Hospital at Home is a care delivery model that allows some patients to receive acute, hospital-level care in their homes, as opposed to a traditional,  in-patient hospital setting. Hospitals that have a Hospital at Home program evaluate patients to determine whether in-home care is appropriate, and while the structure of each program differs, only patients that are stable enough for in-home monitoring are admitted to the home. Monitoring may happen via in-person visits, as well as through remote patient monitoring and telehealth visits. Patients can receive clinically appropriate care in the home, including but not limited to diagnostic procedures, oxygen therapy, intravenous fluids and medicines, respiratory therapy, pharmacy services and skilled nursing.

Approved Facilities/Systems for Acute Hospital Care at Home
Updated as of 05/13/2024

CMS Acute Hospital Care at Home

The Acute Hospital Care at Home program is an expansion of the Centers for Medicare and Medicaid Services (CMS) Hospital Without Walls program. Launched in March 2020, the Hospital Without Walls initiative was part of a comprehensive effort to increase hospital capacity, maximize resources, and combat COVID-19 to keep Americans safe. The program also allowed additional flexibility that allowed certain health care services to be provided outside of a traditional hospital setting and within a patient’s home.

In November 2020, CMS utilized its COVID-19 flexibility authority to launch the Acute Hospital Care at Home (Hospital at Home) program, an expansion of the Hospital Without Walls effort, provided hospitals with unprecedented regulatory flexibilities to treat eligible patients in their homes. The program differentiated the delivery of acute hospital care at home from more traditional home health services. The Hospital at Home waiver program was developed to be only available during the COVID-19 public health emergency.

In March 2022, Senators Tom Carper (D-DE) and Tim Scott (R-SC) and Representatives Earl Blumenauer (D-OR) and Brad Wenstrup (R-OH) introduced the Hospital Inpatient Services Modernization Act (S. 3792/H.R. 7053), which would establish a two-year extension of the Acute Hospital at Care at Home COVID-19 waiver triggered by the end of the public health emergency. Find more information here.

On December 29, 2022, President Biden signed into law the Consolidated Appropriations Act (CAA) for Fiscal Year 2023 (H.R. 2716), which included the two-year extension of the Acute Hospital Care at Home individual waiver.

Americans want home to be the center of their health:

• Americans Are Comfortable Receiving Care in the Home
  • 70 percent of those surveyed are comfortable with care in the home citing that familiarity helps alleviate anxiety and improve communication. This is especially important for those from underserved and minority communities.
• Americans Are Confident in the Quality of Receiving Care in the Home
  • 73 percent of adults are confident in the quality of receiving care in the home.
  • 85 percent of caregivers are confident in the quality of receiving care in the home.
  • 88 percent of adults were satisfied with the clinical care services they received in the home.
• Americans Prefer and Would Recommend Care in the Home
  • 85 percent of people who have had experience with care in the home would recommend it to family and friends.
• Americans Support Expanded Care in the Home
  • A bipartisan majority of consumers say it should be a priority for the federal government to increase access to clinical care in the home (73 percent Democrats, 61 percent Republicans).

To ensure that this program remains permanent after December 31, 2024, Moving Health Home urges policymakers to utilize the already existing data from the waiver experience and permanently ensure home is a clinical site of care.

Related:
Stakeholders Urge House Leaders to Extend Hospital at Home for 5 Years
Stakeholders Urge Congress to Ensure Patient Access to Acute Care at Home
Statement on the Introduction of the Hospital Inpatient Services Modernization Act
Congress Sends a Strong Message on Continuing Innovation in Home-Based Care