Acute Hospital Care at Home Data Release Fact Sheet

Acute Hospital Care at Home Data Release Fact Sheet

Researchers and healthcare innovators can now access additional data from one of the Centers for Medicare & Medicaid Services' (CMS) innovative care delivery models. A second public release of the data submitted to CMS as part of the Acute Hospital Care at Home (AHCAH) initiative will be available beginning on March 17, 2026. CMS plans to release this second batch of data through the Research and Data Assistance Center (ResDAC), and includes data collected from April 1, 2023, through September 30, 2025. Combined with previously released data spanning from the initiative's launch in November 2020 through March 2023, researchers now have access to nearly five years of data on this innovative initiative.

From Crisis Response to Care Innovation
In response to challenges faced by hospitals because of the spread of COVID-19, CMS launched AHCAH initiative in November 2020, which allowed certain Medicare-certified hospitals to treat patients with inpatient-level care at home. Using waiver authorities under section 1135 of the Social Security Act (the Act), which permits the Secretary to waive certain facility standards during declared public health emergencies (PHEs) like the COVID-19 PHE, CMS initially launched the broader "Hospital Without Walls" initiative in March 2020. Expanding on the Hospital Without Walls initiative, CMS subsequently developed the AHCAH initiative, allowing individual hospitals to seek waivers of § 482.23(b) and (b)(1) of Medicare regulations (also known as "conditions of participation" (CoPs)). These waivers suspended the requirements for a hospital's nursing services to be provided on premises 24 hours a day, 7 days a week, and for a registered nurse to be immediately available, respectively. In addition, under section 1135 of the Act, the Secretary waived hospital "Physical Environment" and "Life Safety Code" CoPs in order to deliver care in the patient's home. Hospitals providing care in patients homes continued to meet all health and safety requirements that were not waived through the PHE waiver authority under section 1135 of the Act. The AHCAH initiative has been extended by Congress several times since the end of the COVID-19 PHE; section 6210 of the Consolidated Appropriations Act, 2026 (P.L. 119-75) further extended waivers and flexibilities associated with the AHCAH initiative until September 30, 2030.

Every hospital participating in AHCAH agrees to ongoing monitoring - reporting critical safety and quality metrics to CMS either weekly or monthly depending on their experience level. In addition to data that has been collected since the beginning of the initiative, section 1866G(a)(3)(E) of the Social Security Act requires specific data collection for the purpose of conducting studies to analyze certain factors with respect to the AHCAH initiative, and section 1866G(d) requires CMS to make this data publicly available.

Getting Access
Individuals interested in obtaining the CMS data will need to request the data through ResDAC with an approved Data Use Agreement. This second data release (April 2023 - September 2025) complements the initial data set (November 2020 - March 2023), providing a nearly five-year span of data collected from participating hospitals. CMS is also releasing a comprehensive user's guide to support rigorous analysis.

The data includes the number of new patients admitted to the home setting, the number of patient escalations of care from the home to the hospital, and the number of unanticipated patient mortalities. CMS defines the number of "patient escalations" as the number of patients whose care involved a transfer to the traditional inpatient setting from the home for further care. CMS defines "unanticipated mortality" as the death of a patient which occurred during their hospitalization, including those whose care was escalated to the hospital (excluding those on hospice or receiving palliative care).

Additionally, the data include claims aggregation and eligibility data on beneficiaries who have been provided acute care by hospitals across the country through the AHCAH initiative. This information could be further analyzed by experts in the field to glean important clinical and policy-focused information about this type of care model. The AHCAH initiative represents the first example of payment for this level of care for Medicare Fee-for-Service and non-managed-care Medicaid beneficiaries.

For more information, please visit: https://www2.ccwdata.org/web/guest/data-dictionaries

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