Initial Findings From an Acute Hospital Care at Home Waiver Initiative

JAMA Network November 3, 2023
Danielle Adams, MS, BSN, RN; Ashby J. Wolfe, MD, MPP, MPH; Jessica Warren, RN, BSN, MA, CCRC; Alexandre Laberge, PT, MBA, PhD; Adam C. Richards, MA4; Kurt Herzer, MD, PhD, MSc; Lee A. Fleisher, MD

Introduction

Hospital-at-home programs in the US have been limited to demonstration projects or small pilot programs for commercially insured patients. On November 25, 2020, as part of the Hospital Without Walls initiative to address the COVID-19 public health emergency and concerns about hospital bed capacity, the Centers for Medicare & Medicaid Services (CMS) launched the Acute Hospital Care at Home (AHCAH) initiative.^1–3 Through a waiver-granting process, AHCAH allows individual CMS-approved hospitals to provide inpatient-level care in the home environment for Medicare fee-for-service and nonmanaged care Medicaid beneficiaries. CMS waived specific hospital Conditions of Participation (COP) that require 24-hour onsite nursing for patients and that patients’ homes meet certain structural and physical environment criteria.⁴ Participating hospitals must demonstrate their ability to...

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