| Moving Health Home Update |
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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.
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| Check out our website and Twitter for more information |
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The data is clear: Hospital at Home saves money, improves safety, and earns extraordinary satisfaction from patients and families alike. Leaders from the community will discuss the evolving landscape as well as explore the next frontier of SNF at Home.
Join Moving Health Home at the Hospital at Home Leadership Summit December 3-5, 2025 in Orlando, FL.
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Moving Health Home Updates
With the government shutdown since October 1, 2025, there is a lapse in the Acute Hospital Care at Home (AHCAH) waiver program and expanded Medicare telehealth flexibilities.
Moving Health Home continues to be at the forefront of advocacy for 1) restoring hospital at home, and 2) a long-term AHCAH waiver, unconnected to government funding deadlines.
We have been in regular contact with CMS throughout the planning for the shutdown, advocating for creative ways to ensure participating hospitals have time to see patients through the program before enforcement begins.
We championed the Hospital Inpatient Services Modernization Act (H.R. 4313), which passed out of the House Ways and Means Committee, and would guarantee a five year extension, and urge all stakeholders to support it.
Participation in Moving Health Home moves the needle on care in the home, including hospital at home. As leaders in the coalition, members are instrumental in shaping the policy agenda across Washington, DC and the nation.
Join the movement today. If your organization is interested in joining the push for hospital at home, please reach out to rcheung@movinghealthhome.org.
Fierce Healthcare: Hospital at home providers navigate complexities during government shutdown (10/9) - The lapse of the Centers for Medicare and Medicaid Services (CMS) Acute Hospital Care at Home waiver during the government shutdown created regulatory confusion and uneven program access across states.
“Hospital systems, businesses like mine, are preparing for two different realities,” Pippa Shulman from Dispatch Health, a MHH member,
said. “They're thinking about this program that has such an opportunity for expansion and innovation, and so they're planning for new geographies, to go into new hospitals, to expand into new use cases at the same time as they're planning for a potential interruption of uncertain length and uncertain impact.”
Rikki Cheung of Moving Health Home discussed ongoing congressional efforts to reauthorize the hospital-at-home waiver, noting bipartisan support and the potential for a five-year extension through pending legislation.
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Waiver Expiration Impact
MHH is looking for stories from patients, caregivers, clinicians, and more to share their experience about hospital at home, and the impact from the lapse in hospital at home waiver authority.
UMass: UMass Hospital at Home Program Paused Amid Government Shutdown (11/4) - As a result of the government shutdown, the hospital at home program at UMass has been paused and patients have been moved into brick and mortar facilities. This has caused hospital capacity issues, leading to patients being boarded in the emergency department and creating a strain on providers, patients, and resources.
With more inpatients now boarding in the health system’s UMass Memorial Medical Center (UMMMC) emergency department and in hallway beds, “we are less able to accept high-acuity/complex transfers from our community hospitals in our health system to our UMMMC campus because our UMMMC brick/mortar hospital is too full,” Taki Michaelidis, hospital-at-home medical director at UMass, told Inside Health Policy (paywalled).
Tech Target: How OSF Healthcare Navigates Hospital at Home During Shutdown (10/27) - As a result of the AHCAH waiver expiration, over 400 health care facilities were required to discharge or return hospital at home patients to brick and mortar facilities. As a result, systems like OSF Healthcare are bracing for high volumes and increased costs amid the government shutdown and beyond. Short-term extensions have resulted in considerable stress for hospital-at-home providers. For instance, OSF is expecting increases in patient volumes as the respiratory illness season begins. Navigating the uncertain landscape has had costly administrative and staffing impacts on the system.
The Clinton Chronicle: Hospital at Home Starts Shutting Down (10/10) - This article describes how the government shutdown abruptly ended Medicare’s telehealth and Hospital at Home programs, and uniquely highlights its ripple effects beyond Medicare—such as private insurers mistakenly halting telehealth coverage, confusion among providers, and rural patients losing access to care. It also captures the human impact, including nurses losing jobs overnight, families separated when patients were forced back into overcrowded hospitals, and hospitals struggling to transition patients amid the shutdown.
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Congress
Contact your member of Congress and urge them to restore access to hospital at home as well as pass a long-term fix. Failure to extend access to hospital at home this year has led to an abrupt end for millions of Medicare beneficiaries. This cycle of temporary fixes has resulted in patients and providers facing continued disruptions in care. Another short-term extension is unacceptable.
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Administration
CMS: Rural Health Transformation Program (11/5) - Applications for the Rural Health Transformation Program application were due on November 5. CMS began reviewing the applications and will announce award decisions by December 31, 2025. This is a $50 billion funding opportunity to be allocated to approved states over five fiscal years, starting in 2026. Many states have outlined plans to bring care into the home to improve access and outcomes for rural patients. States are also interested in utilizing telehealth and remote patient monitoring to transform rural health care.
CMS: CY 2026 Physician Fee Schedule Final Rule (10/31) – CMS released the CY 2026 Physician Fee Schedule final rule which updates Medicare physician payment rates and policies effective January 1, 2026. Some key takeaways include:
- Virtual Direct Supervision – CMS is finalizing, for services that are required to be performed under the direct supervision of a physician or other supervising practitioner, to permanently adopt a definition of direct supervision that allows the physician or supervising practitioner to provide such supervision through real-time audio and visual interactive telecommunications (excluding audio-only).
- Efficiency Adjustment – CMS appreciated stakeholders’ diligence in reviewing the list of services that would be impacted by the efficiency adjustment. CMS agreed with the commenters that time-based services and services on the CMS telehealth list should be included in the list of codes exempt from the efficiency adjustment list. CMS removed the time-based physical medicine and rehabilitation services and RTM services and services on the CMS telehealth list from the list of codes to which the efficiency adjustment will apply.
CMS: CMS Released Updated Guidance For All Medicare Administrative Contractors (10/21) - CMS released claims guidance for Medicare telehealth and AHCAH. CMS directed all MACs to continue to temporarily hold claims for other telehealth services (i.e. those that CMS cannot confirm are definitively for behavioral and mental health services) and for AHCAH claims. MHH understands that a claims hold does not alleviate challenges with meeting compliance of conditions of participation. MHH continues to maintain active communication with CMS to relay member concerns.
CMS: CMS Released Telehealth FAQ for Calendar Year 2026 (10/15) – An updated CMS Telehealth FAQ for Calendar Year 2025 summarized what Medicare telehealth rules look like after temporary pandemic flexibilities expired on September 30, 2025. It clarified that, except for behavioral health, telehealth will again be limited to rural beneficiaries located in medical facilities, with narrower eligible provider types and billing rules. The document outlined reinstated in-person visit requirements for mental health care, limits on audio-only use, and the end of remote billing for hospital therapy services. It also detailed continued short-term flexibilities through December 31, 2025, such as virtual direct supervision, suspended visit frequency limits, and special allowances for accountable care organizations (ACOs).
Department of Health and Human Services (HHS): Administration for Community Living Awards $60 Million to Advance Make America Healthy Again Agenda (9/30) – The Administration for Community Living (ACL) announced $60 million in grant awards to states, territories, tribes, and local organizations supporting older adults and Americans with disabilities. These awards aim to strengthen existing programs that protect health, preserve independence, and support caregivers. The grants will fund fall prevention, chronic disease management, caregiver resources, nutrition, and other state and local-based programs.
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Research and Polling
Journal of Hospital Medicine: Safety in a Hybrid Hospital-at-Home Program Versus Traditional Inpatient Care: A Pragmatic Randomized Controlled Trial – This study examined whether a virtual hybrid HaH program enabled by technology has similar clinical outcomes to traditional brick-and-mortar hospital care. The study found that patients in the hospital at home program had lower readmission rates than those in facilities and the program was associated with patients feeling comfortable during their care. The researchers concluded that a hybrid hospital at home model is a safe and comfortable alternative to traditional B&M hospital care.
Health Affairs: Practices That Adopted Remote Physiologic Monitoring (RPM) Increased Medicare Revenue and Outpatient Visits
(11/3) - Using national Medicare claims, researchers identified primary care practices that began billing for RPM during the period 2019–21 and examined practice-level outcomes through 2023. After these practices adopted RPM, Medicare revenue increased by 20 percent relative to similar, matched, nonadopting practices. This was driven by direct billing for RPM as well as more outpatient visits and care management services. Although adopting practices experienced a 2.7 percent increase in billing providers, revenue increases were predominantly driven by increased activity per provider. Increases in care volume for patients receiving RPM did not seem to come at the expense of other patients.
Becker’s Health IT: Hospital at Home Hit Hard by Government Shutdown (10/29) - A trade group survey found that 92 percent of hospital-at-home programs were affected by the ongoing government shutdown, with more than half temporarily or permanently halting operations after the CMS waiver expired on September 30. Following the shutdown, daily admissions fell by 67 percent, and many programs either stopped serving Medicare patients or shifted care to outpatient home settings.
AARP: New State-by-State Data Expose the Crushing Financial Strain of Family Caregiving — and Call for Immediate Federal and State Action (10/28) - A report from AARP and National Alliance for Caregiving revealed major state-by-state disparities in the financial and emotional strain faced by America’s 63 million family caregivers. The analysis showed that states with stronger support such as paid leave, respite care, and integrated health systems, report better outcomes, while caregivers in other states face severe economic hardship. AARP and NAC are urging federal and state lawmakers to enact policies like tax credits, Medicaid compensation, and caregiver training integration to reduce financial burdens and strengthen nationwide caregiving support.
Home Health Care News: Government Shutdown Fallout Hits Hospital-at-Home Providers, Admissions Drop (10/27) - Hospital at Home Users Group conducted a survey among its members, which found that 88% of health care organizations reported that the waiver expiration impacted their hospital-at-home programs. Additionally, 67% of those hospital-at-home programs reported a reduction in admissions.
FMG Leading: Leading Hybrid Healthcare: People-led Strategies that Ensure Virtual and Home-based Care Delivery Models Capture Value and Improve Outcomes (10/21) - This report aims to help healthcare investors and operators stay abreast of hybrid health care investment opportunities to further meet financial and clinical goals; enhance their competitive positioning; and control the rising costs of U.S. healthcare services. Provider organizations have a major opportunity to lead in hybrid health care by combining in-person, remote, and home-based services to improve outcomes and control costs. Technological and organizational barriers can hinder success if not managed effectively. To realize hybrid care’s potential, leaders must strengthen their focus, planning, execution, and impact while addressing people-centered challenges such as workforce management and change resistance.
Commonwealth Fund: State Scorecard on Medicare Beneficiary Experiences (10/16) - This Commonwealth Fund State Scorecard on Medicare Performance (October 2025) evaluated how well Medicare serves beneficiaries across all 50 states and D.C., comparing access, quality, costs, and outcomes using 31 performance indicators. The report highlighted that access to care includes the ability to receive services at home when needed, and that one of the access indicators measures how many Medicare beneficiaries referred for home health care receive timely services. The analysis noted that home health and related supports are critical to ensuring beneficiaries can get care in the right place at the right time, underscoring the importance of strengthening home-based and community-based care infrastructure as part of Medicare performance improvement.
American Geriatrics Society: Role and Expectations of Family Caregivers in Hospital at Home in the US and Canada (10/16) – This study found that nearly all hospital at home programs evaluated caregivers, assessing their willingness to participate in providing care and the associated burden. The findings also show that programs offered supports in a variety of formats, most commonly through hands-on trainings. About half of the programs utilized home health aides as part of their support system. The authors emphasize the need to establish standards for family caregiver roles and training in HaH, and suggest future research examining “associations among caregiver roles, adequacy of training, and the caregiver experience in HaH to guide optimal practice.”
Health Affairs Scholar: Paying Family Caregivers: Self-Direction in Medicaid Personal Care (10/15) - Self-direction has emerged over the past three decades as a Medicaid option that allows individuals to hire and pay their own caregivers, including family members. Using 2021 Medicaid and Medicare data, this study found that more than half of dually eligible adults aged 65 and older receiving personal care use self-direction, and these individuals have more chronic conditions, higher home health use, and greater Medicare costs than those using agency-based care. The authors emphasized that understanding spending patterns and outcomes of self-direction is key to shaping future program expansion and funding.
Health Affairs Scholar: Length of Stay of Post-Acute Care: Determinants and Differences Between Traditional Medicare and Medicare Advantage (10/13) – Researchers analyzed inpatient data to find that clinical factors were the dominant determinants of a patient’s length of stay, explaining about 90 percent of variation in time. They found that facility factors played a smaller role in determining length of stay, but still had an effect on the time a patient stayed in a hospital bed.
Health Affairs: Medicare Can Leverage Home-Based Care to Optimize Value for Homebound Beneficiaries (10/8) - The article discussed how Medicare can use home-based care to improve value and outcomes for homebound beneficiaries as the U.S. population ages and more individuals rely on Medicare. It highlights the growing number of homebound older adults with complex needs, the limitations of current payment and quality models in supporting longitudinal home-based primary care, and the missed opportunities for Medicare Advantage and accountable care organizations to invest in this population. The authors proposed strategies for identifying homebound beneficiaries, building integrated home-based care ecosystems, and aligning CMS policies and payment models to better support care delivered in the home.
AHCJ: How the Shutdown Is Impacting Telehealth and Hospital-at-Home Programs (10/8) - The Association of Health Care Journalists article explained that the federal shutdown halted Medicare’s telehealth flexibilities and the Acute Hospital Care at Home program, forcing some providers to suspend services or discharge patients. It outlined new restrictions for telehealth reimbursement, such as limits on originating sites and ineligible providers, and notes that over 400 hospitals in 39 states have paused hospital-at-home operations. Experts cited in the piece expect both programs to be reinstated once the shutdown ends, though uncertainty remains about timing and retroactive reimbursement.
AJMC: Bridging Boundaries: A Research Consortium to Advance Hospital-at-Home Care Delivery (10/7) - Cleveland Clinic and Mayo Clinic have established the Cleveland Clinic–Mayo Clinic (CCMC) Home-Based Care Research Consortium which focuses on creating a national registry, standardizing data, and developing evidence-based care pathways to evaluate the impact of HAH on patient safety, outcomes, and costs. The consortium will identify which populations can benefit most from care at home and measure cost savings and workforce efficiency.
JAMA Network: Patient-Centered Priorities for Older Adults in Ambulatory Care (10/6) - This retrospective cross-sectional study examined what matters most to older adults in walk-in ambulatory care clinics using the Age-Friendly Health Systems 4Ms framework. Researchers analyzed electronic health record data from adults aged 65 and older seen between January 2021 and March 2024, categorizing their responses to “What matters most to you?” into social activities and inclusiveness, health, family togetherness, independence, or other. Among 388,046 patients, the most frequent priority was social activities and inclusiveness, followed by health, independence, and family togetherness, with social priorities increasing and health- and family-related responses decreasing from 2021 to 2024.
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October 6, 2025
Congress allowed Medicare’s Acute Hospital Care at Home initiative to expire on September 30, 2025, creating uncertainty for hospitals and patients relying on home-based acute care. CMS directed hospitals to discharge or return patients to inpatient facilities and stopped accepting new waiver requests, while some hospitals ceased admissions for Medicare and Medicaid beneficiaries. The Bipartisan Policy Center urged Congress to extend the program for five years to provide regulatory stability, support research, and prevent future disruptions in care delivery.
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News and Market Developments
Innovation News Network: The Virtual Ward Revolution: Can Remote Care Keep Patients Out Of Hospital? (11/3) - This article examined the implications of tech-enabled care in the home for the future of patient care. Virtual hospital ward programs emphasize proactive management of health conditions, reducing the likelihood of hospital readmissions and enhancing overall patient satisfaction. This article positioned hybrid hospitals and homes as the mechanism for reshaping patient care. Hybrid models leverage advanced technology, including telemedicine and remote monitoring, to facilitate real-time communication and optimize resource allocation.
Globe Newswire: Home Healthcare Market Prospects, Opportunities and Competitive Strategies (2025-2033) (11/3) - The Research and Markets report projected that the global home health care market will grow from $382.5 billion in 2024 to $777.46 billion by 2033, driven by aging populations, chronic disease, and demand for in-home care. The report highlighted key trends shaping health care at home, including government initiatives to expand home-based elder care and integrate telehealth and remote monitoring, the growing need for chronic disease management at home, and technological innovations such as wearable devices, connected monitoring tools, and electronic health records. It also identified regulatory, compliance, and reimbursement challenges that continue to limit provider participation and patient access in the home health care market.
Healthcare IT News: HIMSSCast: Hospital-at-Home Lessons from Virtua Health, Part 3 (10/31) - The final installment of this three-part series highlights how virtual acute care programs can enable new innovations at brick-and-mortar hospitals. Hospital at home can serve as a proving ground for new ideas, especially for streamlining throughput and capacity in hospitals.
Healthcare IT News: HIMSSCast: Hospital-at-Home Lessons from Virtua Health, Part 2 (10/24) - In the second episode of this three-part series, guests discuss growing and scaling acute care at home programs, and the resulting clinical, financial and operational ROI. This episode covers challenges such as change management, IT, and cybersecurity. Guests explain how to ensure integration and goal orientation as well.
Home Health Care News: Home-Based Care Companies Improve Outcomes By Training Family Caregivers
(10/24) - Providers that educate patients’ family members have found that the investment pays off with improved outcomes. Practitioners said that training family caregivers keeps patients out of the hospital longer, keeps families in the home, and leads to a better care experience for everyone.
Maryland Reporter: How Expanding Home Health Care Could Strengthen Maryland’s Health System (10/21) - Maryland’s growing older population and overextended hospitals are straining the state’s health system, prompting calls to expand home health care as a cost-effective solution. Home-based services can reduce hospital readmissions, provide affordable care options for seniors, strengthen the healthcare workforce, and prevent social isolation. Expanding preventive and telehealth-enabled home care would also improve public health resilience, particularly in rural areas, by catching health issues early and reducing dependence on crowded facilities.
Modern Healthcare: Why the Infusion Market Is Shifting to At-Home Care (10/21) - Health systems are rethinking how to deliver infusion therapies, as payers and patients increasingly prefer care at home over clinical settings. The changing dynamics have led some health systems to expand existing home infusion businesses, while others are partnering with vendors to deliver some or all infused drugs to patients where they live. The shift is sparking consolidation of the highly fragmented home infusion industry as private equity-backed companies expand into the space and compete for patients.
Healthcare IT News: HIMSSCast: Hospital-at-Home Lessons from Virtua Health, Part 1 (10/17) - In the first installment of a three-part series, guests discuss the history and importance of hospital at home. This episode covers the beginnings of acute care at home programs and the continued challenges and opportunities to scale them.
Home Health Care: The Keys to Building a Durable Hospital-At-Home Program (10/16) - This article covers strategies and insights for building and sustaining hospital-at-home programs. The article emphasized that building a durable hospital-at-home program requires strong leadership support, stable funding, and alignment with organizational priorities. The author highlighted the importance of understanding executive concerns, using storytelling to build commitment, and learning from home health and hospice providers.
Penn Medicine: A PATH to Hospital at Home (10/10) - Penn Medicine’s PATH (Practical Alternatives to Hospitalization) program provided acute-level care to patients in their homes as an alternative to hospital admission, using virtual rounds, remote monitoring, and coordinated home visits. During its nine-month pilot from September 2024 to June 2025, 90 percent of participants avoided hospitalization and 82 percent avoided another emergency department visit within a month. The program is now paused as Penn Medicine shifts focus to launching a systemwide Hospital at Home program in early 2026, with PATH’s outcomes and lessons informing its design and future coexistence alongside Hospital at Home to serve patients with varying care needs.
Stateline: Shutdown Forces Medicare Patients Off Popular Telehealth and Hospital-At-Home Programs (10/10) - The government shutdown caused both Medicare telehealth and hospital-at-home programs to expire on October 1, forcing hospitals to discharge or transfer patients and creating confusion among providers and insurers. Some physicians stopped offering telemedicine appointments altogether, while hospitals like Mayo Clinic and Mass General Brigham had to adjust or end their home care operations. The abrupt lapse led to job losses for home-care staff and disrupted care for patients who could no longer receive treatment at home.
Health Leaders: Waivers' End Pushes Healthcare Leaders to Make Tough Decisions on Telehealth, Hospital at Home (10/8) - Following the expiration of pandemic-era CMS waivers on September 30, 2025, hospitals and health systems began scaling back or pausing telehealth and Hospital at Home programs while advocates push Congress to reinstate or make them permanent. The lapse reinstated pre-pandemic Medicare rules limiting eligible providers, geographic areas, and service types, prompting temporary claims holds and widespread uncertainty. Leaders from the American Telemedicine Association and Alliance for Connected Care warn that millions of patients have lost access to virtual care, while organizations like Mass General Brigham and Advocate Health are seeking ways to sustain home-based care models despite the policy gap.
Inside Health Policy: Hospital At Home Lapse Sows Uncertainty Despite 60-Day Non-Enforcement Policy (10/7) - Even though CMS has signaled it won’t issue citations for 60 days to hospitals continuing to provide at-home care to patients admitted to the Acute Hospital Care at Home (AHCAH) program before the program’s lapse on Oct. 1, some hospitals are still unwilling to serve patients unless they get a firmer commitment from the agency. Some hospitals also want CMS to provide more clarification about the non-enforcement period. However, CMS furloughs tied to the ongoing government shutdown make it difficult for CMS to publish additional guidance or clarification.
Penn Medicine: After the Hospital, Support to Help Patients Thrive At Home (10/7) - A Penn Medicine program offers low-income patients extra support after a hospital stay using virtual teams knitting together a safety net to reduce readmissions. The program is operated in partnership between Penn Medicine at Home and Penn Nursing, providing 30 days of intensive care coordination and virtual nurse case management to address poor communication and health-related social needs in eligible patients.
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