Hospitals across the country are scrambling after the federal shutdown halted Medicare’s “hospital-at-home” program, which lets patients receive acute care in their own homes. The lapse in funding has forced some systems to pull patients back into hospitals just as respiratory season ramps up.
When the government shut down, the Medicare waiver allowing hospitals to bill for at-home care expired. More than 330 hospitals had joined Acute Hospital Care at Home (AHCaH), but several have suspended programs, returning patients to healthcare facilities.
Examples include Parkland Health System in Dallas tapering off its program, with the last patients discharged by Sept. 30, and UMass Memorial Health in central Massachusetts pausing its program, leading to a nearly 20% increase in patients waiting for a bed.
The timing is particularly concerning. Late fall and winter bring surges of respiratory illnesses, straining hospitals that previously relied on home-based care to free up beds. The shutdown also threatens Medicare’s expanded telehealth reimbursements, a critical tool for remote monitoring and home-based care.
Because program funding hinges on short-term political decisions, few hospitals are willing to invest in scaling staff, technology, or home health infrastructure. Even with permanent legislation, nationwide expansion would require substantial investment in training, remote monitoring systems, and data infrastructure.
Congress is considering the Hospital Inpatient Services Modernization Act, which would extend AHCaH through 2030 and evaluate its long-term impact.
