Where hospital at home is lacking

Hospital-at-home programs are largely concentrated at large, urban, nonprofit and academic facilities, a new study found.

The researchers analyzed nearly 300 hospitals that received a CMS waiver to provide acute hospital care at home since 2020.

"If CMS' goal is to continue to expand hospital-at-home, these findings suggest that different incentives or outreach may be needed for smaller, rural and nonteaching hospitals," said Hashem Zikry, MD, a clinical scholar at Los Angeles-based UCLA Health and lead author of the December JAMA research letter, in a news release.

Here are five notes from the study, which compared the initial CMS waiver period starting in November 2020 to after the waiver was extended in December 2022:

1. More than 90% of participating hospitals are in metropolitan areas.

2. Academic hospitals comprise 76% of pre-extension and 81% of post-extension programs.

3. Nonprofits make up 92% of post-extension and 81% of pre-extension hospitals.

4. The programs are most likely to be located in the South or Northeast.

5. More than 80% of hospitals approved for the care model have at least 100 beds.

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