Hospital at home is shifting from pandemic experiment to mainstream capacity strategy. Congress extended Medicare’s Acute Hospital Care at Home waiver for five years through 2030, and as of late 2025 more than 400 hospitals across nearly 40 states had been approved to deliver inpatient‑level care in patients’ homes. Evidence from early programs shows lower readmissions, shorter lengths of stay, and high patient satisfaction, prompting health systems to invest in scaling home‑based acute care as a core service line.