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INTRODUCTION: The adoption of pediatric advanced care at home (PACH) in the U.S. has been limited and lagged behind analogous care models in adults. For example, there is only a single pediatric home hospital (HH) program compared with nearly 400 adult programs nationwide. Gaps persist due to multifactorial considerations, from differences in reimbursement to technology access. These challenges prompted a national, multiday roundtable discussion in November 2025. More than 50 experts in pediatric clinical care, healthcare administration, health services research, and policy convened to define the roadmap for the implementation and expansion of PACH. In this Perspective article, we describe the central insights from the roundtable, established by consensus from roundtable participants, with an emphasis on the current landscape of the field and areas of opportunity.
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Brewster et al. (2026) studied this question.
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