July 7, 2025

Welcome to the Moving Health Home newsletter!

In this monthly newsletter, you will find policy developments, research, and updates on how health care organizations are striving to shift more health care delivery into the home – meeting patient needs where they are and expanding access to quality health care.

Please send any news or events to rcheung@movinghealthhome.org for future inclusion in this newsletter.

Moving Health Home Updates

McKnights Home Care: Hospital-at-Home Advocates on Extension (6/11) – While Congress so far has dragged its feet on a permanent solution to the Acute Hospital Care at Home waiver, industry stakeholders feel confident that a multiyear extension is forthcoming. “We are working hard to get a five-year extension in the government funding bill in September, and there are new bipartisan champions of the provision in both the House and Senate,” Krista Drobac, founder of Moving Health Home, a hospital-at-home lobbying group, told McKnight’s Home Care Daily Pulse. “Congress understands that it’s difficult to operationalize a program, and evaluate its impact on cost and outcomes, if we have a bunch of short-term extensions.”

Administration

Centers for Medicare and Medicaid Services (CMS): Calendar Year (CY) 2026 End-Stage Renal Disease (ESRD) Prospective Payment System Proposed Rule (6/30) - CMS issued a proposed rule to update payment rates and policies under the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS). CMS proposes ending the ESRD Treatment Choices Model as of December 31, 2025, as aligned with its March announcement to better align with the CMS Innovation Center’s statutory mandate and to protect taxpayers.

Department of Health and Human Services (HHS): Administration for a Healthy America Congressional Justification for Fiscal Year (FY) 2026 Budget (6/13) – HHS requested funding through the Teaching Health Center Graduate Medical Education (THCGME) Payment program would be used to foster innovation and support curriculum enhancements aimed at improving the quality of patient care, such as the Patient-Centered Medical Home model, Electronic Health Record utilization, population health, telemedicine, and health care leadership. Additionally, a portion of funding for Family-To-Family Health Information Centers would be used to support the Health Center Program Patient Centered Medical Home (PCMH) Initiative, which would use a team-based approach to improve quality through coordination of care and patient engagement.

HHS: Administration for Children, Families, and Communities Congressional Justification for Fiscal Year (FY) 2026 Budget (6/13) – HHS requested funding through the Aging Network Support Activities (ANSA) program for Strengthening the Direct Care Workforce, Care Corps, and Eldercare Locator programs. Other funding announced goes to the National Family Caregiver Support Program which would fund a range of supports that assist family and informal caregivers to care for their loved ones at home for as long as possible as well as develop, test, and scale models to implement recommended actions from the National Strategy to Support Family Caregivers.

HHS: HHS Secretary Kennedy, CMS Administrator Oz Secure Industry Pledge to Fix Broken Prior Authorization System (6/23) – During a roundtable discussion hosted by HHS, health insurers pledged six key reforms aimed at cutting red tape, accelerating care decisions, and enhancing transparency for patients and providers. Companies that agreed to streamline and improve the prior authorization processes included Aetna, Inc., AHIP, Blue Cross Blue Shield Association, Centene Corporation, The Cigna Group, Elevance Health, Humana, Inc., Kaiser Permanente, and UnitedHealthcare.

HHS: HHS Secretary Kennedy, CMS Administrator Oz Secure Industry Pledge to Fix Broken Prior Authorization System (6/23) – On June 23, about 50 health insurance plans pledged to address the prior authorization system. Companies represented at the roundtable included Aetna, Inc., AHIP, Blue Cross Blue Shield Association, CareFirst BlueCross BlueShield, Centene Corporation, The Cigna Group, Elevance Health, GuideWell, Highmark Health, Humana, Inc., Kaiser Permanente, and UnitedHealthcare. Participating health insurers have pledged to:

• Standardize electronic prior authorization submissions using Fast Healthcare Interoperability Resources (FHIR®)-based application programming interfaces.
• Reduce the volume of medical services subject to prior authorization by January 1, 2026.
• Honor existing authorizations during insurance transitions to ensure continuity of care.
• Enhance transparency and communication around authorization decisions and appeals.
• Expand real-time responses to minimize delays in care with real-time approvals for most requests by 2027.
• Ensure medical professionals review all clinical denials.

CMS: CMS Seeks Public Input on Improving Technology to Empower Medicare Beneficiaries (6/16) – Stakeholders from across the healthcare industry submitted comments to the Health Technology Ecosystem RFI. The comments covered a range of topics including remote patient monitoring, telehealth, digital health apps, value-based care, health IT, data sharing and interoperability, and reimbursement.

Medicare Payment and Access Commission (MedPAC): June 2025 Report to Congress (6/12) – MedPAC released its June 2025 Report to Congress, which reports on Medicare fee-for-service (FFS) payment systems, Medicare Advantage (MA), and Medicare Part D. The report found that Medicare Advantage Organizations (MAOs) frequently contract with vendors to administer nonmedical supplemental benefits such as in-home supports and services. Vendors providing in-home supplemental benefits emphasized their ability to identify members’ diagnoses and boost star ratings.

CMS: Advancing Healthcare Quality through Technology (AHQT) Readiness Assessment (6/9) – CMS announced that its Quality Improvement Network will be collecting data on nursing homes’ “readiness” to access, share and use electronic data. Use of health information technology (HIT) is imperative to assess, monitor, and improve healthcare quality, patient safety, and care coordination. The results of the assessment will be used to determine which providers/practices may benefit from participation in a technical assistance pilot specific during the QIN-QIO 13th SOW intended to advance provider/practice capacity for engaging in quality improvement and reporting activities facilitated by HIT.

Centers for Medicare and Medicaid Services (CMS): CMS Building Foundational Infrastructure for Digital Healthcare Ecosystem (6/3) – CMS hosted an in-person listening session to discuss the digital health ecosystem request for information (RFI) and ways to use the health technology innovations to enhance patient care and promote efficiencies in the healthcare system. The meeting brought together stakeholders from across the healthcare ecosystem to share their insights and best practices on ways to leverage digital health technologies to reduce fraud, cut administrative burdens, and deliver higher-quality care to millions of beneficiaries.

Congress

House of Representatives: Introduction of Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) (6/26) – On June 26, Reps. Thompson (D-CA), Schweikert (R-AZ), Matsui (D-CA), and Balderson (R-OH) introduced the CONNECT for Health Act of 2025 (H.R. 4206), which would expand access to telehealth services. Sens. Schatz (D-HI), Wicker (R-MS), Warner (D-VA), Hyde-Smith (R-MS), and Welch (D-VT) introduced the companion bill in the Senate (S. 1261) on April 2.

Senate: Introduction of Expanding Access to Palliative Care Act (6/5) – Sens. Rosen (D-NV), Barrasso (R-WY), Baldwin (D-WI), and Fischer (R-NE) introduced the Expanding Access to Palliative Care Act (S. 1935), which would establish a demonstration project through Medicare to expand access to palliative care at the time of diagnosis of serious illness or injury.

Senate: Introduction of the Improving Access to Transfusion Care for Hospice Patients Act (6/5) – Sens. Rosen (D-NV), Barrasso (R-WY) and Baldwin (D-WI) introduced the Improving Access to Transfusion Care for Hospice Patients Act (S. 1936), which would carve out payment for transfusion services within the Medicare hospice benefit, allowing for separate billing to Medicare for transfusions.

Research and Polling

JAMA Internal Medicine: Addressing the Hospital Boarding Crisis in the US—Time to Act (6/30) – This commentary on existing studies analyzed hospital adherence to CMS Age-Friendly Hospital Measures regarding transferring older patients out of the emergency department (ED) within eight hours of arrival and/or three hours of the decision to admit. Research showed that both ED boarding time and ED visits by older adults increased between 2017 and 2024.

Hospital Pediatrics: Family Perceptions of Pediatric Acute Hospital Care at Home in the United States (6/27) – This qualitative analysis found that family caregivers were largely receptive to the hospital-at-home concept, notable barriers to implementation included caregiver burden and clinical monitoring and safety, and pediatric expertise among hospital-at-home clinicians was important to positive perceptions.

Hospital Practice: Factors Leading To Escalations in Hospital-at-Home: A Scoping Review (6/25) – This scoping review searches the existing literature for common reasons for escalation from hospital-at-home to traditional inpatient settings. Findings included falling, lack of treatment response, exacerbation of the primary disease, cardiac symptoms, and medication adverse effects. Generally, researchers found that escalations are influenced by primary underlying conditions, patient comorbidities, and care complexity.

Sg2: Industry Report: Post-Acute Care Increasingly Moving into the Home (6/25) – A report by health care trends and analytics firm Sg2 found that cost pressures and consumer preference for convenient access to care increasingly are driving post-acute services into patients’ homes. The report found that home health patient volumes are expected to increase by roughly 13 percent over the next five years and 24 percent over the next ten. Additional coverage can be found in McKnights Home Care.

JAMA Network: Challenges of Economic Evaluations of Unreimbursed Care Models (6/23) – This commentary highlights care models that keep acutely ill patients requiring hospital-level care out of hospital as a solution to adverse events and high costs associated with brick-and-mortar hospital stays.

The Joint Commission Journal on Quality and Patient Safety: A Remote Patient Management Care Model for Pediatric Home Care Ventilator Patients Conserves Resources (6/20) – Children’s Hospital of Philadelphia’s Home Care program integrated remote patient management into its current service model. The program had a 39 percent reduction in home visits compared to prior year. Results also included savings in time, improved communication between members of the care team, and potential prevention of hospital admissions.

Rosalynn Carter Institute: The Power of Evidence (6/6) – RCI released several impact papers exploring the realities of caregiving and connecting evidence with actionable recommendations for progress. RCI created a conceptual framework which provided key factors to consider when designing or implementing caregiver support interventions.

JAMA Network Open: Economic Burden of Alzheimer Disease and Related Dementias by Race and Ethnicity, 2020 to 2060 (6/5) – Dementia caregivers’ total unpaid economic impact is expected to exceed $3 trillion by 2060. The total estimated economic burden of ADRD was close to $344 billion in 2020. Understanding ADRD prevalence, comorbidity, and inadequate care may attenuate economic burdens for all US residents in the coming decades, with increased focus on caregiver support polices.

Journal of Clinical Oncology: Cancer Care Beyond Walls (CCBW): A Randomized Pragmatic Trial of Home-Based Versus In-Clinic Cancer Therapy Administration (6/4) – Researchers from Mayo Clinic submitted a meeting abstract to the 2025 American Society of Clinical Oncology Annual Meeting describing a randomized controlled trial that evaluates feasibility and impact of home-based versus in-clinic cancer directed therapy. Researchers found no safety concerns related to care location and most patients preferred home-based treatment.

Journal of Patient Experience: Patient-Centered Care: A Qualitative Analysis of Patient and Caregiver Experiences in a Hospital at Home Program (6/2) – This descriptive qualitative study aimed to address a gap in the literature by exploring the experiences of Hospital at Home (HaH) patients and caregivers. Thematic analysis revealed three main themes: patient-centered communication and education, differences in medical care at home, and the impact of technology on the overall experience.

Mayo Clinic Proceeding: Hospital-at-Home Patient Fall Predictors – A retrospective study showed that in patients hospitalized at home, the risk of falls may increase with older age, higher Charlson Comorbidity Index, and supplemental oxygen use. Larger prospective studies of fall predictors in the HaH setting are needed to develop predictive tools that will mitigate fall risk in vulnerable patient populations.

Health Economics: Home-Based Care Outcomes: Does the Care Provider Matter? (4/28) – A person's use of formal and family care is affected by factors that also may affect their outcomes. This study examined three types of home-based care combinations: family only, formal only, and both formal and family care. The study found once the endogeneity of the care provider is accounted for, having both formal and family care leads to better self-rated health, mobility and lower depression compared to people receiving family care only. Findings suggest the importance to best meet the growing demand for person-centered, high-quality long-term care in the least restrictive setting possible. A press release can be found here.

News and Market Developments

Modern Healthcare: In-Home Pediatric Primary Care Providers Court Medicaid Insurers (6/25) – Home-based primary care companies promise to do for kids what others are doing for older adults: keep them healthy and out of hospital emergency rooms. Start-up companies are partnering with Medicaid managed care organizations to provide a variety of primary care services to low-income kids where they live. Easy access to care could help prevent more costly interventions down the road and save money for states.

Becker’s Health IT: New Jersey Health System to Launch Hospital at Home Program (6/24) – Valley Health System in Northern New Jersey is launching a hospital at home program this summer to deliver high-acuity inpatient care directly to eligible patients in their homes. The program aims to enhance patient experience by delivering hospital-level care in the comfort of patients’ homes.

Home Health Care News: At-Home Care’s New M&A Strategy: From Scale to Density (6/24) – Strengthening home-based care operations within current markets now drives census growth more effectively than geographic expansion via M&A or de novo growth – a shift that is expected to gain even more momentum in the coming years.

Boise State Public Radio: A New Program is Stepping Out of the Hospital and into Patients’ Homes (6/24) – St. Luke’s Hospital at Home program, provides hospital-level care to patients in the comfort of their homes. The program allows patients with conditions such as heart failure, infections requiring IV antibiotics, pneumonia or asthma to receive necessary treatments at home.

The Healthcare Technology Report: Sprinter Health Invests $55M to Grow Home-Based Preventative Care (6/17) – Sprinter Health invested in hybrid care models that blend in-person visits with virtual clinical support, focusing on reaching people who are often left out of traditional health care by deploying trained staff into communities to deliver preventive services and diagnostics at home. Its platform uses advanced logistics and scheduling tools to help its staff provide care efficiently, adapting to varied local conditions. The company is looking to expand its services to four more states by the end of summer 2025.

Franchising: PocketRN and SYNERGY HomeCare Announce a Partnership to Test Medicare Dementia Care Model Developed by Centers for Medicare & Medicaid Services (6/12) – PocketRN and SYNERGY HomeCare’s collaboration integrates in-home memory care, respite services, and 24/7 virtual nursing support to enhance care access, reduce hospitalizations, and sustain caregivers at home. By combining medical and non-medical supports, the partnership addresses gaps in dementia care through comprehensive care navigation and education.

Medscape: Home Is the New Hospital: Nurses Rethink Where Patients Heal (6/12) – With ERs overwhelmed, hospitals are scaling up Hospital at Home programs—now active in 378 hospitals—to deliver acute care like IV meds, diagnostics, and 24/7 monitoring at home. Making Hospital at Home a permanent option for patients is critical to the future of health care and plays a critical role in alleviating burnout, reducing wait times, and providing safe, effective, value-based care.

SSM Health: Building Stronger, Healthier Communities (6/10) – In 2024, SSM Health invested $406 million in programs and services that have improved the health of our communities. Based on findings from its Community Health Needs Assessments, SSM Health facilities developed and implemented programs that bolstered community access to medical care and nutritious food, safe housing and respite care, and other resources that play an important role in overall health and well-being.

Home Health Care News: ‘It’s Going to Be the Expectation’: Alternative Care Models Reshape Home-Based Care (6/10) – At-home care providers are increasingly investing in alternative home-based care models, such as hospital-at-home. DispatchHealth, Contessa Health and Alivia Care are some of the organizations that have jumped headfirst into alternative home-based care models, enabling the creation of more comprehensive care delivery models. This article states that these models are set to become an expectation for home-based care providers.

McKnights Home Care: How Mass General Brigham Scaled Home Hospital by 200 Percent (6/9) – Mass General Brigham, an integrated health care system based in Massachusetts, launched its home hospital pilot in 2017. Since then, the organization has strategically expanded and scaled the program, making it one of the largest and most established hospital-at-home initiatives in the nation. The health system tripled its monthly discharges, nearly doubled its average daily census, and reduced length of stay—all while maintaining patient safety through low readmission rates, minimal escalations, and no unexpected mortalities.

Home Health Care News: Hospital At Home Faces ‘Wait-And-See’ Moment Amid Waiver Uncertainty (6/6) – Health systems that have yet to launch hospital at home programs are hesitating amid questions about its long-term future. Still, industry experts remain optimistic about the future of hospital at home, even as they acknowledge that the path to a permanent hospital at home policy is fraught with challenges including uncertainty about the waivers that make the programs possible.

Hospital Management: Nest Health Introduces Home-Based Opioid Addiction Treatment Program (6/4) – Health care provider Nest Health introduced its home-based treatment for opioid addiction, Nest Rooted Recovery, which incorporates medical, behavioral, and social care for families. The program offers in-home clinical assessments to assess the seriousness of opioid dependence, concurrent substance use, social determinants of health, and infectious diseases. The fully integrated care model extends beyond addiction treatment to include primary care, chronic condition management, mental health services, and social care.

The Wall Street Journal: America’s Hospital-Bed Shortage Is About to Become a Crisis (5/30) – The U.S. has a growing scarcity of unoccupied hospital beds in this country, contributing to emergency room boarding, overcrowding, and inadequate treatment. An aging population will increasingly require more acute, and increasingly technological. Providers are calling for federal action to train more health care workers, prevent hospital closures, and move care to home settings.

Detroit Area Agency on Aging: Home based Primary Care Program – The Detroit Area Agency on Aging (DAAA) introduced its Home-Based Primary Care (HBPC) Program, a transformative new initiative to meet the healthcare needs of adults who are homebound or face significant barriers accessing traditional medical services. Home-Based Primary Care will serve communities across Wayne, Macomb, and Oakland counties, becoming the only Area Agency on Aging-supported primary care initiative of its kind in Southeast Michigan.

Upcoming Events

July 18, The John A. Hartford Foundation, "Age-Friendly Health Systems Research Network." 

September 15-17, Home Health Care News, "FUTURE Conference." 

December 3-5, Hospital @ Home Leadership Summit, "Embracing the Future of Healthcare."

Please subscribe to this newsletter and send any news or events to rcheung@movinghealthhome.org for inclusion in this newsletter.