After years of uncertainty surrounding the federal Acute Hospital Care at Home waiver and repeated short-term funding extensions, health systems now have something they have long lacked: a five-year reimbursement runway.

That stability is changing the conversation around Hospital at Home. The question is increasingly shifting from whether healthcare organisations should explore the model to how they can build, operate and scale it effectively as a long-term component of care delivery.

The issue was examined during the first webinar in Healthcare Innovation’s Digital Health Intelligence Series, which brought together healthcare leaders to discuss the implications of greater reimbursement certainty. Dr. David Levine, associate professor of medicine at Harvard Medical School and clinical director of research and development for Mass General Brigham Health Care at Home, highlighted both the opportunities and complexities involved in expanding the model.

From Experiment to Long-Term Strategy

According to Levine, many health systems have expressed interest in Hospital at Home for years but hesitated to make significant investments because they could not predict how long federal reimbursement would remain available.

The five-year horizon is now encouraging those organisations to move from consideration to implementation. Health system leaders are asking more practical questions: Which technology and service providers should they partner with? What staffing structure will be required? How should clinical operations be designed? And what digital infrastructure is necessary to safely manage patients in their homes?

These decisions represent significant organisational commitments rather than quick technology upgrades.

Building the Right Infrastructure

Establishing a Hospital at Home programme can take six to 12 months, particularly for organisations that lack an established home-based care infrastructure.

That means the extended reimbursement period provides more than financial predictability. It gives health systems sufficient time to develop clinical workflows, recruit and train staff, establish technology platforms, coordinate logistics and build the operational capabilities required for high-quality care outside traditional hospital settings.

Scaling With Purpose

Greater reimbursement certainty does not eliminate the challenges associated with Hospital at Home. Instead, it gives health systems the confidence to address those challenges as part of a long-term strategy.

As healthcare organisations move forward, successful programmes will likely depend on thoughtful planning, appropriate technology, reliable clinical support and strong operational foundations. The five-year runway creates an opportunity to transform Hospital at Home from a promising alternative-care model into a sustainable part of modern healthcare delivery.

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