Fleisher oversaw the development of the CMS Acute Hospital Care at Home (AHCAH) waiver in 2020 as hospitals faced a bed shortage crisis during the COVID-19 pandemic.[1] The exemption allows hospitals to provide acute inpatient treatment at home for patients with diagnoses such as pneumonia, heart failure or infections.[1][6] The program includes daily virtual medical visits, nursing support, intravenous therapy, diagnostics and monitoring.[1] Nearly 400 hospitals in 39 US states have launched programs and invested in the necessary infrastructure.[1] Patients at home are more mobile, less prone to delirium and infections, begin rehabilitation more quickly, and are supported by families in their recovery.[1] A 2024 CMS evaluation showed lower mortality, lower postdischarge spending, and high patient satisfaction, although readmissions varied and data reporting was inconsistent.[1] The program depends on short-term extensions and will expire without congressional action, with the House of Representatives approving a five-year extension but the Senate yet to act before the January 30 deadline.[1]