October 6, 2025
The Honorable Vern Buchanan
U.S. House of Representatives
2409 Rayburn House Office Building
Washington D.C. 20515
The Honorable Lloyd Smucker
U.S. House of Representatives
302 Cannon House Office Building
Washington, D.C. 20515
The Honorable Dwight Evans
1105 Longworth House Office Building
Washington D.C. 20515
U.S. House of Representatives
Dear Representatives Buchanan, Smucker, and Evans:
The Society of Hospital Medicine (SHM), representing the nation’s more than 50,000 hospitalists, is pleased to express our strong support for H.R. 4313, the Hospital Inpatient Services Modernization Act, which would extend the Acute Hospital Care at Home waiver flexibilities through 2030.
In response to the extraordinary pressures on inpatient capacity during the pandemic, the Centers for Medicare & Medicaid Services (CMS) established the “Hospitals Without Walls” program, which evolved into the Acute Hospital Care at Home initiative. This waiver-based model allows hospitals to deliver certain acute-level services in patients’ homes, for appropriately selected patients who would otherwise be hospitalized. In doing so, hospitals may ensure that patients with lower acuity needs receive care in the least intensive and safest environment.
Hospitalists are front-line physicians in America’s hospitals whose professional focus is the general medical care of hospitalized patients, many of whom are Medicare and Medicaid beneficiaries. Because of their expertise and presence in inpatient settings, many hospitalists have directly led or participated in Hospital at Home programs. As such, they have direct experience with how this model complements and relieves pressure on brick-and-mortar hospital operations while being a better option than a traditional inpatient setting for some patients.
H.R. 4313 would provide much-needed stability and certainty by extending waiver flexibilities through 2030 — thereby avoiding the cliff that Hospital at Home programs are currently experiencing after the current authorities expired on September 30, 2025. We believe the extension of the flexibilities along with the evidence-gathering provisions in H.R. 4313 strike the right balance: they provide necessary continuity for existing and developing Hospital at Home programs, while ensuring Congress and regulators have the data to calibrate future policy. A longer-term waiver period will also lessen uncertainty for existing programs and for those considering launching such programs, thereby encouraging wider adoption.
For these reasons, SHM is proud to support H.R. 4313. If you or your staff have questions or would like further input, please feel free to contact Josh Boswell, Chief Legal Officer, at jboswell@hospitalmedicine.org.
Thank you for your leadership on this important issue.
Sincerely,
Chad Whelan, MD, MHSA, SFHM
President
Society of Hospital Medicine
October 6, 2025
The Honorable Tim Scott
United States Senate
104 Hart Senate Office Building
Washington, DC 20510
The Honorable Raphael Warnock
United States Senate
717 Hart Senate Office Building
Washington, DC 20510
Dear Senators Scott and Warnock:
Dear Representatives Buchanan, Smucker, and Evans:
The Society of Hospital Medicine (SHM), representing the nation’s more than 50,000 hospitalists, is pleased to express our strong support for S. 2237, the Hospital Inpatient Services Modernization Act, which would extend then Acute Hospital Care at Home waiver flexibilities through 2030.
In response to the extraordinary pressures on inpatient capacity during the pandemic, the Centers for Medicare & Medicaid Services (CMS) established the “Hospitals Without Walls” program, which evolved into the Acute Hospital Care at Home initiative. This waiver-based model allows hospitals to deliver certain acute-level services in patients’ homes, for appropriately selected patients who would otherwise be hospitalized. In doing so, hospitals may ensure that patients with lower acuity needs receive care in the least intensive and safest environment.
Hospitalists are front-line physicians in America’s hospitals whose professional focus is the general medical care of hospitalized patients, many of whom are Medicare and Medicaid beneficiaries. Because of their expertise and presence in inpatient settings, many hospitalists have directly led or participated in Hospital at Home programs. As such, they have direct experience with how this model complements and relieves pressure on brick-and-mortar hospital operations while being a better option than a traditional inpatient setting for some patients.
S.2237 would provide much-needed stability and certainty by extending waiver flexibilities through 2030 — thereby avoiding the cliff that Hospital at Home programs are currently experiencing after the current authorities expired on September 30, 2025. We believe the extension of the flexibilities along with the evidence-gathering provisions in S. 2237 strike the right balance: they provide necessary continuity for existing and developing Hospital at Home programs, while ensuring Congress and regulators have the data to calibrate future policy. A longer-term waiver period will also lessen uncertainty for existing programs and for those considering launching such programs, thereby encouraging wide adoption.
For these reasons, SHM is proud to support S. 2237. If you or your staff have questions or would like further input, please feel free to contact Josh Boswell, Chief Legal Officer, at jboswell@hospitalmedicine.org.
Thank you for your leadership on this important issue.
Sincerely,
Chad Whelan, MD, MHSA, SFHM
President
Society of Hospital Medicine