Medically Home bet CMS's home-hospital waiver would last; DispatchHealth absorbed it

A software platform (Cesia Continuum) plus staffed clinical command centers that let hospitals deliver inpatient-level acute care in patients' own homes.

That health systems would buy a platform to move inpatient wards into living rooms — and that the emergency waiver would become permanent Medicare policy

$65M across three rounds by May 2021, then $100M from Mayo Clinic and Kaiser Permanente, then a $110M strategic round led by Baxter International, Global Medical Response and Cardinal Health.

Medically Home was founded in Boston in 2016 on the argument that roughly 30% of hospitalized patients could be treated at home, and built Cesia Continuum to integrate monitoring and communications for dispersed care teams. In November 2020 CMS launched the Acute Hospital Care at Home (AHCAH) initiative under section 1135 waiver authority: it suspended the conditions of participation requiring nursing services on the premises around the clock and an immediately available registered nurse, plus hospital physical-environment and Life Safety Code requirements, for care delivered in a patient's home. Six health systems — Brigham and Women's, Massachusetts General, Huntsman Cancer Institute, Mount Sinai, Presbyterian Healthcare Services and UnityPoint — were granted waivers at launch to treat more than 60 acute conditions, and CMS called it the first time Medicare fee-for-service paid for this level of care outside a hospital.

Mayo Clinic and Kaiser Permanente put $100M into the company in May 2021; Baxter International, Global Medical Response and Cardinal Health added a $110M strategic round in early 2022, joining the board. But the payment authority stayed on a clock. The Consolidated Appropriations Act, 2023 extended AHCAH only to December 31, 2024, and a stop-gap funding bill signed in March 2025 stretched it to September 30, 2025 —CMS's own fact sheet noted that continuation beyond 2024 was 'contingent on further Congressional action.' On March 18, 2025 Medically Home agreed to merge into Denver-based DispatchHealth, founded in 2013 and funded by a $330M equity-and-debt round in late 2022. The combined company was to reach 50 metropolitan areas with nearly 40 health systems and 2,200+ employees, on top of the 55,000+ patients already treated through Medically Home's program alongside partners including Yale New Haven Health and Cleveland Clinic.

The merger closed in late May 2025 and was announced on June 4, 2025. DispatchHealth CEO Jennifer Webster leads the combined company and Dr. Pippa Shulman became chief medical officer; Graham Barnes, who led Medically Home into the deal, departed. Terms were not disclosed and the Medically Home brand is being phased out — the company that bet on the waiver no longer trades under its own name.

The waiver created the revenue. Medicare had never paid inpatient rates for care at home before November 2020, so the regulation was the market rather than a tailwind.

Section 1135 authority is tied to a declared emergency. Once the public health emergency ended, only Congress could keep it alive, and it did so in increments of months.

Hospitals would not sign multi-year commitments against a payment rule that could expire mid-contract, so pipeline length was capped by the renewal calendar.

Clinical proof attracted capital — Mayo and Kaiser wrote a $100M check — but capital cannot manufacture a permanent Medicare benefit category.

DispatchHealth had the piece Medically Home lacked: a same-day field operation across 20+ states, funded by a $330M round in late 2022.

A waiver is not a market. If revenue depends on temporary authority, price the renewal risk into the model or find customers who can absorb it — hospitals cannot.

DispatchHealth runs the combined platform: more than 20 states, 50+ enterprise customers, and Medically Home's command-center model being folded into a national system, with the Medically Home brand phased out. The waiver itself is finally on a five-year footing: the Consolidated Appropriations Act, 2026 (H.R. 7148), signed February 3, 2026, extends Acute Hospital Care at Home through fiscal 2030 and Medicare telehealth flexibilities through December 31, 2027. The long-term certainty health systems kept asking for now exists — held by the survivor of the consolidation.