With a Five-Year Waiver Runway, Hospital-at-Home Is Finally Ready to Scale
Nearly 400 hospitals are CMS-approved to deliver acute care at home. With the Medicare waiver now secure through 2030, program leaders from Mass General Brigham and Tampa General say participation will 'skyrocket.'
Hospital-at-home is poised for its growth phase. With Congress extending the Medicare Acute Hospital Care at Home waiver through September 30, 2030, program leaders say the single biggest barrier to investment — a waiver that kept lapsing on short extensions — is gone.
Nearly 400 hospitals are now approved by CMS to operate hospital-at-home programs. At the ViVE 2026 conference, Mass General Brigham's Dr. Shiv Sutaria described a mature program running a daily census of 50 to 60 patients, while Tampa General Hospital CEO John Couris predicted participation will "skyrocket" now that systems can build against a five-year runway.
Why systems held back — and why that's over
The clinical case has been strong for years: programs report low mortality, reduced readmissions, less delirium, and high patient and staff satisfaction. Federal rules require at least two in-person visits per day, with the rest of monitoring and care delivered through connected devices and virtual teams — making hospital-at-home one of the most demanding, and most complete, expressions of the remote-care technology stack.
What held systems back was financing risk: nobody wanted to build supply chains, staffing models, and logistics for a program Medicare might defund in eighteen months. The 2030 extension removes that excuse.
The remaining dependency is payer followership — growth economics still hinge on commercial and Medicaid payers matching Medicare's lead. But the direction is set: the hospital bed is becoming a service, not a place.
Reporting: Chief Healthcare Executive, from ViVE 2026.
Source
Original reporting: Chief Healthcare Executive ↗