Dive Brief:
- The House of Representatives has voted to extend Medicaid waivers for the hospital at home program for five years, offering a longer extension for the pandemic-era program after a slew of short-term reprieves.
- The bill, which passed the House unanimously on Monday, would waive certain requirements to enable hospitals to provide acute inpatient care in patients’ homes until Sept. 30, 2030. The waivers were previously set to expire on Jan. 30, 2026.
- Hospital and telehealth groups applauded the bill’s passage. “This is a perfect example of how our government should work,” said Alexis Apple, director of federal affairs at ATA Action, the advocacy arm of the American Telemedicine Association, in a statement. The bill now heads to the Senate for voting.
Dive Insight:
Hospitals groups lobbied for the bill’s passage, which ensures longer-term funding security for hospital at home programs after a series of brief extensions.
Although hospital at home has been used for decades, the offerings surged in popularity during the pandemic, after CMS launched the Acute Hospital Care at Home initiative. The program, meant to help hospitals struggling with capacity challenges and the spread of COVID-19, waived various facility and nursing requirements and cleared a regulatory pathway to reimburse for acute hospital at home care. In exchange, hospitals agreed to report patient safety data to the government.
Major health systems like the Mayo Clinic launched hospital at home programs during the pandemic. New healthcare entrants, like Best Buy, also expanded in hospital at home during the pandemic. As of July, 400 hospitals across more than 140 systems had been approved to provide hospital at home care, according to the American Hospital Association.
Hospitals argue the program saves money and frees up space in facilities while allowing patients to receive care in the comfort of their home. Studies have shown that patients recover better at home and rarely need to return to facilities for care. A 2024 study from the CMS found the program had lower mortality rates and fewer costs after discharge compared to brick-and-mortar facilities.
Still, the hospital at home waivers were originally slated to expire at the end of the pandemic public health emergency in 2023. The waivers were extended by Congress multiple times in short-term increments. This year, the program expired during the 43-day government shutdown, leaving hospitals in a temporary capacity bind. After the government reopened, the waivers were extended until Jan. 30, 2026.
Hospital and telehealth groups have argued that a longer extension is needed for the program’s stability and to encourage new participants to stand up their own programs.
“Standing up a [hospital at home] program requires logistical and technical work, with an investment of time, staff and money,” the AHA said in a September letter to a House subcommittee in support of the bill’s passage. “In addition to being approved for the federal waiver, some providers must navigate additional regulatory requirements at the state level. For some, this whole process could take a year or more to complete before the first patient can be seen at home.”
In addition to extending the program until 2030, the bill also directs the CMS to collect data on care quality on hospital readmission, mortality rates, nurse staffing and hospital transfers.
