Dr. Jared Conley at home with his family while receiving intravenous antibiotics
Dr. Jared Conley
The Hospital-at-Home (HaH) model under Medicare allows patients to receive hospital-level care at home instead of a traditional hospital. However, when the waiver funding the program expired on September 30, 2025, hospitals and patients faced challenges navigating a less efficient system.
Recently, one of Dr. Conley’s elderly patients, who usually receives care through HaH for heart failure exacerbations, had to spend a night in the hospital before returning home due to the program’s expiration. This experience is not uncommon, with many patients enduring long waits in emergency departments before receiving care.
Headshot of Dr. Jared Conley
Dr. Jared Conley
Dr. Jared Conley, Assistant Professor at Harvard Medical School and co-chair of the US-based Hospital at Home Tech Council, emphasizes the benefits of the HaH model. Patients often express a desire to return home sooner, as the home environment promotes better sleep and a sense of autonomy.
HaH programs have successfully reduced inpatient census and alleviated bottlenecks in emergency departments, showcasing their value across the healthcare system. The recent reinstatement of the program by Congress provides temporary relief, but the need for a long-term solution remains evident.
Development of Hospital at Home
HaH has evolved over decades, with pioneers like Dr. Bruce Leff recognizing the toll traditional hospital environments took on patients’ overall health. Research has consistently demonstrated the benefits of HaH, with programs like Mount Sinai’s receiving grants to evaluate its effectiveness.
The COVID-19 pandemic accelerated the adoption of HaH, with CMS waivers allowing hospitals to provide care at home. As of October 2024, over 31,000 patients have been served by HaH programs, indicating a growing national momentum.
The Hospital at Home Patient Experience
Dr. Conley’s personal experience with HaH following a foot injury highlighted the advantages of receiving care at home. The familiar environment and personalized care contributed to his recovery, showcasing the value of HaH programs.
Dr. Jared Conley in the hospital receiving intravenous treatment for his wound.
Dr. Jared Conley
HaH programs offer comprehensive care comparable to traditional hospitals, including monitoring, labs, and therapy. The home setting allows clinicians to gain a deeper understanding of a patient’s life, leading to more tailored care.
Normalizing HaH for Patients and Clinicians
Dr. Conley believes that HaH can reduce burnout among healthcare professionals and improve patient outcomes. Patient appreciation for receiving care at home is crucial for enhancing the care experience.
Paramedic arrives at Dr. Conley’s house to provide clinical care
Dr. Jared Conley
While some patients may initially resist HaH due to unfamiliarity, research shows that the benefits often outweigh concerns about receiving care at home. Caregivers play a vital role in supporting patients during HaH, alleviating burdens associated with traditional hospital stays.
Scaling the Model and Future Challenges
The expansion of HaH faces challenges related to payment models and legislation. With an aging population and limited hospital capacity, HaH offers a viable solution to meet the growing demand for acute care.
Medical Supplies arrive at Dr. Conley’s house to provide monitoring and treatment.
Dr. Jared Conley
The Future of Hospital at Home
HaH programs leverage advanced technology to ensure patient safety and improve outcomes. Dr. Conley collaborates with various stakeholders to enhance technologies that support HaH initiatives, aiming to make home-based care even more effective.
The temporary reinstatement of HaH funding underscores the need for a permanent solution to ensure the sustainability and effectiveness of the model. As HaH becomes more widely adopted, it is clear that home-based care offers numerous benefits for patients, healthcare providers, and the healthcare system as a whole.
