As health care continues to evolve, one model gaining significant traction is “hospital-at-home.” Designed to deliver hospital-level care in the comfort of a patient’s home, this innovative approach is transforming how older adults experience health care. For many, it’s a welcome change.

Hospital-at-home (H@H) programs provide hospital-level treatment—such as IV medications, oxygen therapy and close clinical monitoring outside the traditional hospital setting. Initially launched in select health systems, these programs have expanded nationally, especially after Medicare created waivers to support them during the COVID-19 public health emergency. According to the American Hospital Association, 378 hospitals in 39 states have been approved to provide H@H services to patients as of November 2024.

A 2024 report by Center for Medicare & Medicaid Services found that H@H patients had fewer readmissions, lower costs and improved patient satisfaction compared to those receiving traditional hospital care. Now, with evidence backing its safety and cost-effectiveness for patients with lower health care complexity scores, the model is positioned to become a permanent fixture in how care is delivered to older adults.

Why it matters for older adults

For many older patients, hospitalization comes with risks: hospital-acquired infections, falls, functional decline and even delirium. These complications can lengthen recovery or lead to long-term health setbacks.

With H@H, patients stay in familiar surroundings, maintain better sleep and routines and avoid many of the disorienting effects of hospital stays. Families often report greater satisfaction, and studies show equal or better outcomes in clinical recovery.

The role of nurse advocates

Transitioning care from the hospital to the home environment requires thoughtful planning, and that’s where nurse advocates can make all the difference. As certified case managers, nurse advocates ensure the home is safe and properly equipped; care instructions are clearly communicated; support services are in place (i.e., physical therapy, social work and in-home nursing), and that patients and families feel confident managing care. Nurse advocates also serve as the bridge between health care providers, patients and caregivers to ensure no detail is overlooked.

Key considerations for families

H@H isn’t a one-size-fits-all solution. Here are a few things older adults and their loved ones should consider:

Eligibility: Not all conditions qualify. Programs typically focus on conditions like pneumonia, heart failure, COPD exacerbations and urinary tract infections without other complicating diagnoses requiring closer monitoring.
Support: While H@H reduces the need for inpatient hospital stays, caregivers may need to assist with basic tasks. Families should evaluate whether additional in-home support is needed.
Technology: Remote monitoring tools such as Bluetooth-enabled vital sign devices and telehealth visits are essential care components. Comfort with technology—or support in using it—can impact the experience.

What’s Next?

As reimbursement structures shift and technology improves, H@H is poised to become a viable option. Major health systems like the Mayo Clinic, Johns Hopkins and Mount Sinai are expanding their programs, and many smaller community hospitals are following suit.

For older adults, H@H is more than a trend—it’s a shift toward more personalized, dignified, and patient-centered care. As a nurse advocate, I believe this model holds enormous promise, especially when paired with the guidance of professionals who understand both the medical and personal sides of care.

Dr. Porter is CEO and founder of MyHealth.MyAdvocate in Palm Desert. She is an experienced health care professional with over 30 years of nursing practice dedicated to unraveling the mysteries of health care processes and advocating for patients, families and caregivers. Immediate assistance is available by calling (760) 851.4116. www.myhealthmyadvocate.com.

Sources: 1) American Hospital Association (2025). Fact Sheet: Extending the Hospital-at-Home Program. https://www.aha.org/fact-sheets/2024-08-06-fact-sheet-extending-hospital-home-program; 2) Center for Medicare and Medicaid Services (2024). Acute Hospital Care at Home Reports. https://qualitynet.cms.gov/acute-hospital-care-at-home/reports