Department of Research & Evaluation News

For carefully selected patients, receiving advanced-level care at home after heart failure may be just as safe and effective as staying in the hospital, a new Kaiser Permanente Southern California study shows.

The study, published on July 16, 2026, in JAMA Network Open, examined adults hospitalized for acute heart failure. Researchers compared patients who continued treatment at home through Advanced Medical Care at Home, or AMCAH, with those who continued treatment in a brick-and-mortar hospital.

AMCAH is designed to deliver many of the same services patients receive in the hospital but in their own homes. The program includes services such as mobile lab testing, intravenous medications, in-home nursing visits, remote monitoring, and daily virtual check-ins with physicians.

“This study helps show that advanced care at home can be a safe and effective option for some heart failure patients when doctors carefully choose who is eligible,” said the study’s senior author Huong Q. Nguyen, PhD, RN, a researcher with the Kaiser Permanente Southern California Department of Research & Evaluation.

Heart failure is one of top causes of hospitalization

Heart failure is one of the leading reasons for hospitalization in the United States. As the number of people living with heart failure continues to rise, health systems are exploring new ways to deliver care that maintain quality while improving patient experience.

In this study, researchers used real-world data from Kaiser Permanente Southern California to compare outcomes among patients admitted to the hospital between February 2023 and December 2024 who continued treatment either at home or in the hospital. Researchers compared outcomes including readmissions, mortality, and use of recommended heart failure medications.

The study’s design included only patients who were initially hospitalized, helping ensure that the comparison groups were similar and that the results reflect real-world care for patients who truly needed hospital-level treatment.

Patients treated at home had similar outcomes

Patients treated at home through the AMCAH program had similar outcomes to those treated in the hospital.

• Within 30 days, about 19% of patients treated at home were readmitted, compared with 24% of patients who were treated only in the hospital.
• Within 30 days, death rates were also similar, at 3% for those treated at home and 5% for those treated in the hospital.
• At 60 days, the results remained consistent, with mortality rates at 8% in both groups and no significant differences in readmissions.
• Out of every 100 patients treated at home in the program, only about 5 or 6 needed to be transferred back to a regular hospital for in-hospital care.

Researchers also looked at how long patients stayed out of the hospital after discharge. Both groups averaged nearly the same number of days alive and out of the hospital: about 28 days within the first month and more than 55 days over 2 months.

Another key measure was whether patients received guideline-directed medical therapy, which includes medications proven to improve outcomes in heart failure. Patients in both groups received these treatments at similar rates, suggesting that care quality was consistent regardless of where patients recovered.

Study findings support milestone program

“AMCAH represents an important milestone in offering patients another care delivery method that combines what is traditional hospital-based care in the comfort of a home setting, particularly for those with chronic conditions like heart failure,” said lead author Cheng-Wei “Charlie” Huang, MD, a hospitalist at the Kaiser Permanente Los Angeles Medical Center. “We hope our study provides reassurance to patients and providers alike that for the right patients, AMCAH offers similar safety and quality to the hospital for acute heart failure management with the added benefit of the comfort of home.”

The researchers also note that advanced-care-at-home programs are still evolving. Only a small share of eligible patients, about 6% to 7%, participated in the AMCAH program during the study period. This may reflect hesitation among patients and clinicians, as well as the challenges of scaling a relatively new model of care.

Critical component of program: patient selection

The authors emphasize that careful patient selection, which is done on a case-by-case basis, is key, said study co-author Dan Huynh, MD, a medical director for the hospital-based service line and AMCAH quality lead for Kaiser Permanente in Orange County.

“From an operational standpoint, these findings reinforce the importance of having the right systems, staffing, and clinical protocols in place to safely deliver advanced-level care in the home,” Dr. Huynh said. “Advanced care at home is not simply moving hospital care to a different setting; it requires careful patient selection, close coordination across care teams, reliable monitoring, and the ability to quickly escalate care when needed. When those elements are in place, programs like AMCAH can help expand care options for appropriate patients while maintaining quality and safety.”

In addition to Dr. Nguyen and Dr. Huang, other authors of this study include Bing Han, PhD, and Janet S. Lee, MS, of the Department of Research & Evaluation; Dan N. Huynh, MD; Mingsum Lee, MD, PhD; Kiet V. Liu, MD; Alyssa T. Millan, MPH; Romina S. Rosen, MD; Mehran R. Sina, MD; Christopher C. Subject, MD; and Khang A. Nguyen, MD, of the Southern California Permanente Medical Group. Dr. Nguyen, Dr. Huang, and Dr. Lee also are affiliated with the Kaiser Permanente Bernard J. Tyson School of Medicine.