CMS extends home hospital waivers through 2030

Patients receiving hospital-level care in their own homes now have a more stable funding pathway. The Centers for Medicare and Medicaid Services approved a waiver extension that runs through September 2030. This move ends a period of temporary, short-term extensions that had followed the pandemic. The new rule allows hospitals to bill federal health programs for care delivered outside traditional facility walls.

The federal waiver is the mechanism that permits hospitals to treat patients at home and receive payment for those services. Before the recent extension, the waiver had only been granted on a temporary basis. Krista Drobac, a representative for Moving Health Home, said the new timeline provides the regulatory certainty needed for more facilities to launch these programs. She noted that the approval process took a long time but that the outcome allows for growth in the sector.

More than 30,000 patients have already been treated through hospital-at-home programs. These services bring monitoring equipment and nursing visits directly to a patient’s residence. Colleen Callahan, a 75-year-old patient from Peoria, Illinois, used the program for bacterial pneumonia. She received care through OSF Healthcare’s OnCall Digital Hospital. Her stay lasted five days, and she received visits from nurses at least twice daily. Doctors checked in via video, and remote monitors tracked her vitals. Callahan said the experience felt like an old-fashioned house call, offering a personal touch that a hospital room did not.

Hospitals participating in these programs must meet specific criteria to accept patients. Akin Demehin of the American Hospital Association stated that patients generally must live within 30 minutes of the hospital. They must also be stable enough for home monitoring. The programs treat conditions ranging from infections to chronic illnesses like congestive heart failure and COPD. Melissa Meier, manager of digital care at OSF OnCall, said the approach frees up beds in medical centers. Those freed beds then become available for the sickest patients who require inpatient care.

The financial implications of the program are a key focus for advocates and consultants. Tom Kiesau, with the healthcare consulting firm Chartis Group, said the model saves the government money and improves access. He noted that readmission rates and hospital-acquired infections are lower for patients treated at home, according to a 2024 Centers for Medicare and Medicaid study. Kiesau explained that lower spending for Medicare patients translates to savings for the taxpayer-funded program. He described the model as a no-brainer because it delivers better outcomes while reducing costs. He added that the need for such capacity is urgent as the population ages.

Caregiver advocates have raised questions about the strain on family members. A 2022 study in JAMA Health Forum noted that the program did not sufficiently consider the role of family caregivers. Drobac countered that research often shows caregivers feel less stress because they have professionals to ask for guidance. Callahan said her husband and daughter felt supported by the arrangement. She noted that being at home helped the entire family, not just the patient. The program remains voluntary and does not replace all hospital services, such as surgeries. Demehin said hospitals will always be needed for treatments that require being inside a medical facility.

The expansion of these programs is part of a larger shift in how medical care is delivered. More than 350 hospitals across the country have similar initiatives. The new waiver extension through 2030 aims to solidify this shift. For now, the focus is on providing an alternative for patients who are stable enough for home monitoring. The data suggests that this model can reduce overall spending while maintaining high standards of care. The regulatory framework now supports a longer-term commitment to this style of treatment.