,septemb] #cj1 #bjbh1 ! ,secret>y %all 
conduct a /udy to-- 7,a7 analyze1 to !  
ext5t practicable1 ! crit]ia e/abli%$ by
 hospitals "u ! ,acute ,hospital ,c>e at
 ,home initiative to det]m9e :i*        
individuals may be furni%$ s]vices "u   
su* initiative2 &  7,b7 analyze & comp>e
 7bo? )9 & betwe5 hospitals p>ticipat+ 9
 ! initiative1 & relative to comp>able  
hospitals t d n p>ticipate 9 !          
initiative1 = relevant p>amet]s su* z   
diagnosis-relat$ gr\ps7-- 7i7 quality ( 
c>e furni%$ to individuals ) simil>     
conditions & *>act]i/ics 9 ! inpati5t   
sett+ & ?r\gh ! ,acute ,hospital ,c>e at
 ,home initiative1 includ+ heal?        
outcomes1 hospital readmission rates    
7includ+ readmissions bo? )9 & beyond   
#cj days po/-dis*>ge71 hospital         
mortality rates1 l5g? ( /ay1 infection  

rates1 composition ( c>e team 7includ+ !
 types ( labor us$1 su* z contract$     
labor71 ! ratio ( nurs+ /aff1 transf]s f
 ! hospital to ! home1 transf]s f ! home
 to ! hospital 7includ+ ! tim+1         
frequ5cy1 & causes ( su* transf]s71     
transf]s & dis*>ges to po/-acute c>e    
sett+s 7includ+ ! tim+1 frequ5cy1 &     
causes ( su* transf]s & dis*>ges71 &    
pati5t & c>egiv] exp]i5ce ( c>e2  7ii7  
cl9ical conditions treat$ &             
diagnosis-relat$ gr\ps ( dis*>ges f     
inpati5t sett+s relative to dis*>ges f !
 ,acute ,hospital ,c>e at ,home         
initiative2  7iii7 co/s incurr$ by !    
hospital = furni%+ c>e 9 inpati5t sett+s
 relative to co/s incurr$ by ! hospital 
= furni%+ c>e ?r\gh ! ,acute ,hospital  
,c>e at ,home initiative1 includ+ co/s  
relat+ to /aff+1 equipm5t1 food1        
prescriptions1 & o!r s]vices1 z det]m9$ 
by ! ,secret>y2  7iv7 ! quantity1 mix1 &
 int5sity ( s]vices 7su* z 9-p]son      
visits & virtual contacts ) pati5ts & ! 
int5sity ( su* s]vices7 furni%$ 9       

inpati5t sett+s relative to ! ,acute    
,hospital ,c>e at ,home initiative1 &1  
to ! ext5t practicable1 ! nature & ext5t
 ( family or c>egiv] involvem5t2  7v7   
socioeconomic in=mation on individuals  
treat$ 9 comp>able inpati5t sett+s      
relative to ! initiative1 includ+ racial
 & e?nic data1 income1 h\s+1 geographic 
proximity to ! brick-&-mort> facility & 
:e!r su* individuals are dually eligible
 = b5efits "u ?is title & title ,,xix2 &
  7vi7 ! quality ( c>e1 outcomes1 co/s1 
quantity & int5sity ( s]vices1 & o!r    
relevant metrics betwe5 individuals :o  
ent]$ into ! ,acute ,hospital ,c>e at   
,home initiative directly f an em]g5cy  
dep>tm5t comp>$ ) individuals :o ent]$  
into ! ,acute ,hospital ,c>e at ,home   
initiative directly f an exi/+ inpati5t 
/ay 9 a hospital4  7#b7 ,selection bias 
,9 conduct+ ! /udy "u p>agraph 7#a71 !  
,secret>y %all1 to ! ext5t practicable1 
analyze & comp>e individuals :o         
p>ticipate & d n p>ticipate 9 !         
initiative controll+ = selection bias or

 o!r factors t may impact ! reliability 
( data4  7#c7 ,report ,n lat] ?an       
,septemb] #cj1 #bjbh1 ! ,secret>y (     
,heal? & ,human ,s]vices %all submit to 
! ,committee on ,ways & ,means ( ! ,h\se
 ( ,repres5tatives & ! ,committee on    
,f9ance ( ! ,s5ate a report on ! /udy   
conduct$ "u p>agraph 7#a74  4  ,octob]  
#ca1 #bjbe,report$ ) an am5dm5t1        
committ$ to ! ,committee ( ! ,:ole ,h\se
 on ! ,/ate ( ! ,union1 & ord]$ to be   
pr9t$