Hospital-at-home program treats more than 30,000 patients in U.S.

More than 30,000 patients have received hospital-level care in their own homes through a federal program that is gaining traction across the United States. The model, which brings medical equipment and nursing staff to patients' residences, originated as a temporary response to pandemic-related capacity issues. Industry leaders now describe it as a permanent fixture in healthcare delivery, with over 350 hospitals operating similar programs nationwide.

The program operates under waivers from the Centers for Medicare and Medicaid Services. After several short-term extensions following the pandemic, Congress approved the waivers through September 2030 with bipartisan support. Krista Drobac of Moving Health Home stated that this regulatory certainty allows more hospitals to launch services. Drobac advocates for making the program a permanent standard, noting that it aligns with patient preferences for receiving care at home.

Colleen Callahan, 75, experienced the program in 2024 after being diagnosed with bacterial pneumonia in both lungs. She spent three days in a hospital before the care team proposed the digital hospital option operated by OSF Healthcare in Peoria, Illinois. Callahan initially hesitated, worried she was not well enough to leave the medical center. After accepting, she received a tablet for video visits and remote monitoring equipment. OSF staff provided training and even supplied internet access for the setup.

Nurses visit patients at least twice daily, while doctors conduct virtual check-ins. Melissa Meier, manager of digital care at OSF OnCall, explained that the program treats conditions ranging from infections to chronic illnesses like congestive heart failure and COPD. Patients must live within 30 minutes of the hospital and be stable enough for home monitoring. Meier noted that freeing up inpatient beds allows hospitals to admit their sickest patients.

Akin Demehin of the American Hospital Association called the model one of the most promising care innovations in recent years. He stated that patients are generally billed at the same rate as in-hospital stays. Callahan confirmed her insurance covered all costs as it would have for a traditional admission. Tom Kiesau of the healthcare consulting firm Chartis Group pointed to a 2024 Centers for Medicare and Medicaid study showing lower readmission rates and fewer hospital-acquired infections for home-based patients.

Kiesau argued that reduced hospitalizations lead to lower spending for the taxpayer-funded Medicare program. He described the current healthcare capacity as a crisis, given the increasing number of older patients requiring care. A 2022 study in JAMA Health Forum raised concerns about the strain on family caregivers, but Drobac countered that research indicates caregivers often feel less stress because they have professional support to consult.

The program is voluntary and does not replace all hospital functions. Demehin noted that surgeries and other complex treatments still require inpatient facilities. Callahan, who spent five days in the OSF OnCall program, said the experience felt personal and reminiscent of old-fashioned house calls. According to Moving Health Home, 85 percent of patients who receive care through the program say they would recommend it to family and friends.

Hospitals in Davidson County and across the region continue to evaluate how to integrate these remote care options into their service lines. The extended waiver period provides a defined timeframe for hospitals to establish infrastructure and staffing models. Advocates say the next legislative step will determine whether the program becomes a standard part of the healthcare system or remains a temporary waiver-based service.