Evolving Hospital-at-Home to Meet the Needs of Children
Hospital-at-home (HaH) seeks to deliver hospital-level services in the home setting for patients with acute illness. For more than 30 years, these programs have been found to be safe and cost-effective for adults, with outcomes comparable to traditional hospital care. HaH care models have evolved over time and typically include home delivery of equipment and supplies, daily nursing visits, virtual or in-person clinician visits, and an emergency response system.
Growth of HaH accelerated in 2021, after the Centers for Medicare & Medicaid Services (CMS) established the Acute Hospital Care at Home (ACHAH) waiver program. The initial intention was to expand hospital capacity during the COVID-19 pandemic. Since then, more than 400 hospitals across 39 states have received waivers for adult HaH reimbursement. Although the waiver expired in September 2025 alongside the US government shutdown, many hospital leaders anticipate that HaH programs will continue with a new waiver or longer-term reimbursement policy.