Hospital at Home Programs Face Uncertain Future Amid Waiver Concerns

Updated June 07, 2025

Best Buy Health recently announced a restructuring of its health‌ division,‍ attributing the decision to the slow adoption of at-home care models. CEO Corie Barry‍ highlighted‌ the inconsistencies surrounding the ⁣Acute Hospital Care at Home program, which ‍is set to expire in September, as a contributing⁣ factor.

While Best Buy Health grapples with the uncertainty, other health systems are also hesitant ‍to‍ launch hospital at home (HaH) programs⁤ due to questions about the ‌program’s​ long-term viability. Despite these concerns,industry ‍experts express optimism about the future of hospital at home,acknowledging the ‌challenges in establishing a permanent policy​ for at-home acute‍ care.

Dr. ‍Robert moskowitz, president and chief‍ medical officer at Contessa Health, emphasized the continued need for such​ programs. He cited ongoing hospital⁣ capacity issues ⁣and the ​vulnerability of rural hospitals as key factors driving the importance of hospital-at-home⁣ initiatives.

The⁤ Centers for Medicare & Medicaid Services (CMS) introduced the Acute Hospital‌ Care at Home program⁣ in 2020, enabling hospitals to receive Medicare waivers for treating patients remotely. as of⁢ March 2025, the American ​Hospital Association ⁣reported that 391 health care facilities across 39 states have been approved to provide HaH services.

Dr. Michael Maniaci, enterprise medical director of⁢ virtual care ‌at the Center ⁤for Digital Health at Mayo Clinic, notes that hospital at home is evolving from initial⁣ experimentation to strategic refinement. Major health systems​ like Mayo Clinic and Mass General Brigham (MGB) have integrated HaH into ⁢their operational planning.

According to Dr.​ Stephen Dorner, chief clinical and innovation officer for Mass General Brigham Healthcare at home, the continued short-term⁢ extensions of the ⁢CMS⁢ waiver are causing ⁤hospitals to delay investing in new programs. He advocates for a long-term ⁤extension to ensure the adoption of this ‌patient-centric care model.

Dorner also pointed to a crowded policy landscape as a challenge, noting ⁣the wide range of competing legislative priorities. Maniaci ‍added that HaH‍ disrupts traditional definitions of hospitalization,impacting billing structures and site-of-care rules. The variability in HaH ⁤programs further complicates the creation of⁢ a universal policy.

Caroline Rogers, vice president of quality and safety‍ at Contessa Health, stressed the importance of data in driving permanent‍ policy decisions. She noted that last year’s proposed five-year waiver extension included requirements for robust data collection and ‍analysis.

rogers also‌ cautioned that the expiration ⁤of ⁤the waiver ‍in September would strain hospital capacity,‍ requiring‌ immediate patient transfers back to physical facilities.

“The movement is stronger than ever. Hospital capacity issues ‍have not improved, and​ the‌ viability of rural hospitals continues to be at risk. The ⁤factors that created the need for hospital-at-home programs continue ⁣to underscore the importance of the movement.”

“While the initial pandemic-era surge in hospital-at-home enthusiasm has naturally⁤ leveled off,‍ what we’re seeing now is a shift from broad experimentation to targeted ‍refinement and scaling. The​ movement hasn’t lost momentum; it’s entering⁣ a more disciplined and strategic phase.”

What’s ⁢next

Despite the uncertainty, Maniaci believes that forward-thinking organizations will continue to expand hospital at home⁣ programs. Health systems are diversifying their ‌offerings by forming payer partnerships, piloting bundled contracts, and ​investing in flexible care models. the Mayo Clinic, for example, has created a modular system that⁤ scales across different geographies and regulatory frameworks.