record information, or through such other means 
as the Secretary determines appropriate.’’; 
(2) in subsection (b), in the subsection heading, 
by striking ‘‘STUDY’’ and inserting ‘‘INITIAL STUDY’’; 
(3) by redesignating subsections (c) and (d) as 
subsections (d) and (e), respectively; and 
(4) 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 param-
eters such as diagnosis-related groups)— 
‘‘(i) quality of care furnished to indi-
viduals with similar conditions and charac-
teristics in the inpatient setting and 
through the Acute Hospital Care at Home 
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initiative, including health outcomes, hos-
pital readmission rates (including readmis-
sions 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 nurs-
ing staff, transfers from the hospital to the 
home, transfers from the home to the hos-
pital (including the timing, frequency, and 
causes of such transfers), transfers and dis-
charges to post-acute care settings (includ-
ing the timing, frequency, and causes of 
such transfers and discharges), and patient 
and caregiver experience of care; 
‘‘(ii) clinical conditions treated and di-
agnosis-related groups of discharges from 
inpatient settings relative to discharges 
from the Acute Hospital Care at Home ini-
tiative; 
‘‘(iii) costs incurred by the hospital for 
furnishing care in inpatient settings rel-
ative to costs incurred by the hospital for 
furnishing care through the Acute Hospital 
Care at Home initiative, including costs re-
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lating to staffing, equipment, food, prescrip-
tions, and other services, as determined by 
the Secretary; 
‘‘(iv) the quantity, mix, and intensity 
of services (such as in-person visits and vir-
tual contacts with patients and the inten-
sity of such services) furnished in inpatient 
settings relative to the Acute Hospital Care 
at Home initiative, and, to the extent prac-
ticable, the nature and extent of family or 
caregiver involvement; 
‘‘(v) socioeconomic information on in-
dividuals treated in comparable inpatient 
settings relative to the initiative, including 
racial and ethnic data, income, housing, ge-
ographic 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 individ-
uals who entered into the Acute Hospital 
Care at Home initiative directly from an 
emergency department compared with indi-
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viduals 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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Union Calendar No. 311 
119TH CONGRESS 
1ST SESSION 
H. R. 4313 
[Report No. 119–359] 
A BILL 
To amend title XVIII of the Social Security Act to 
extend acute hospital care at home waiver flexi-
bilities, and to require an additional study and 
report on such flexibilities. 
OCTOBER 31, 2025 
Reported with an amendment, committed to the Com-
mittee of the Whole House on the State of the Union, 
and ordered to be printed 
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