Somerville, Mass.-based Mass General Brigham is entering its next phase of growth for its hospital-at-home program after CMS extended the Acute Hospital Care at Home waiver through September 2030, giving health systems long-sought regulatory certainty.
Since 2022, Mass General Brigham’s Home Hospital program has treated nearly 10,000 patients, expanded into oncology care and reached a 70-bed capacity milestone.
“We’ve expanded from two academic medical centers to five hospitals. The level of patient complexity we manage has increased significantly — including oncology patients and postoperative care,” Heather O’Sullivan, president and COO of Healthcare at Home at Mass General Brigham, told Becker’s.
But leaders say the most significant shift isn’t volume — it’s stability.
“The multiyear waiver extension replaces the short-term policy windows and uncertainty that health systems were operating under,” Ms. O’Sullivan said. “That stability allows not just Mass General Brigham, but all health systems, to plan, invest, scale and fully model a program that delivers safe, effective, patient-centered acute care at home.”
Daniel Metzger-Traber, vice president of strategic business operations for Healthcare at Home at Mass General Brigham, said the extension shifts the conversation from contingency planning to strategic expansion.
“We’re not in survival mode anymore,” Mr. Metzger-Traber told Becker’s. “We’re in thrive-and-growth mode.”
In 2026, the program’s growth will focus on expanding clinical pathways in oncology and postoperative care while exploring behavioral health services and dementia clinical trials in the home. The health system also plans to evaluate machine-learning tools to identify eligible patients earlier and accelerate their transition to home-based acute care.
“When the first waiver launched, there was an explosion of innovation,” Mr. Metzger-Traber said. “I believe we’re entering another phase of that innovation cycle. We’re seeing renewed engagement from technology partners who recognize this runway and want to co-develop with us. We’re ready to partner on what comes next.”
Growth will also center on adding capabilities, improving efficiency and supporting the workforce — not just increasing patient numbers.
“Our focus is on better patient care, job satisfaction and delivering value at scale. That means continuously refining efficiency, throughput and team support,” Ms. O’Sullivan said. “We’re also learning from other health systems across the country to understand what the ideal model should look like five years from now.”
For Mass General Brigham, capacity and patient experience are key drivers for home-based acute care.
“The capacity crisis isn’t going away. We’ll continue asking: What does the system need from us? What is the appropriate natural scale for this model?” Mr. Metzger-Traber said.
But even as the model scales, leaders say its long-term future depends on policy permanence.
“There’s important work underway to establish standards so patients and stakeholders clearly understand what hospital at home entails,” Mr. Metzger-Traber said. “We’ve been fortunate to operate within a fee-for-service framework. But the model generates additional value — reduced readmissions, lower post-acute utilization and lower total cost of care. With greater certainty, we can integrate Home Hospital into a broader longitudinal care framework and partner with commercial payers to reduce total cost of care over time.”
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