White Paper: Hospital at Home: Navigating Risk Outside the Traditional Hospital Setting

A practical guide for identifying, managing, and mitigating the clinical, operational, legal, and technological risks of delivering acute-level hospital care in patients’ homes.

Who It’s For

This white paper is designed for:

• Health care risk management professionals
• Hospital and health system leaders
• Quality, safety, compliance and legal teams
• Clinical and operational leaders responsible for Hospital at Home (HAH) or Acute Hospital Care at Home (AHCAH) programs
• Organizations considering launching, expanding or refining hospital‑at‑home services

What It Can Be Used For

Use this resource to:

• Understand the unique risk profile of hospital‑at‑home programs compared to traditional inpatient care
• Support program design, implementation and governance for HAH services
• Inform policy development, informed consent processes and patient selection criteria
• Guide clinical, operational and technology risk mitigation strategies
• Strengthen regulatory compliance with CMS AHCAH waiver requirements and state‑specific rules
• Educate interdisciplinary teams on best practices for safe, high‑acuity care in the home

What’s Inside

This white paper provides a comprehensive, risk‑focused examination of hospital‑at‑home care, including:

• Overview of the Hospital at Home model
  • History, growth, and acceleration during and after COVID‑19
  • CMS Acute Hospital Care at Home (AHCAH) waiver framework
• Clinical risk considerations
  • Patient selection and exclusion criteria
  • Informed consent in the home setting
  • Acute care competencies, training and staffing models
• Operational and workforce risks
  • Human capital readiness and caregiver involvement
  • Employee and provider safety in home environments
  • Emergency preparedness and escalation protocols
• Technology and data risks
  • Remote monitoring, telehealth and EHR integration
  • Technology reliability, downtime planning and cybersecurity
  • Privacy, HIPAA compliance and third‑party vendor oversight
• Legal, regulatory, and insurance implications
  • Licensure, scope of practice and compliance considerations
  • Claims, coverage and financial risk exposures
  • Fraud, waste and abuse considerations
• Performance measurement and governance
  • Quality and safety metrics for HAH programs
  • Accreditation and certification considerations
  • Leadership, governance and enterprise risk management strategies
• Real‑world case studies and risk management takeaways
  • Practical examples illustrating common challenges and solutions

Why It Matters

As hospital‑at‑home programs continue to expand, risk leaders play a critical role in ensuring these innovative models are safe, compliant, and sustainable. This white paper equips organizations with the insight needed to confidently deliver hospital‑level care beyond traditional walls—without compromising quality, safety or patient trust.
 

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