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Innovative Hospital Models

The Department of Health (Department) is charged with overseeing health care services and facilities to ensure access to high quality care and encouraging innovation and continuous development of improved methods of health care in the Commonwealth. In carrying out these duties, the Department continues to monitor advancements in technology and care models to support an effective and efficient health care system. To that end, the Department has been reviewing innovative hospital models as a viable alternative for hospitals and is pleased to offer the following streamlined options for implementation of new and updated innovative models for eligible hospitals: micro-hospitals (updated); tele-emergency department; and outpatient emergency department.

Below are brief descriptions of each model. Details on the eligibility criteria can be found in the guidance document for the model, with supplemental information available in the FAQ and matrix.


A micro-hospital refers to an acute care hospital that offers emergency services and maintains facilities for at least ten inpatient beds with a narrow scope of inpatient acute care services, such as no surgical services. Formerly known as the "innovative hospital model," this model has proven to be a viable alternative to many facilities and will continue to be an option for providers seeking to offer acute care services in a smaller footprint.

Tele-emergency Department or "tele-ED"

Tele-ED refers to the operation of a tele-ED staffed by Advanced Practice Providers (APP) 24 hours per day/7 days per week (24/7) with a physician available at all times through telecommunications but not physically present in the emergency department. The Department is making available a structured exception request for eligible low-volume rural hospitals to operate a tele-ED.

Outpatient Emergency Department or "OED"

An OED refers to an outpatient location of a hospital that offers only emergency services without inpatient beds on-site and is not located on the grounds of a main licensed hospital. Hospitals will be able to operate an OED in rural areas in accordance with the guidance.​