For the last century, traveling to a hospital has been the main option for people who need acute medical care. Today, however, a growing number of patients are receiving hospital-level care in the comfort of their own home. The hospital-at-home model flourished during the COVID-19 pandemic when hospital beds were in short supply. It continues to prove its value as an effective way to care for patients and keep hospital beds open for more critical cases.

Instead of being admitted to a hospital, patients with conditions like pneumonia, heart failure, infections, and chronic diseases can now be treated safely at home. Care teams visit patients in person, check-in virtually through telehealth technology, and use remote monitoring devices to track their health status in real time. The hospital-at-home approach improves patient comfort and satisfaction while still serving patients with remarkable care.

From idea to national solution

Hospital-at-home isn’t an entirely new concept; it was first used in the United Kingdom in the 1970s and began gaining traction in the United States in the 1990s. Early adopters saw that many patients could safely recover at home and often did better there than in a traditional hospital setting. In the early 2000s, Johns Hopkins took hospital-at-home from pilot program to nationwide study that showed promising results. Patients treated at home had fewer complications, recovered faster than their in-patient counterparts and reduced costs.

Other hospitals and health systems experimented with this approach, but it wasn’t until 2020 that hospital-at-home became a more significant part of the U.S. healthcare system. When the COVID-19 pandemic overwhelmed hospitals across the nation, the federal government created the Acute Hospital Care at Home Waiver program through the Centers for Medicare & Medicaid Services (CMS). This temporary waiver removed many of the legal and payment barriers that previously discouraged the use of hospital-at-home. As of April 2026, data shows 365 official Community Care Network (CCN) facilities in 37 states are approved for the CMS waiver. The model has seen rapid growth and promising outcomes for patients, but its long-term future remains uncertain without permanent policy support.

Funding remains a critical piece of the puzzle

One of the biggest challenges facing hospital-at-home is sustainable funding. Right now, the model relies on a mix of public and private funding:

• Medicare and Medicaid: The CMS waiver has been the backbone of hospital-at-home expansion. It allows hospitals to receive inpatient-level reimbursement for care delivered at home, making the programs financially viable and enabling investments in staffing, equipment, and other infrastructure. However, the waiver is only temporary. In February 2026, the waiver was extended into 2030, providing short-term certainty for participating hospitals. Lawmakers also recently introduced legislation to build on the model’s success. The At Home Observation and Medical Evaluation (HOME) Services Act was introduced in May 2026. It would expand Medicare’s hospital-at-home framework by establishing a pilot program to allow observation-level services to be delivered in patients’ homes. While this proposal would broaden access and flexibility, separate congressional action would still be needed to make the overall hospital-at-home waiver permanent.
• Private insurance: Some private insurers are experimenting with hospital-at-home coverage, but adoption has been uneven. Many payers want more evidence before fully committing and may be hesitant to reimburse home-based care at the same rates as traditional hospital stays without longer-term data showing it saves money and keeps patients safe.

Without a stable and widespread reimbursement structure, many hospital-at-home programs may struggle to continue. Advocates are urging policymakers to make the CMS waivers permanent and for private insurers to more broadly adopt the model.

Novant Health hospital-at-home

Novant Health has demonstrated the effectiveness of the hospital-at-home model within its own system. Since the program launched in 2024 at Novant Health New Hanover Regional Medical Center in Wilmington, more than 482 patients have been admitted and 5,378 virtual visits have been conducted while earning high patient satisfaction. Patients with conditions such as sepsis, COPD, and pneumonia have all been treated at home resulting in zero hospital-acquired infections and saving more than 1,595 hospital bed days, freeing up critical capacity.

Patients consistently say they like this type of care because they’re in familiar surroundings which lowers stress and supports faster recovery.

“It was a great experience. I could sleep in my own bed and still feel like I was being closely monitored,” said Janice Martinez, a Novant Health patient in the hospital-at-home program.

Hospital-at-home’s future

Hospital-at-home has made significant strides in the last six years with measurable benefits for patients. It has improved outcomes, enhanced patient experiences, and helped address capacity challenges, but its continued growth is dependent on policy solutions that remove funding uncertainties.

Making the Acute Hospital Care at Home Waiver permanent would provide the stability health systems need to make greater investments in infrastructure, workforce, and technology needed to grow the program.