Advocacy Issue: Hospital-at-Home Waivers

The Issue

The hospital-at-home (H@H) model — where patients receive acute level care in their homes, rather than in a hospital — has emerged as an innovative and promising approach to provide high quality care to patients in the comfort of their homes. Since the start of the program, Congress has extended the waivers twice. First in 2022 (Consolidated Appropriations Act of 2023) for two years and then again in 2024 (H.R. 10545 the American Relief Act) for 90 days. Both extensions received no score from the Congressional Budget Office. Congressional action is needed to extend the waivers for this program, which are now set to expire March 31, 2025.

AHA Position

The AHA supports the Hospital Inpatient Services Modernization Act to extend the H@H waiver for five years.

Hospitals and health systems see H@H programs as a safe and innovative way to care for patients in the comfort of their homes. This kind of care is well suited for medium acuity patients who need hospital level care but are considered stable enough to be safely monitored from home. Rather than staying three days or longer in the hospital, these patients can be treated safely by their doctor and a team of medical professionals along with the patient’s support system at home.

A long-term extension will not only provide additional time to continue gathering data on quality improvement, cost savings, and patient experience, but will also provide much needed stability for new programs and may ease state concerns about updating Medicaid policies to allow for coverage of these services.