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The U.S. House of Representatives has unanimously voted on legislation to continue acute hospital care at home, a program supported by the American Hospital Association and numerous other provider organizations.
On Monday, the House passed the Hospital Inpatient Services Modernization Act (H.R. 4313), which extends the Acute Hospital Care at Home (AHCaH) through 2030.
It now moves to the Senate for a vote. The American Telemedicine Association has urged for passage and for President Donald Trump’s signature before a January deadline when the program expires.
“This is an important step to avert another lapse of essential care for Medicare patients on January 30, 2026,” said ATA Action, the advocacy arm of the American Telemedicine Association. “ATA Action strongly urges the U.S. Senate to quickly pass this legislation to ensure certainty for thousands of patients across the country.”
The ATA has long been an advocate for not only extending the program, but making it permanent.
In a move supporting a continuation of the initiative, in September more than 140 healthcare organizations, including more than 50 health systems, sent a letter to Congress urging inclusion of a five-year extension of the Acute Hospital Care at Home waiver program in a government funding package.
In its own September statement to the Committee on Ways and Means, the American Hospital Association said that as of August 2025, 413 hospitals across 146 systems and 39 states had been approved to provide acute hospital services to patients at home.
Hospitals need stability to justify the needed investment for the program, the AHA indicated.
“Standing up a H@H program requires logistical and technical work, with an investment of time, staff and money,” the AHA said in the September letter. “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.”
WHY THIS MATTERS
Initiatives to move acute hospital care to the home are not new. John Hopkins began its Hospital at Home program around 1995. But acute hospital care at home gained traction during the COVID-19 pandemic when the Centers for Medicare and Medicaid Services allowed for the flexibilities needed for hospitals to provide, and get paid for, acute care services at home.
During the pandemic, many hospitals ramped up acute hospital care at home programs to free up beds needed for patients with COVID-19.
Hospitals also found an economic benefit by being able to backfill lower acuity patients with higher margin patients, said Mark Larson, principal of Sg2, a Vizient subsidiary, in a 2021 interview with Healthcare Finance News.
In a win-win situation, most patients prefer recovering at home. Those who receive hospital care at home generally have lower mortality rates than their brick-and-mortar inpatient counterparts, said a Centers for Medicare and Medicaid Services report on the acute hospital care at home initiative.
CMS also said it could not conclude that the acute hospital care at home program resulted in lower Medicare spending overall compared to brick-and-mortar inpatient care.
One of the flexibilities provided under the pandemic was for virtual care.
“The Acute Hospital Care at Home program, in place for over half a decade, has become a critical part of the nation’s care delivery system. More than 330 hospitals across 37 states now rely on AHCaH to safely care for appropriate patients in their homes,” said Alexis Apple, director of Federal Affairs at the American Telemedicine Association. “In a solid show of bipartisan support, the House passed legislation under suspension, to ensure that millions of Medicare beneficiaries will continue to have access to a proven care model that reduces complications, shortens recovery times and strengthens bed capacity for patients with life-threatening or complex illness requiring intensive medical care and monitoring.”
THE LARGER TREND
In November 2020, CMS approved waivers for six health systems to provide acute care at home. The hospitals included Brigham and Women's Hospital in Massachusetts; Huntsman Cancer Institute in Utah; Massachusetts General Hospital in Massachusetts; Mount Sinai Health System in New York City; Presbyterian Healthcare Services of New Mexico; and UnityPoint Health of Iowa.
The Hospital Inpatient Services Modernization Act extends the current Hospital at Home waiver program, first established by CMS in November 2020, through 2030.
Email the writer: SMorse@himss.org