CMS waiver extension introduces opportunities for hospital at home expansion

Hospital-at-home models offer a scalable solution to improve patient experiences, expand inpatient capacity, and differentiate services. With the Centers for Medicare & Medicaid Services (CMS) extending the Acute Hospital Care at Home Program through 2030, hospitals can deliver inpatient-level care at home—enhancing outcomes and reducing total costs of care. More than 370 hospitals across 37 states are currently approved to participate. 

Hospital-at-home programs admit eligible patients into a home setting, improving hospital inpatient capacity, access, and the patient/family experience. These models can lower care costs by up to 30%.¹  

A growing body of research shows hospital-at-home care improves length of stay, reduces readmissions, prevents healthcare-acquired infections, and lowers costs.² Compared to traditional hospital care, home-based care often yields higher patient satisfaction scores. ^3,4 An aging population further drives demand for robust at-home services—two-thirds of the U.S. population aged 60-79 years old prefer receiving care at home.³     

Addressing workforce shortages and operational challenges 

Hospitals are currently face significant workforce shortages, network leakage, and throughput issues. Acute hospital-at-home models offer a strategic response to these challenges. A Guidehouse survey of more than 130 CEOs found hospitals are expanding services outside traditional settings by approximately 20%.⁵ 

However, implementation experience and scale varies widely. Some waiver-approved hospitals have launched successful programs, while others struggle to launch or grow to an impactful level. 

Guidehouse has helped health systems secure CMS waiver approval and design enterprise-wide hospital-at-home programs. Our experts work with provider organizations to align ambulatory workflows, integrate them into the EHR, and facilitate investments in technology to enhance safety and mitigate risk. These efforts position systems to better serve their community and strengthen market competitiveness. 

Launching and growing hospital-at-home programs 

The five-year waiver extension presents a pivotal opportunity for hospitals to address capacity issues, improve efficiency, and differentiate their services through improved patient experiences.   

Consider a hospital-at-home strategy if your organization faces: 

• Excess length of stay, readmissions, and patient throughput challenges 
• Capacity constraints limiting patient access  
• Difficulty managing total cost of care 

For organizations with existing programs, now is the time to invest in expansion and improvement. Hospital-at-home models deliver high-quality acute care in the setting that patients most prefer: their homes.