Congress Restores Hospital-At-Home—For Safe, Comfortable Patient Care
Hospital at Home (HaH) programs have revolutionized the way patients receive hospital-level care by allowing them to stay in the comfort of their own homes rather than in a traditional hospital setting. When the waiver funding for the program expired on September 30, 2025, hospitals and patients faced challenges navigating a less efficient system.
Dr. Jared Conley, an Assistant Professor at Harvard Medical School and co-chair of the US-based Hospital at Home Tech Council, has been a strong advocate for HaH. He emphasizes the benefits of receiving care at home, where patients experience better sleep and a sense of autonomy. Not only does HaH improve patient comfort, but it also reduces inpatient census and relieves bottlenecks in emergency departments, making it a valuable system-wide solution.
The development of Hospital at Home has been a long process, with pioneers like Dr. Bruce Leff laying the groundwork in the 1980s and 1990s. Despite initial challenges with funding, research consistently demonstrated the model’s effectiveness. Mount Sinai’s research in 2014 showed improved clinical outcomes, faster recovery, and lower readmission rates, paving the way for wider adoption.
During the COVID-19 pandemic, CMS issued a waiver allowing hospitals to be reimbursed for HaH, leading to increased interest in the program. As of October 2024, 366 hospitals have served over 31,000 patients through HaH, indicating a growing national momentum.
Dr. Conley recently experienced the HaH model firsthand when he sustained an injury while mountain biking. After receiving inpatient care due to the expiration of the HaH waiver, he was able to transfer home for further treatment. He noted the challenges of the hospital environment and highlighted the benefits of receiving care at home, where clinicians gain a deeper understanding of a patient’s real-life circumstances.
Scaling the HaH model presents challenges related to payment, legislation, and cultural shifts in physician and patient practices. With the aging population expected to increase significantly in the coming years, HaH offers a solution to the shortage of hospital beds. By reallocating care to those who truly need it, hospitals can provide safer, more efficient care to patients at home.
The future of Hospital at Home lies in advanced monitoring and integrated technology to ensure patient safety. Dr. Conley collaborates with startups, the FDA, and large companies to develop technologies that de-risk patients at home and detect complications earlier. While the recent reinstatement of HaH funding is a step in the right direction, a permanent pathway is needed to fully realize the benefits of this patient-centered, evidence-based model.
