Hospital Care Comes Home for 30,000 Patients
A federal program allowing hospital-level treatment in living rooms has expanded, offering a cheaper, less stressful option for recovering seniors.
By Aiko Soto ·
For Colleen Callahan, a 75-year-old resident of Peoria, Illinois, the decision to leave the hospital felt counterintuitive. In 2024, after being diagnosed with bacterial pneumonia in both lungs, she spent three days in a medical center. On the fourth day, a care team proposed a digital hospital alternative. Callahan initially hesitated, worried she was not well enough to return home. However, she accepted the offer, spending the final five days of her treatment in her own bed with a tablet and remote monitoring equipment.
Callahan is one of more than 30,000 patients treated through the hospital-at-home program. While the model gained initial traction as a temporary response to pandemic surges, it is now being adopted by more than 350 hospitals across the United States. The program provides hospital-level care in patients' residences, aiming to reduce the burden on hospital beds while offering a more comfortable recovery environment for patients.
The logistics of the program are designed to minimize friction for patients who may not be technologically savvy. OSF Healthcare, which operates the OnCall Digital Hospital in Peoria, provides all necessary equipment, including video visit tablets and monitoring devices. The company also supplies internet service and trains patients and their caregivers on how to use the tools. Nurses conduct at least two daily in-person visits, and physicians check in virtually. If a patient’s condition deteriorates, protocols allow for a rapid return to the medical center.
Melissa Meier, the manager of digital care at OSF OnCall, stated that the program treats a range of conditions, including infections, congestive heart failure, and COPD. Eligibility requires that patients live within 30 minutes of the hospital and are stable enough for home monitoring. Meier noted that freeing up physical hospital beds allows medical centers to treat their sickest patients more effectively.
Financially, the program mirrors traditional hospital billing. Patients are generally charged the same rates as in-hospital stays, and insurance coverage remains consistent. Akin Demehin of the American Hospital Association described the model as one of the most promising care innovations in recent years. He pointed to potential savings in the post-discharge period, suggesting that spending for hospital-at-home patients is lower than for those hospitalized in traditional settings.
A 2024 study by the Centers for Medicare and Medicaid Services found that readmission rates for certain conditions and the incidence of hospital-acquired infections are lower for hospital-at-home patients. Tom Kiesau of the Chartis Group noted that these outcomes translate into lower spending on the taxpayer-funded Medicare program. He emphasized that the demographic shift toward an older, sicker population creates an urgent need for care capacity that traditional hospitals cannot fully provide.
The regulatory status of the program was uncertain for years. Most hospitals required a temporary waiver from CMS to bill for home-based care. After several short-term extensions, Congress approved the waiver through September 2030 with bipartisan support. Krista Drobac of Moving Health Home said this regulatory certainty allows more hospitals to bring the service online. Drobac advocates for making the program a permanent fixture, arguing that it aligns with patient preferences for care in familiar environments.
Advocates and researchers continue to examine the impact on family caregivers. A 2022 study in JAMA Health Forum suggested the program did not sufficiently consider the role of family members. However, Drobac countered that caregivers often report less stress because they have direct access to medical professionals for guidance. Callahan said her husband and daughter felt supported during her treatment. According to Moving Health Home, 85% of patients who receive care through the program say they would recommend it to family and friends.
The program is voluntary and does not replace all hospital functions. Surgeons and specialists still require physical hospital infrastructure for procedures like surgeries. Demehin stated that hospitals will remain essential for treatments that cannot be performed in a home setting. For patients like Callahan, the primary benefit is the return to a personal space during recovery. She described the experience as similar to house calls from a traditional doctor, noting the care felt more personal because she was in her own home.
