How Health Systems Are Turning Living Rooms Into Hospital Rooms

This recent article (excerpted below for length) explains that the Hospital At Home model is an innovation that seems to be demonstrating value for America’s healthcare system.

Under the CMS waiver that expanded this model, Mobile Healthcare Paramedics are approved members of the healthcare team supporting this model.

Some EMS systems have partnered with local hospitals to be part of this model, but the CMS waiver that enables the intervention is due to expire on September 30, 2025.

EMS advocacy groups should include the continuation of this waiver as part of their legislative educational efforts, along with the waivers that enable telehealth services available that some EMS systems are using to provide patient-centered patient navigation.

How Health Systems Are Turning Living Rooms Into Hospital Rooms
By Alexis Kayser, Healthcare Editor
Sep 10, 2025

https://www.newsweek.com/2025/09/19/how-health-systems-are-turning-living-rooms-hospital-rooms-2126557.html

How Do Hospital at Home Programs Work?
Demand for hospital beds skyrocketed during the pandemic. To alleviate some of the pressure on inpatient wards and emergency departments, the U.S. Centers for Medicare and Medicaid Services launched the Acute Hospital Care at Home initiative in November 2020. The new rule permitted certain Medicare-certified hospitals to provide inpatient-level care in patients’ homes.

While this wasn’t the first test run for hospital at home—the model is popular around the world and had been piloted in the U.S. for specific disease cases—the legislation sparked unprecedented interest. People over the age of 65 represent a large portion of hospitalized patients, so it was tough for health systems to justify this kind of treatment without a reimbursement route for Medicare, the federal health insurance program for seniors.

By July 2025, 400 hospitals across 39 states were participating in the AHCAH program. Many of them use a combination of remote patient monitoring technology, in-home nursing and rehabilitation visits and virtual doctors’ appointments to provide hospital-level care in the comfort of patients’ own homes. Often, the remote monitoring devices can be operated with the click of a button and automatically send readings to hospitals’ data dashboards—reducing pressure on the less technologically savvy. Patients with respiratory, circulatory, renal and infectious diseases are common candidates for this type of care.

The success is not just anecdotal. Medicare beneficiaries who received care under the AHCAH initiative had lower mortality rates, according to a September 2024 CMS report. And a June 2024 research analysis published in the journal BMC Medicine found a 25 percent reduction in mortality rates for patients who had been discharged early from an inpatient hospital stay into a hospital at home program.

In the 30 days after a patient was discharged from the hospital, Medicare spending was significantly lower in the hospital at home group than in the traditional hospital group as well.

Hospital CEOs are worried about a “triple threat” to their budgets, DiLullo said: People need more health care services than ever, and need them for longer as life expectancies go up, yet the industry doesn’t have enough staff to meet demand. As health care costs rise at a quicker pace than inflation, industry leaders are feeling the pressure to make care more affordable without sacrificing quality. He believes that virtual and hospital at home programs could be a solution.

What are the Challenges Facing Hospital at Home Programs?
OSF Healthcare has generally seen “incredibly high” satisfaction scores for hospital at home, according to Moots. But the model is far from perfect. Caregivers lose the solace and privacy that once marked their space. Oftentimes, they’re also tasked with providing medical care, making sure equipment is up to date, medications are filled and nurses show up to their shifts.

But that momentum is tempered by the uncertain policy environment. When CMS launched the AHCAH initiative in 2020, they did not promise that it would be permanent. The program has been extended by Congress three times, most recently in 2025 for six months. The current waivers are set to expire on September 30, 2025—which would end hospitals’ ability to provide care in the home.

Health systems and House representatives—from both parties—have been working to keep hospital at home programs alive. The Hospital Inpatient Services Modernization Act, which would extend the AHCAH program through 2030, was introduced in the House in July. Backed by professional organizations like the American Hospital Association and the Association of American Medical Colleges, the legislation also calls for a formal evaluation to compare home-based to traditional hospital care, and help CMS set standards.

On September 3, a group of 140 health care stakeholders—including health systems, digital care companies and advocacy organizations—wrote a letter to Congress, urging them to include the waiver extension in the September government funding package. If the legislation passes, it would benefit systems like OSF HealthCare that have spent much of the past five years in a waiting game.

“Our CMS waiver has been unevenly renewed, and that’s been a real struggle,” Moots said. “If you’re living six months to six months in a program that requires a lot of capital investment, that’s really tough to do.” A longer extension would also incentivize more hospitals to invest. Many have been holding off because they’re unsure of the AHCAH’s future, according to the American Hospital Association.

“We always have to make sure that Medicare extends the [AHCAH waiver],” Banos said when asked about the greatest challenges facing hospital at home programs. “We want to focus permanently on Medicare.”