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.
