Congress has extended telehealth and Hospital at Home waivers through September. This may be the healthcare industry’s last chance to prove their value.
Telehealth and Hospital at Home advocates are once again celebrating an extension of key pandemic-era waivers with last week’s funding bill passage.
But the six-month extension isn’t making things any easier for healthcare execs looking to plot long-term strategies. And while supporters are taking heart in the fact that Congress has consistently kept these programs in view, they also know that the cycle of kicking the can down the road has to end. Either Congress or the Centers for Medicare & Medicaid Services (CMS) makes these waivers permanent, or they end them once and for all.
This gives healthcare leaders the summer to make their case for permanent CMS support of telehealth flexibilities and the Acute Hospital Care at Home (AHCAH) program. That means finding and showing data that proves these flexibilities are saving money, reducing complexity and improving clinical outcomes.
Are we ready for the Summer of Telehealth?
Supporters, beginning with the American Telemedicine Association (ATA) and extending to the hundreds of advocacy groups, healthcare organizations and lawmakers that have signed so many letters calling for waiver permanence, have long lobbied for a multi-year extension of anywhere between two and five years. That time frame, they argue, is necessary for healthcare leaders to conduct their studies and pilots and gather the data they need to support these programs.
That’s particularly true of the Hospital at Home movement. Close to 400 health systems and hospitals across the country are following the CMS model, which qualifies them for Medicare reimbursements but is quite complex. Others are forgoing reimbursements to develop their programs to treat patients with acute care needs at home (or, in some cases, a SNF or rehab center).
Stephen Dorner, MD, MPH, MSc, Chief Clinical and Innovation Officer of Mass General Brigham’s Healthcare at Home program, says the regulatory uncertainty is slowing down growth, and he worries what will happen if the waivers are ended. But at the same time, the fact that so many healthcare organizations have invested in this strategy means it does have value.
“We’re in this journey to build out the whole continuum of care in the home” he said at the recent HIMSS 2025 conference and exhibition in Las Vegas.
Dorner is part of a Hospital at Home program that’s widely considered to be one of the best in the country, with services that impact a growing number of patient populations, from those with chronic care concerns to veterans. Supporters point to the published studies by the health system showing how the program saves money and improves clinical outcomes; critics, meanwhile, note those studies are small and hyper-focused, and there’s no guarantee the program can be scaled and sustained.
Dorner says the industry needs time to prove its value—and to tinker with the model to find the right mix of efficiency and outcomes.
“I don’t think that the way it’s structured now is necessarily that way it will be structured forever,” he said. “We need more of a critical mass of information” to prove what works and what doesn’t.
The same goes for the collection of pandemic-era waivers on telehealth expansion and use. Virtual care comprised a small percentage—roughly 15%--of all healthcare interactions before the COVID-19 crisis, at which point providers scrambled to put as many services as possible onto a telemedicine platform to help overcrowded hospitals and enable patients and providers to connect and isolate at the same time.
With the end of the pandemic, many patients expressed a desire to see their providers in person again, swinging the telehealth pendulum in the other direction. Some mistakenly assumed this would be the end of telehealth, but the technology had done enough to reduce access pain points and improve outcomes that patients still asked for it and providers found a way to integrate virtual and in-person care. As a result, the waivers were continued.
Which brings us back to the road ahead. With the waivers extended until September 30, the healthcare industry has the summer to prove the value of these flexibilities. They know the extensions won’t go on forever, and with each passing Congressional action the drumbeat is growing to end them and move on.
Supporters can’t keep recycling thank you notes to Congress and the White House for these extensions and vow to continue working to make them permanent. They’ve been doing that for the last two years, and nothing has changed.
Eric Wicklund is the associate content manager and senior editor for Innovation at HealthLeaders.
KEY TAKEAWAYS
Pandemic-era waivers supporting telehealth adoption and coverage and the Hospital at Home strategy have been extended several times over the past few years.
While Congress has seen enough value in the waivers to keep extending them, there will come a time when lawmakers or the White House either make them permanent or end them altogether.
Healthcare leaders should see the September 30 extension as a deadline to prove once and for all that these flexibilities have value, through reduced costs, improved workflows and better clinical outcomes.