What’s the news: In a win for Medicare patients and their physicians, older-adult Americans will continue to benefit from hospital-level care in their homes after Congress extended a proven, physician-led model through 2030.
The Acute Hospital Care at Home waiver extension that was part of the Consolidated Appropriations Act, 2026, gives some certainty to the safe and popular home-care initiative that the Centers for Medicare & Medicaid Services (CMS) launched in response to the COVID-19 public health emergency. The program grants waivers to individual hospitals to provide Medicare patients with inpatient-level home care.
This is one of eight major wins for patients and physicians included in the latest federal budget deal. These victories didn’t happen by chance. They happened because the AMA fought for them, and they were only possible because the AMA brought the full strength of its advocacy to Capitol Hill. That powerful effort encompasses thousands of interactions with congressional offices, hundreds of letters and resources, congressional testimony and more, says the new “AMA Advocacy Impact Report.”
Why this win matters: Studies have shown that providing hospital-level care to patients at home is beneficial on many levels: lower mortality rates, fewer hospital-acquired conditions and lower costs in the 30 days following hospital discharge. The program can also help to address problems that arise due to hospital capacity constraints like emergency department boarding, since patients who are able to be effectively and safely treated at home free up beds for use by patients who can only be treated in an inpatient hospital setting. Meanwhile, patients and families like it.
Meanwhile, a LINUS report showed that two-thirds of American 60–79 years old want to stay at home in their later years. Currently, 366 programs across 139 health systems in 37 states have been approved to provide acute hospital care at home, and other health systems and hospitals have indicated that they are interested in setting up these programs but have been hesitant without a long-term extension of the program.
The AMA has long backed extending the Acute Hospital Care at Home waiver. In an August letter (PDF) to Sens. Tim Scott (R-S.C.) and Raphael Warnock (D-Ga.), AMA CEO and Executive Vice President John J. Whyte, MD, MPH, noted the AMA’s support for legislation to extend the Acute Hospital Care at Home Act waiver through 2030.
In addition to shorter says, lower costs and improved outcomes, Dr. Whyte wrote that it was equally important to note “the waiver’s ability to free up hospitals to better care for patients dealing with conditions or ailments that can only be treated in the inpatient setting.”
He also wrote that “continuation of this policy truly embodies the mantra in medicine of treating patients in the right setting, at the right time. Furthermore, extending the waiver will provide much needed certainty to current participants and signal to health systems that Congress supports investment in innovative models of care than enhance capacity and improve patient outcomes.”
Learn more: Catch up with more insights in the AMA report, “The State of Health at Home Models: Key Considerations and Opportunities” (PDF).
Also, find out how participants in the AMA Health System Member Program have innovated with hospital-at-home efforts.
Marshfield Clinic Health System in rural Wisconsin—which is now part of Sanford Health—was an early adopter of the idea of providing hospital-level care at home, which it had proposed (PDF) as a physician-focused alternative payment model for Medicare, one of about 20 institutions nationwide to offer this option before the waiver program. Marshfield saw its program achieve a more than 90% satisfaction rate, a 44% reduction in readmission rate and a 35% drop in average length of stay.
Ochsner Health in New Orleans established an acute care at home program in 2024 to provide at-home services for eligible emergency department patients. In less than a year, more than 1,000 bed-days were saved by avoiding hospital admissions or stays in the observation unit. Instead, they saw patients the same or next day at home by a virtual physician leading an in-home care team.
Physicians with The Permanente Medical Group helped launch the Kaiser Permanente Advanced Care at Home program in 2021 that combines home visits, telehealth encounters and remote patient monitoring connected to specialized command centers that coordinate services to help achieve a 30-day readmission rate lower than the national average.
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