The Acute Hospital Care at Home (AHCAH) program has seen its share of turbulence in recent years—with multiple short-term extensions, ongoing uncertainty, and plenty of debate casting doubt on its future. Finally, there’s an update: a six-month extension.

On March 14, 2025, lawmakers passed a federal spending bill extending key healthcare provisions set to expire at the end of the month. This includes an extension of the AHCAH program through September 30, 2025, a critical step for patients, providers, and health systems that have embraced the hospital-at-home model. This extension ensures hospitals can continue delivering safe, high-quality inpatient care at home, expanding access to innovative care that prioritizes patient comfort and recovery beyond traditional hospital settings.

At Inbound Health, we’re encouraged by this progress and remain committed to helping health systems launch and scale advanced care at home programs with the clinical, operational, and technological support they need. While this extension provides much-needed relief, the next six months are critical—we must continue advocating for a long-term solution that ensures the future of hospital-at-home care.

Proven Quality of Care Under the AHCAH Program

Extending the waiver should have been an easy decision, given the program’s strong outcomes. In September 2024, CMS released a report to Congress showing that at-home acute care leads to lower mortality rates, reduced post-discharge spending, and high patient and caregiver satisfaction. The program has flourished with the help of innovative technology and a dedicated workforce eager to treat patients where they are.

Key Findings include:

• Quality of Care: AHCAH patients experienced lower mortality and hospital-acquired infection rates compared to those in traditional inpatient settings. However, 30-day readmission rates varied, with some higher and others lower than inpatients.
• Cost and Utilization: AHCAH episodes had a slightly longer average length of stay but resulted in lower Medicare spending in the 30-day post-discharge period for over half of the top 25 diagnosis-related groups.
• Patient and Caregiver Experience: Patients and caregivers reported high satisfaction, reinforcing that receiving care at home is not just effective but also preferred.

These results confirm that hospital-at-home is a safe, effective, and scalable alternative to traditional inpatient care, strengthening the case for its long-term expansion.

What a Six-Month Extension Means for Health Systems

The AHCAH program has become a key component of Medicare, with over 350 approved hospitals across more than 130 health systems delivering acute care at home. Yet, with just a six-month extension, hospitals still face uncertainty about the long-term viability of these programs. This means:

• More patients will benefit from this innovative care model in the short term, but without a permanent solution, access remains uncertain
• Health systems must continue making difficult decisions about whether to invest in expanding hospital-at-home programs amid policy instability
• Short-term policy changes create operational and financial challenges, making long-term program development more difficult

The hospital-at-home waiver also ensures hospitals receive reimbursement for treating Medicare and Medicaid patients at home, while lifting the 24/7 on-site nurse requirement. The extension also preserves Medicare telehealth flexibilities, allowing virtual care from more locations and provider types. These provisions highlight the critical role of healthcare modernization in expanding access, improving outcomes, and reducing strain on traditional hospitals.

Why a Permanent Hospital-at-Home Payment Model Is the Next Step

While the six-month extension provides a short reprieve, the future remains uncertain. Without a permanent payment model, health systems face long-term financial and operational risks. Many hospitals are investing heavily in infrastructure and staffing, but without guaranteed future reimbursement, planning remains a challenge.

Additionally, payer participation is inconsistent, and state-level adoption varies, adding another layer of complexity to long-term sustainability.

“We’re grateful lawmakers extended the AHCAH waiver, but a six-month extension falls shorts of the long-term stability health systems need. We remain hopeful that when this waiver expires in September, the next step will be a five-year extension, followed by a permanent payment model. The future of care at home is bright, with incredible innovation and proven success to build on,” Dave Kerwar, CEO, Inbound Health.

The next goal must be securing a lasting policy framework. Here’s how we can move forward:

• Health systems, policymakers, and industry leaders must continue advocating for permanent policy changes that ensure hospital-at-home programs thrive
• Continued data collection and outcome measurement will reinforce the long-term value of hospital-at-home models
• Collaboration with payers and policymakers is essential for designing a sustainable reimbursement model that supports the program’s future

The American Hospital Association is a strong advocate for a long-term extension, stating, “It will not only provide additional time to continue gathering data on quality improvement, cost savings, and patient experience but will also provide much-needed stability for new programs and may ease state concerns about updating Medicaid policies to allow for coverage of these services.”

The Future of Home-Based Care Starts Now

At Inbound Health, we’re proud to support health systems in delivering safe, effective, and scalable hospital-at-home programs. As we look ahead, we’re committed to helping our partners create innovative care solutions that meet patients’ needs today—and throughout the years to come.

With AHCAH now extended, health systems have a critical opportunity to expand home-based care and bring its benefits to more patients. Inbound helps hospitals build, launch, and operate acute and post-acute care-at-home programs, providing the expertise needed to create successful, cost-effective solutions.

Now is the time to keep the momentum going. Let’s continue advocating for lasting policy changes that support the future of hospital-at-home care.

In the fast-paced world of healthcare, patient safety is more than just a buzzword—it’s a fundamental part of providing the best care. Whether you’re a doctor, nurse, or any other healthcare professional, making patient safety a priority isn’t just a nice-to-have; it’s essential for giving your patients the best care possible.  

At the heart of our mission is a constant commitment to patient safety, reflecting our core value of providing care with the same dedication we would want for our own family. We believe that every patient deserves the highest standard of care, and this guiding principle drives us to create a safe, compassionate environment where every patient’s well-being is our top priority. By upholding these values, we ensure that our care is not only effective but also deeply respectful of the trust our patients place in us. 

Patient safety is basically about preventing harm to patients while delivering healthcare. It encompasses a broad range of issues, from avoiding medical errors to ensuring that the healthcare environment is free from risks. The ultimate goal is to create a culture where safety is ingrained in every action, decision, and interaction within the healthcare system. 

Why Patient Safety Matters 

Enhancing Patient Outcomes: Patient safety directly influences clinical outcomes. Errors and adverse events can lead to complications, extended hospital stays, and even fatalities. By prioritizing safety, clinicians can reduce the incidence of these events and improve overall patient outcomes. 

Building Trust and Satisfaction: Patients who perceive that their safety is a priority are more likely to trust their healthcare providers and be satisfied with their care. This trust fosters a collaborative relationship between patients and clinicians, which is essential for effective treatment and adherence to medical advice. 

Mitigating Legal and Financial Risks: Patient safety incidents can lead to legal action and financial repercussions. By adhering to safety protocols and best practices, clinicians can minimize the risk of litigation and associated costs, safeguarding both their practice and the institution they represent. 

Fostering a Positive Work Environment: A strong culture of safety promotes a supportive and respectful work environment. When clinicians are confident that safety is a shared responsibility, they are more likely to engage in open communication, collaborate effectively, and feel valued in their roles. 

Leadership plays an important role in ensuring patient safety within healthcare settings. Effective leaders set the tone for a culture of safety by promoting open communication, encouraging the reporting of errors without fear of retribution, and emphasizing the importance of adherence to safety protocols. They are responsible for implementing systems and processes that identify and mitigate risks, while also fostering an environment where staff feel empowered and supported in their efforts to prioritize patient well-being. By championing continuous education and improvement, leaders can drive systemic changes that enhance safety standards and ultimately lead to better patient outcomes. In essence, strong leadership is fundamental in creating and maintaining a safety-centric culture that prioritizes the well-being of patients and the effectiveness of healthcare delivery. 

Ultimately, patient safety is a shared responsibility that requires a concerted effort from every member of the healthcare team. Clinicians play a pivotal role in shaping a safe care environment. By fostering a culture of safety, embracing evidence-based practices, and committing to continuous improvement, you can significantly enhance patient outcomes and contribute to a more effective and compassionate healthcare system. 

The pursuit of safety is not a destination but a continuous journey. Let’s make patient safety an integral part of our daily practice, ensuring that every patient receives the high-quality care they deserve. 

What Patient Safety Means to Us 

Safety holds a unique meaning for each of us. We spoke with some of our clinicians and healthcare leaders to learn what safety signifies to them.  

To me… Patient safety means patients are receiving the appropriate level of care, with the correct treatment, by knowledgeable providers who deliver compassionate care.   

-Nurse Practitioner 

Patient Safety means that we are providing the same level of care that I’d expect for my parents in every interaction we have.  Patient safety means that every decision we make as caregivers and as a business is centered around the patient’s best interest.  Patient safety is looking for ways opportunities for failure in our processes and fixing them.  Patient safety is speaking up and pausing when something isn’t right.  

-VP Operations 

Safety:  patient is out of harm’s way physically, emotionally and spiritually in any continuum of care 

-Manager, Clinical Liaisons 

1. Safety is ensuring patients receive care that is free from harm. 2. Safety is advocating for patients and making decisions that prioritize their well-being. 3. Safety is recognizing the importance of one’s own well-being to maintain a high level of care. This includes striving for work-life balance and managing stress to ensure you are physically and mentally capable of performing your duties safely. 

-Nurse Practitioner/Provider Lead 

– Preventing medical errors or complications: Making sure patients receive the right care at the right time. Implementing practices to keep patients safe and prevent the spread of germs and diseases. 

– Providing a safe environment: Making sure patients feel safe and relaxed while receiving care. 

-Program Implementation Manager 

Patient safety to me means preventing harm to patients during their interaction with Inbound Health from admission to discharge. To me it involves creating an environment where patients receive care that is free from errors and harm, while continually evaluating risks to patients that can be added to our patient care processes. 

-CTO 

To me, patient safety is about creating a culture that is designed around psychological safety, continuous improvement, and seeking patient and frontline care giver feedback.  Psychological safety gives us all the freedom to identify and discuss areas of improvement as it relates to delivering patient care without fear of retribution or negative impacts.  Continuous improvement creates an expectation around measurement, accountability, and iterative improvement around our clinical protocols.  Finally, patient and front-line caregiver feedback allows us to hear from patients and their family members, stakeholders that are key for us to learn and improve in this most important aspect of our company’s mission. 

-CEO 

-Patient safety should be at the forefront of every nurse, provider, and caregiver’s mind with each and every patient every day. 

-A very loved family member of mine was found to have stage 4 esophageal cancer. Got a PORT placed for immunotherapy and chemotherapy. I remember this loved one telling me, “My nurse didn’t wear gloves when she changed the dressing on my PORT.” A week later, they ended up septic and admitted to unit, and the PORT had to be removed. Since this event, I personally am VERY cautious about central line care for all patients. I think real life experiences help us become better RNs and with that we can teach new RNs to do the right thing while ALWAYS having patient safety on their mind.  

-I also, have an experience with a family member declining in an Assisted Living Facility. Staff did not have patient safety at the forefront of their mind. I therefore personally cared for this family member on my own so they could receive safe and excellent care. Patients deserve to be cared for by caregivers that focus on safety, quality, and compassionate care. 

-Nurse Manager 

Safety means reducing or eliminating risks and ensuring protection from harm or danger in any given situation. 

-Triage Nurse 

Safety-situational awareness to prevent harm to ones self or to pay attention to what is happening around them. Caring for patients to ensure they have what they need to be without harm at home. 

-Manager of Community Paramedics 

Safety to me means communication. Communication between our team and providers, inhome/HC nurses, Management, CP’s, and CA’s to care for our patients as a team. Communication within the clinical team  ensures that out pt’s are being cared for safely. There is less chance of duplicating services or med errors. It also increases patient satisfaction. Communication with Mgmt ensures that we all have the tools to our job and are up to date on changes. It also helps us all feel as we are part of the whole team when we are all included in any changes. 

-Patient Care Manager, RN