New York City-based NewYork-Presbyterian is beginning to see early signals from its hospital-at-home program, which launched in November 2025 as health systems across the country continue testing whether acute-level hospital care can be delivered safely in patients’ homes.
The model allows certain patients who would otherwise require inpatient admission to receive hospital-level treatment at home through a combination of in-person nursing visits, remote patient monitoring and virtual physician oversight. Programs like these expanded rapidly during the COVID-19 pandemic under a federal waiver that allowed hospitals to bill Medicare for hospital-at-home services.
Although the waiver was extended until 2030, many health systems are still evaluating whether the care model can deliver consistent outcomes and operational reliability outside traditional hospital walls.
At NewYork-Presbyterian, early data has been encouraging.
“We have seen strong quality, safety performance and patient satisfaction, along with very low rate of having to escalate care or readmit patients,” said Paul Dunphey, senior vice president and COOfor the health system’s Northern Market.
The program has enrolled patients through both emergency department and inpatient pathways as the system evaluates how the care model functions across different types of acute cases. Patients receive monitoring equipment and structured clinical oversight while remaining in their homes, allowing care teams to track vital signs and respond quickly if conditions change.
Health system leaders said the home setting itself can change the care dynamic.
Clinicians participating in the program have reported that treating patients at home can offer a broader view of how patients function in their day-to-day environments. Observing medication routines, living conditions and support systems can provide context that is often difficult to capture during a traditional inpatient stay.
Nurses have also reported that patients often appear more comfortable and engaged when receiving care at home, which can make education about medications and recovery plans easier.
Technology infrastructure has played a central role in enabling the program. Remote monitoring tools provide clinicians with near real-time visibility into patient conditions, while daily virtual rounds allow physicians, nurses and care managers to review patient status and coordinate treatment plans.
Digital communication platforms also allow patients and caregivers to quickly reach care teams through messaging and video visits, helping clinicians respond to changes without requiring an immediate hospital transfer.
“Remote monitoring provides near real-time insight into patient status, allowing clinicians to detect subtle changes early and intervene before issues escalate,” Mr. Dunphey said.
Despite the clinical promise of the model, operational logistics remain one of the most complex elements of hospital-at-home programs, particularly in dense urban environments.
Delivering hospital-level care at home requires coordinating the rapid delivery of medications, diagnostic services, monitoring equipment and clinical staff across a distributed network of patients. In New York City, those logistics can be particularly challenging.
“Logistics present a unique level of complexity, especially in coordinating the timely delivery of equipment, medications and clinical services at a pace that aligns with acute inpatient care,” Mr. Dunphey said.
To prepare for those challenges, NewYork-Presbyterian conducted full-scale operational simulations before launching the program. The exercises were designed to replicate real-world scenarios, helping teams test workflows and refine processes prior to the program’s go-live.
Health system leaders said that preparation helped ensure a smoother launch and positioned the program for sustainable growth as the care model evolves.
More broadly, the experience has reinforced that hospital-at-home programs require more than simply moving inpatient care into a different setting. Health systems must redesign workflows, technology infrastructure and care coordination processes to account for the variability of home environments.
For organizations considering launching similar programs, Mr. Dunphey said preparation, adaptability and scalable program design are essential.
“Investing in comprehensive training and robust simulations prior to going live is critical, as is designing for growth and scale from day one,” he said.
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