What do Short-term Waiver Extensions mean for Hospital-At-Home?

In the funding bill Congress passed last week, which narrowly averted a government shutdown, lawmakers extended Medicare telehealth flexibilities and the Acute Hospital Care at Home (AHCAH) waiver through Sept. 30, 2025.Virtual care and hospital-at-home program stakeholders celebrated the federal waiver's extension. However, unless Congress plans to further extend the waiver by several years -- or, better yet, make it permanent -- hospital-at-home program leaders must navigate this gray area of short-term extensions. The AHCAH waiver has undoubtedly had a pronounced impact on the nationwide adoption of the hospital-at-home model. Though the model has been around since the mid-2000s, CMS launching the waiver in November 2020 enabled hundreds of facilities to implement it.

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The waiver has been extended several times. Prior to the most recent extension, Congress had included it in its year-end funding bill that prevented a government shutdown in December 2024. Initially set to expire at the end of 2024, the bill extended the waiver and other telehealth flexibilities through March 2025.Though relieved, hospital-at-home proponents were also disappointed because an earlier version of the funding bill included a five-year extension for the waiver. In February, the home-based care advocacy group Moving Health Home sent a letter signed by nearly 100 stakeholders urging congressional leaders to include a five-year extension for the hospital-at-home waiver in the funding package.

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