Hospital at Home Is Now Funded Through 2030. Here’s What It Means for Revenue Cycle Leaders.
Congress just took a major step toward redefining inpatient care. The House voted unanimously to extend Medicare’s Hospital at Home waivers through September 2030, giving hospitals five more years of regulatory flexibility to deliver acute inpatient care at home. The bill now heads to the Senate, but the direction is already clear.
This is not a temporary pandemic workaround anymore. It is a long-term signal about where care is moving.
Hospital at Home has been around for decades, but it took off during the pandemic when CMS waived facility and nursing requirements. Hospitals could treat eligible patients at home and still receive inpatient-level reimbursement. It was a lifeline for capacity issues and an opening for remote care innovation.
As of this year, more than 400 hospitals across 140 systems have federal approval to provide acute care at home. Major health systems like Mayo Clinic have embraced it. Even nontraditional entrants like Best Buy have built roles in the ecosystem. With this extension, more hospitals will follow.
For revenue cycle and hospital finance leaders, this model comes with real implications.
First, inpatient care is no longer tied to a building.
The location of care is separating from the billing category. Patients can receive acute-level services in their homes, and hospitals can bill Medicare for it. This blurs historic lines between inpatient, outpatient and home health. By 2030, reimbursement models will reflect this shift.
Second, the revenue cycle has to function outside the four walls.
Hospital at Home workflows include remote monitoring, pharmacy delivery, diagnostics, virtual rounds, supply chain coordination and rapid escalation paths back to facilities. Every piece of that requires accurate orders, clean documentation and real-time data flow. Billing mistakes will multiply if the underlying workflows are not tight.
Third, this model depends on automation and clean digital operations.
You cannot run Hospital at Home with manual processes, paper forms, siloed systems or inconsistent documentation. The entire model depends on being able to verify, transmit and audit clinical and financial data from anywhere. Hospitals with fragmented systems will experience higher costs and lower margins.
Fourth, quality reporting will get tougher.
The bill directs CMS to collect data on mortality, readmissions, nurse staffing and hospital transfers. Hospitals will need reliable tracking and reporting capabilities that extend into the home.
Fifth, this is the transition zone for 2030.
Hospital at Home is not the full future, but it is the bridge to a system where care follows the patient, not the facility. It previews a world where inpatient, outpatient and home settings merge into a continuous, data-driven care model supported by AI, automation and real-time revenue cycle operations.
Hospitals should not see this extension as extra time to wait. They should see it as time to build a modern financial and operational backbone that can support care anywhere.
The next decade will reward systems that can deliver acute care beyond their walls and bill for it accurately, cleanly and confidently. The House just made it clear that this direction is not temporary. It is the new normal.
