Hospital Inpatient Services Modernization Act

Hospital Inpatient Services Modernization Act

This bill extends the Acute Hospital Care at Home Program under Medicare and requires an additional study regarding the program. The program allows hospitals to treat certain patients from emergency departments or inpatient hospital beds at home.

Specifically, the bill extends the program through FY2030 and requires the Centers for Medicare & Medicaid Services to conduct a study of the program with respect to several metrics, including the quality of care, incurred costs, types of services, and demographics of patients under the program compared to inpatient settings.

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4313 Introduced in House (IH)]

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119th CONGRESS
  1st Session
                                H. R. 4313

    To amend title XVIII of the Social Security Act to extend acute 
     hospital care at home waiver flexibilities, and to require an 
           additional study and report on such flexibilities.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 10, 2025

Mr. Buchanan (for himself, Mr. Smucker, and Mr. Evans of Pennsylvania) 
 introduced the following bill; which was referred to the Committee on 
                             Ways and Means

_______________________________________________________________________

                                 A BILL


 
    To amend title XVIII of the Social Security Act to extend acute 
     hospital care at home waiver flexibilities, and to require an 
           additional study and report on such flexibilities.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Hospital Inpatient Services 
Modernization Act''.

SEC. 2. EXTENDING ACUTE HOSPITAL CARE AT HOME WAIVER FLEXIBILITIES.

    Section 1866G(a)(1) of the Social Security Act (42 U.S.C. 1395cc-
7(a)(1)) is amended by striking ``2025'' and inserting ``2030''.

SEC. 3. REQUIRING ADDITIONAL STUDY AND REPORT ON ACUTE HOSPITAL CARE AT 
              HOME WAIVER FLEXIBILITIES.

    Section 1866G of the Social Security Act (42 U.S.C. 1395cc-7), as 
amended by section 2, is further amended--
            (3) in subsection (b), in the subsection heading, by 
        striking ``Study'' and inserting ``Initial Study'';
            (4) by redesignating subsections (c) and (d) as subsections 
        (d) and (e), respectively; and
            (5) by inserting after subsection (b) the following new 
        subsection:
    ``(c) Subsequent Study and Report.--
            ``(1) In general.--Not later than September 30, 2028, the 
        Secretary shall conduct a study to--
                    ``(A) analyze, to the extent practicable, the 
                criteria established by hospitals under the Acute 
                Hospital Care at Home initiative to determine which 
                individuals may be furnished services under such 
                initiative; and
                    ``(B) analyze and compare (both within and between 
                hospitals participating in the initiative, and relative 
                to comparable hospitals that do not participate in the 
                initiative, for relevant parameters such as diagnosis-
                related groups)--
                            ``(i) quality of care furnished to 
                        individuals with similar conditions and 
                        characteristics in the inpatient setting and 
                        through the Acute Hospital Care at Home 
                        initiative, including health outcomes, hospital 
                        readmission rates (including readmissions both 
                        within and beyond 30 days post-discharge), 
                        hospital mortality rates, length of stay, 
                        infection rates, composition of care team 
                        (including the types of labor used, such as 
                        contracted labor), the ratio of nursing staff, 
                        transfers from the hospital to the home, 
                        transfers from the home to the hospital 
                        (including the timing, frequency, and causes of 
                        such transfers), transfers and discharges to 
                        post-acute care settings (including the timing, 
                        frequency, and causes of such transfers and 
                        discharges), and patient and caregiver 
                        experience of care;
                            ``(ii) clinical conditions treated and 
                        diagnosis-related groups of discharges from 
                        inpatient settings relative to discharges from 
                        the Acute Hospital Care at Home initiative;
                            ``(iii) costs incurred by the hospital for 
                        furnishing care in inpatient settings relative 
                        to costs incurred by the hospital for 
                        furnishing care through the Acute Hospital Care 
                        at Home initiative, including costs relating to 
                        staffing, equipment, food, prescriptions, and 
                        other services, as determined by the Secretary;
                            ``(iv) the quantity, mix, and intensity of 
                        services (such as in-person visits and virtual 
                        contacts with patients and the intensity of 
                        such services) furnished in inpatient settings 
                        relative to the Acute Hospital Care at Home 
                        initiative, and, to the extent practicable, the 
                        nature and extent of family or caregiver 
                        involvement;
                            ``(v) socioeconomic information on 
                        individuals treated in comparable inpatient 
                        settings relative to the initiative, including 
                        racial and ethnic data, income, housing, 
                        geographic proximity to the brick-and-mortar 
                        facility and whether such individuals are 
                        dually eligible for benefits under this title 
                        and title XIX; and
                            ``(vi) the quality of care, outcomes, 
                        costs, quantity and intensity of services, and 
                        other relevant metrics between individuals who 
                        entered into the Acute Hospital Care at Home 
                        initiative directly from an emergency 
                        department compared with individuals who 
                        entered into the Acute Hospital Care at Home 
                        initiative directly from an existing inpatient 
                        stay in a hospital.
            ``(2) Selection bias.--In conducting the study under 
        paragraph (1), the Secretary shall, to the extent practicable, 
        analyze and compare individuals who participate and do not 
        participate in the initiative controlling for selection bias or 
        other factors that may impact the reliability of data.
            ``(3) Report.--Not later than September 30, 2028, the 
        Secretary of Health and Human Services shall submit to the 
        Committee on Ways and Means of the House of Representatives and 
        the Committee on Finance of the Senate a report on the study 
        conducted under paragraph (1).''.
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