Johns Hopkins is generally cited as the first to pilot the Hospital at Home care model over 20 years ago. The model has been subsequently adopted by the VA and overseas in Australia, Canada, Israel and the UK among other countries. CMS first tested the model in 2014 when it awarded Mount Sinai a grant to test the model, however, the model was not expanded having failed to the meet statutory criteria for expansion. In order to better manage hospital capacity and reduce COVID infections, in 2020 under its waiver authority CMS allowed hospitals to provide alternative sites of acute care including homes. Per research published by CMS this past December there are 186 hospitals across 33 states that have implemented the AHCaH model. Currently, CMS' AHCaH model will last last as long as the Public Health Emergency (PHE) - that HHS just extended until July. Hospital at Home research findings have been on balance favorable. For example, research published in 2018 in JAMA found hospital at home patients had comparably lower rates of readmissions, ED and Skill Nursing visits and were more likely to rate their hospital care highly, research findings are however compromised by selection bias.