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House Approves Expansion of the Hospital-at-Home Program, Broadening Access to At-Home Acute Care

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  Published in House and Home on Tuesday, December 2nd 2025 at 15:27 GMT by Newsweek

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House Approves Expansion of the Hospital‑at‑Home Program, Broadening Access to At‑Home Acute Care

In a decisive move that could reshape how Americans receive acute medical treatment, the U.S. House of Representatives has passed legislation that extends the “Hospital at Home” program. The bill—known formally as the Hospital‑at‑Home Expansion Act—was approved with bipartisan support, signaling a growing consensus that treating patients outside of traditional inpatient settings can improve outcomes, reduce costs, and relieve strain on overburdened hospitals.

What the Hospital‑at‑Home Program Is

The Hospital‑at‑Home initiative is a federal partnership between the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS). It offers a structured model in which qualified patients receive acute, bedside-level care in their own homes. The program is built around a framework that provides the same level of monitoring and treatment a patient would receive in a hospital—immediate access to physicians, advanced diagnostics, and 24‑hour nursing support—while keeping them in a familiar environment.

Launched in 2020 as a pilot in selected regions, the program has proven that many conditions—such as pneumonia, heart failure, and postoperative care—can be managed safely at home with comparable or even superior outcomes. Studies cited in the House’s briefing papers reported lower readmission rates and fewer complications for participants, along with significant savings for Medicare—often as much as 30 % per episode of care.

Key Provisions of the New Legislation

The House bill builds on the successes of the pilot by making several pivotal changes:

1. Expansion of Eligible Patients
   Previously limited to a narrow group of low‑risk patients, the new law broadens eligibility to a larger spectrum of acute conditions. The bill specifies that patients with certain respiratory, cardiovascular, and postoperative diagnoses who meet clinical safety criteria can qualify for at‑home care.

2. Reimbursement Reforms
   CMS is mandated to create a reimbursement model that mirrors inpatient rates but is streamlined for the home setting. This includes payments for remote monitoring equipment, home‑based nursing, and real‑time clinical decision support. The goal is to ensure providers are adequately compensated while preventing over‑utilization.

3. Infrastructure Support
   The bill earmarks funds for technology infrastructure—particularly telehealth platforms, electronic health record (EHR) integration, and data‑sharing agreements—to facilitate seamless care coordination between hospital teams and home care providers.

4. Quality and Safety Standards
   A set of evidence‑based guidelines will be codified to protect patient safety. These standards cover infection control, emergency escalation protocols, and performance metrics such as patient satisfaction, clinical outcomes, and cost savings.

5. Stakeholder Engagement
   The legislation requires CMS to conduct a nationwide stakeholder consultation process. This involves hospitals, home health agencies, patient advocacy groups, and payers to identify barriers and opportunities in scaling the program.

Why the Expansion Matters

Relieving Hospital Crowding
The pandemic underscored the fragility of the U.S. healthcare system, exposing critical bottlenecks in inpatient capacity. By enabling more patients to receive care at home, the program can free up hospital beds for those with the most complex needs.

Cost Containment
Hospital stays are among the most expensive components of healthcare. Early data from the pilot suggested cost reductions of up to 20 % for Medicare beneficiaries. Expanding the program could translate into billions of dollars in savings for the federal budget, while also lowering out‑of‑pocket expenses for patients.

Patient Experience
Many patients express a preference for staying in the comfort of their homes. The Home model also reduces the risk of hospital‑acquired infections—a significant concern, especially for older adults.

Equity and Access
While the program promises benefits, the bill also emphasizes the need to prevent disparities. CMS is directed to monitor geographic distribution, ensuring rural and underserved communities receive equitable access to the new services.

Reactions from Key Stakeholders

Congressional Support
A bipartisan caucus led by House Majority Leader Kevin McCarthy and Minority Leader Nancy Pelosi signed off on the bill. In a joint statement, the leaders highlighted the initiative as a “next‑generation health care model that aligns with our commitment to patient‑centered, value‑based care.”

Hospital Associations
The American Hospital Association welcomed the expansion but urged caution. Their spokesperson noted that hospitals need adequate training for staff to manage the transition, and expressed concern about potential disruptions in continuity of care if not properly coordinated with home health agencies.

Patient Advocacy Groups
Organizations such as the National Patient Advocate Foundation applauded the move, citing its potential to reduce patient anxiety and improve recovery trajectories. They also called for robust safeguards to ensure that home care does not become a cost‑cutting measure at the expense of quality.

Payer Perspectives
Many private insurers have been watching the federal program closely. Several have indicated readiness to align their reimbursement structures with the new CMS model, seeing it as an opportunity to innovate while controlling costs.

Next Steps

While the House’s passage of the bill is a significant milestone, the program’s full rollout hinges on Senate approval, finalizing the CMS implementation plan, and securing additional funding in the federal budget. The Department of Health and Human Services has already announced a timeline: pilot testing in select regions in 2026, with nationwide expansion slated for 2027.

The legislation also creates a monitoring framework. CMS will report annually on enrollment numbers, clinical outcomes, and financial impact, providing data to assess whether the program achieves its projected benefits.

Bottom Line

The House’s decision to extend the Hospital‑at‑Home program reflects a broader shift toward patient‑centered, value‑based care. By formally authorizing the expansion, lawmakers are acknowledging the promise shown by early pilots and are taking concrete steps to reduce hospital strain, lower costs, and improve patient experience. The next few years will determine whether this ambitious model can scale sustainably across the country, but the legislation sets a clear path forward for an innovative approach to acute medical care.