The concept of "Hospital at Home" is gaining traction, supported by the reimbursement for acute services delivered in the home and continued efforts to equip homes for optimal care delivery with emerging technology. Starting something new is never without challenges with innovators facing the continued shortage of clinical workforce, internal barriers to changing long-standing traditional brick and mortar hospital culture towards a home-centered model, and the task of establishing strong payer engagement for a new clinical delivery approach. In a case study panel discussion, Mass General Brigham's impressive Home Hospital service will shed light on a truly scalable operation. Past the initial startup phase, they are on to bigger priorities including growing payer partners, achieving an optimal care model, and proving the downstream cost savings and improved clinical outcomes made possible by the relocation of acute hospital level care into the home. The ultimate goal is to expand consumers' perceptions and ultimately patient choices for how and where they receive care, whereby the hospital is not a physical entity but part of a versatile healthcare system without walls.