5-year hospital-at-home extension unanimously passes House

In a rare show of unity, the House of Representatives has unanimously voted yea on a bill to approve a five-year extension of Medicare’s Acute Hospital Care at Home Initiative, commonly known as hospital-at-home.  

The bid to extend the program, which was paused during the recent government shutdown and was slated to expire at the end of January 2026 in any case, will now go to the Senate for a vote. 

“At a time when our health care system is stretched thin, we need solutions like ‘Hospital at Home’ programs that help patients recover faster and get safe, high-quality care at a lower cost,” said Republican Congressman Vern Buchanan of Florida, who authored the Hospital Inpatient Services Modernization Act with sponsorship from both sides of the aisle.  

“With hospitals under strain and chronic disease on the rise, today’s unanimous vote to extend this proven model reflects the kind of commonsense, bipartisan action Americans deserve. With nearly 200,000 seniors in my district, I’m grateful my colleagues and I can preserve a model that expands access and delivers real results for patients.” 

A surprisingly rocky road for a wildly popular program

Since its introduction during the pandemic as a way to reduce stress on overloaded health system resources, the hospital-at-home program has helped acute, yet stable, patients receive hospital-level care in the comfort of their own homes.  

It was immediately a hit with patients, who have expressed high levels of satisfaction with their care and experiences, as well as with hospitals that quickly saw better outcomes and lower costs while easing the strain on their inpatient facilities.  

For example, a 2024 report from CMS on the initiative concluded that hospital-at-home patients experienced lower mortality rates than similar inpatient populations, as well as lower readmission rates for certain conditions.   

Despite its early successes, enthusiastic support from the American Hospital Association (AHA), and subsequent expansion to more than 400 hospitals in 39 states, the program has suffered from instability around its funding. 

It’s been stop-and-go for the initiative since its inception, with a series of short-term extensions tied to the perennial wrangling over annual governmental appropriations. Every time lawmakers threaten to shut down the government, hospital-at-home providers – as well as telehealth and remote care providers in general – hold their breath for the axe to come down on their reimbursements. 

With providers scrambling to find room in their inpatient wards for home-based patients during the latest shutdown, when reimbursements went on hold for more than a month with no certainty of retrospective payment, it became increasingly clear that fits and starts will no longer cut it for patients or their care teams. 

What happens now? 

With the five-year extension bill clearing the House with flying colors, it’s time for the Senate to get involved.  

Given the full-throated approval in the lower chamber, advocates might be justified in feeling optimistic that the program will be extended until 2030. Doing so would allow the initiative to flourish in ways that have not been possible before, asserted the AHA in a September 2025 letter of support for Buchanan’s bill. 

“A long-term extension of the hospital-at-home waiver would not only provide additional time to continue gathering data on quality improvement, cost savings and patient experience but would also provide much-needed stability for patients and providers,” the organization said at the time. 

“Standing up a hospital-at-home program requires logistical and technical work, with an investment of time, staff, and money. In addition to being approved for the federal waiver, some providers must navigate additional regulatory requirements at the state level. For some, this whole process could take a year or more to complete before the first patient can be seen at home. A longer extension would provide much-needed stability for existing programs to continue providing care and encouragement for additional hospitals and health systems to participate.” 

The legislation now goes on to the next step in the process as the Senate takes up the issue. It is currently in the hands of the Committee on Finance, which will subsequently decide whether to move it forward or not. 

Jennifer Bresnick is a journalist and freelance content creator with a decade of experience in the health IT industry.  Her work has focused on leveraging innovative technology tools to create value, improve health equity, and achieve the promises of the learning health system.  She can be reached at jennifer@inklesscreative.com.