Hospital-at-Home Managers

Johns Hopkins University School of Medicine developed the hospital-at-home model in 1995. “Researchers tested the concept at several Medicare managed care sites and reported a cost savings of about 30 percent compared with traditional inpatient care; better clinical outcomes; lower average length of stay; and fewer lab and diagnostic tests,” according to an article about HaH care on the American Hospital Association’s Web site. “Other hospitals used the John Hopkins model to launch pilot programs but struggled to secure reimbursement or regulatory flexibility from the CMS or private payers to sustain the programs.”

In 2020, the COVID pandemic caused bed shortages at hospitals and the need for more patient care paths outside of hospitals for COVID patients and those with other acute conditions. In November 2020, the CMS announced the creation of an Acute Hospital Care at Home Initiative that would reimburse qualifying hospital-at-home models for its care of patients. As a result, the HaH model grew quickly, and a need developed for managers to develop and oversee hospital-at-home programs. As of August 2025, 413 hospitals across 146 systems and 39 states were approved to provide HaH services to patients, according to the American Hospital Association. Many healthcare systems would like to add HaH programs, but they are hesitant to do so unless Congress extends the Acute Hospital Care at Home program. The program is set to expire on September 30, 2025.