4 ways to improve hospital at home

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While the CMS waiver to provide acute hospital care at home has existed since 2020, the majority of hospitals and health systems still don’t have a program.

Here are four ways to increase adoption, according to Austin Kilaru, MD, a senior fellow at the Philadelphia-based Penn Leonard Davis Institute of Health Economics, in an April 29 news release:

1. Simplify the model — focus on what patients actually need. “Allow flexible, lower-intensity versions (more virtual care, fewer in-person visits) instead of requiring full hospital replication,” Dr. Kilaru recommended.

2. Invest upfront, not just reimburse later. “Create payment models that cover startup costs, not just per-patient care, especially for rural and safety-net hospitals,” he said.

3. Align payers to support scale. “Bring Medicaid and commercial insurers into the model so hospitals can build programs that work across all patients — not just those on Medicare,” he suggested.

4. Build toward integrated, at-home care episodes. “Move beyond ‘hospital replacement’ to bundled models that combine acute and post-acute care at home for better outcomes and lower costs,” he said.

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