October 3, 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.

GOVERNMENT SHUTDOWN & HOSPITAL AT HOME 

Congress was unable to come to an agreement on government funding and the government shutdown at 11:59 PM ET, September 30, 2025. There is now a lapse in the Acute Hospital Care at Home (AHCAH) waiver program and expanded Medicare telehealth flexibilities. 

The Senate continues to vote on Republican government funding proposal (which would fund the government and extend hospital at home through November 21) and the Democratic counterproposal (also would fund the government and extend HaH through October 31).

Developments to Date

The Centers for Medicare & Medicaid Services (CMS) released guidance:

• Acute Hospital Care at Home Individual Waiver – During the lapse in government funding and authorization of this waiver, if a hospital is found to be out of compliance with the Physical Environment condition of participation (including Acute Hospital @ Home waivers that will no longer be waived), CMS—after receiving the survey—would make the hospital’s compliance with this requirement part of a “plan of correction.” Typically, hospitals have 60 days to respond to CMS with an acceptable plan of correction.
• Medicare Telehealth – CMS directed all MACs to implement a temporary claims hold, of up to 10 business days. In the absence of Congressional action, practitioners who choose to perform telehealth services that are not payable by Medicare on or after October 1, 2025, may want to evaluate providing beneficiaries with an Advance Beneficiary Notice of Noncoverage. Practitioners should monitor Congressional action and may choose to hold claims associated with telehealth services that are not payable by Medicare in the absence of Congressional action.

Congress: The House Ways and Means Committee advanced Rep. Buchanan’s (R-FL) bipartisan Hospital Inpatient Services Modernization Act (H.R. 4313), which would extend the Hospital at Home program for five years. The bill passed the Committee with a vote of 44-0 and heads to the full House for consideration.

Highlighted Coverage

Washington Post: Millions of Seniors Could Lose Access to Telehealth and Hospital At Home Without Deal in Congress (9/30) - Millions of American seniors could lose access to telehealth appointments with their doctors if Congress fails to fund them, while thousands more who have been receiving high-level, acute care at home face being sent back to the hospital or discharged. Without getting paid or receiving some assurance they would be compensated retroactively, doctors and hospitals say they will be unable to provide services. Particularly for elderly people with limited mobility or transportation hurdles, these services have become a vital service improving their access to care, advocates say.

Time: Telehealth Is About to Abruptly End for Seniors (9/30) –After the September 30 expiration date, older adults no longer have access to telehealth services or hospital at home services under Medicare. The telehealth program has been threatened before—Congress had to extend it in 2021, 2022, 2023, and in March 2025. Both Medicare flexibilities should be extended for longer terms, making easier access to care more permanent.

Becker’s Health IT: ‘A Huge Loss’: Hospital-At-Home Leaders Prepare for CMS Waiver Expiration (9/24) - The expiration of CMS’ hospital-at-home waiver is sowing confusion and uncertainty among health system executives who oversee the programs. Some leaders told Becker’s that if the CMS waiver expires Sept. 30 without an extension, they ended their programs and sent home-based patients back to the hospital. The care model allowed patients to receive hospital-level care via in-home technology and medical equipment and in-person and virtual visits with clinicians.

Stat News: Hospital Programs In ‘Terror’ As They Grind To Halt Ahead Of Government Shutdown (9/30) – “Tying the waiver extension to the continuing resolution is an ongoing risk that limits the ability of hospitals to invest in this program,” said Lee Fleisher, CEO of Rubrum Advising and former chief medical officer and director of the Center for Clinical Standards and Quality at CMS. “A longer waiver extension is required to determine what a final program should look like.”

Fierce Healthcare: Hospitals, Doctors Face Virtual Care Cliff With Telehealth, Hospital At Home Services On The Line (9/29) – CMS has provided a notice that directs hospitals to transport Medicare patients in the hospital at home program back to a brick-and-mortar facility or discharge them if the program authority runs out. "For all hospitals with active AHCAH waivers, all inpatients must be discharged or returned to the hospital on September 30, 2025, in the absence of Congressional action to extend the initiative," the guidance says.

Moving Health Home Updates

Moving Health Home: MHH Supports Long-Term Extension of Hospital at Home Through House Ways and Means Markup (9/17) – Moving Health Home submitted a statement of support on the House Ways and Means focus for a long-term extension of hospital at home through the markup of the Hospital Inpatient Services Modernization Act (H.R. 4313). Last month, Moving Health Home led over 140 leading health care organizations, including hospitals, health systems, and provider and patient advocacy groups, to send a letter to Congress urging leadership to pass at least a 5-year extension of the AHCAH waiver. (Additional coverage can be found in Healthcare IT News and others). By doing so now, this Committee would have set up current and future programs with the predictability and stability they needed to continue to expand capacity and lead innovation in health care delivery. The AHCAH waiver extension will bring care to more patients, caregivers, and families who rely on high-quality health services at home in both urban and rural communities.

Moving Health Home: MHH Responds to the Centers for Medicare & Medicaid Services (CMS) Calendar Year (CY) 2026 Medicare Physician Fee Schedule Proposed Rule (9/12) – Moving Health Home responded to the CMS CY 2026 Medicare Physician Fee Schedule proposed rule. Going back to institutional norms will waste the experience generated by the current care at home innovations, which flourished under the first Trump Administration. MHH believes shifting away from facility-centric regulations enables innovative care models that focus on patient and caregiver choice and allows for technology-enabled care tools like telehealth, remote patient monitoring, home infusion, home labs, home diagnostics, and primary care at home.

Podcast Feature: Beyond the Hospital: Voices in Advanced Care at Home – MHH member Inbound Health interviewed Krista Drobac, Partner at Sirona Strategies, Executive Director of Moving Health Home, and a longtime policy leader and advocate for care in the home. Drawing on her decades of experience shaping federal healthcare policy, Krista discusses the challenges and triumphs surrounding the push for hospital-at-home and highlights how coalitions, health systems, and industry partners each play a critical role in driving change for the future of care delivery.

Highlighted Coverage

• Inside Health Policy: Telehealth, Hospital at Home Program Lapses Sow Chaos For Providers (10/2)
• Stat News: Patients Set to Lose Hospital Care at Home if Government Funding Isn’t Extended (9/26) – “It’s hardest for patients,” said Chad Ellimoottil, medical director of virtual care, Michigan Health – a Moving Health Home Member. “Because you’ve been waiting two months for your discussion about cancer management, and then you’re getting a message about a potential cancel or that your visit might not be covered.”

Congress

House Ways and Means Committee: What They Are Saying: Bipartisan Ways & Means Policies Protect Patient Access to Quality At-Home Care, Regulatory Stability for Health Care Providers (9/30) – The House Ways and Means Committee published a compilation of statements of support from key stakeholder groups related to legislation that recently moved through the committee. “On behalf of Moving Health Home, we are writing in support of your focus on a long-term extension of hospital-at-home through the markup of the Hospital Inpatient Services Modernization Act (H.R. 4313).” – Krista Drobac, Executive Director, Moving Health Home

House Ways and Means Committee: Markup of Several Bills Including the Hospital Inpatient Services Modernization Act (H.R. 4313) (9/17) – The House Ways and Means Committee advanced seven bills including Rep. Buchanan’s (R-FL) bipartisan Hospital Inpatient Services Modernization Act (H.R. 4313), which would extend the Hospital at Home program for five years. The bill passed the Committee with a vote of 44-0 and heads to the full House for consideration. The vote and ultimate movement received national press coverage.

House of Representatives: Momentum Grows For Buchanan’s Bipartisan Hospital at Home Bill (9/4) – Rep. Buchanan (R-FL), Chair of the Health Subcommittee on Ways and Means, issued a statement after more than 140 leading health care organizations, including hospitals, health systems, provider groups and patient advocates, sent a letter to congressional leaders urging a five-year extension of the Acute Hospital Care at Home (AHCaH) waiver:

“Momentum is building for my bipartisan effort to extend the Hospital at Home program, which allows efficient, high-quality care at lower costs, especially for the nearly 200,000 seniors in my district. My Hospital Inpatient Services Modernization Act will enable over 200 hospitals across 34 states, including 23 in Florida, to continue this program. With over 140 organizations supporting this extension, Congress must act now to ensure hospitals can expand access to this vital care model.”

Administration

Centers for Medicare & Medicaid Services: Contingency Plans – State Survey and Certification Activities During Government Shutdown (10/1) – CMS oversees waiver compliance through state survey agencies. State survey agencies will still conduct state-funded surveys, investigations in complaints alleging harm, among other things. Hospitals out of compliance with physical environment condition of participation may be surveyed if a complaint of harm is submitted. Moving Health Home remains confident that hospital at home is a priority for CMS and will continue. MHH continues to urge CMS for clear communication about hospital at home programs during this turbulent time.

Administration for Community Living (ACL): $60 Million in New Grants for Older Adults, People with Disabilities, and Caregivers (9/30) – ACL announced $60 million in awards to support caregivers and protect the health and independence of older adults and people with disabilities. Grant initiatives include advancing state caregiver strategies, managing chronic conditions, and reducing hospitalizations and care costs.

Advanced Research Projects for Health (ARPA-H): POSEIDON Program to Develop At-Home Cancer Screening Kits (9/30) – ARPA-H announced the research and development teams receiving awards from its Platform Optimizing SynBio for Early Intervention and Detection in Oncology (POSEIDON) program. POSEIDON intends to develop the most sensitive and specific first-in-class, at-home, over-the-counter, tests to identify 30+ Stage 1 solid tumors using only breath or urine samples.

Department of Health and Human Services (HHS): Fiscal Year 2026 Contingency Staffing Plan (9/25) – HHS released its contingency plan for FY 2026. During a government shutdown, CMS typically furloughs about half of its staff during a shutdown, which can slow down certain activities, such as telehealth reimbursement processing and payments to providers could be delayed. CMS would also be largely unable to provide oversight to many of its major contractors, including Medicare Administrative Contractors, the Medicare Call Center, and other IT contractors. Additionally, CMS payment rule development, such as the PFS final rule, and other policy decisions will depend on available funding and the duration of the lapse. With limited staff, delays in rulemaking and policy development are expected.

Office of Management and Budget (OMB): Federal Reduction in Force During Government Shutdown Memo (9/24) – OMB released a memo directing federal agencies to issue Reduction in Force (RIF) notices for employees in programs, projects, or activities (PPAs) that (1) would lose discretionary funding on October 1, (2) have no alternative funding sources such as H.R. 1 resources, and (3) are not consistent with the President’s priorities.. RIFs would be in addition to furlough notices and would apply to all employees in the affected programs, even if they are otherwise considered excepted..

Agency for Healthcare Research and Quality (AHRQ): Updated Priorities (9/22) – The Agency for Healthcare Research and Quality (AHRQ) updated its mission statement and priorities as per the executive orders. Most notably, AHRQ is prioritizing telehealth, overmedication (particularly psychoactive medications) of children, digital health tools, real-world data platform, artificial intelligence, nutrition, and autism data resources. “Telehealth can potentially provide needed care for patients with reduced access such as those in rural areas or individuals with poor mobility and for providers for which there is a limited or inadequate supply or geographic concentration such as certain specialty medical care, genetic counselors, and mental health counselors. AHRQ is interested in defining appropriate and cost-effective uses of telehealth to improve patient outcomes.”

Research and Polling

Trust for America’s Health (TFAH): Public Health’s Roles in Supporting Informal and Family Caregiving (9/30) – This policy brief provides recommendations for supporting informal caregivers through a public health approach. TFAH recommends that the health care sector ensure that health care providers understand and can refer caregivers to non-clinical support resources in their communities.

Health Affairs Scholar: Stranded in the Emergency Department: An Analysis of Boarding Trends in Older Adults in the United States (9/29) – A cross-sectional analysis of US emergency department boarding trends showed that boarding over three hours has increased across the country. Adults over 85 years of age face the greatest risk of long boarding times. Researchers highlight opportunities to avoid the negative effects of hospital boarding on older patients, including alternate admission pathways.

Journal of General Internal Medicine: There’s No Place Like Home: Mitigating Delirium by Enhancing Sleep and Circadian Health in Home Hospital (9/22) - Delirium is associated with adverse outcomes including functional and cognitive decline, hospitalizations and increased readmissions, and high health care costs. One-third of hospitalized general medical patients aged 70 years or older experience delirium; half the cases develop after patients are hospitalized, owing to the many aspects of the hospital-based provision of services that can precipitate delirium. Home hospital models are uniquely positioned to optimize sleep and circadian health, addressing a core element of delirium prevention and providing an opportunity to improve patient outcomes.

Health Affairs Scholar: Caregivers at the Crossroads: Shifting Policies and the Challenges Faced by Employed Caregivers (9/22) – A survey of employed family caregivers in Utah showed that almost half of working caregivers experienced moderate to severe difficulties balancing paid work and caregiving. Caregivers said that flexibility in work schedule and help from family and friends was important to helping them achieve balance.

Journal of the American Geriatrics Society: Feasibility and Acceptability of a Clinician-Caregiver Co-Designed Dementia Care Intervention for Home-Based Primary Care (9/21) – A study of 50 caregivers participating in a Dementia Care Quality at Home (DCQH) intervention showed high caregiver satisfaction and feeling heard or understood. The home-based primary care model, adapted to meet the needs of patients with dementia and their caregivers, shows promise of delivering the unique care the population needs.

Massachusetts Health Policy Commission: Hospital at Home in Massachusetts: Trends in an Emerging Clinical Model (9/18) - This policy brief explores how the hospital at home model of care has been implemented in Massachusetts. Through this model, hospitals provide hospital-level services in a patient’s home, rather than in a traditional “brick and mortar” setting for patients who are clinically stable enough to receive this care at home.

News and Market Developments

Cleveland Clinic Revolutionizing Care: The Hospital At Home Model (Podcast) (9/24) – This podcast describes Cleveland Clinic’s hospital at home care delivery program. The speakers discuss challenges, solutions, and innovation that occurs because of the transformative model.

American Hospital Association (AHA): Statement to Ways and Means Committee Markup (9/17) – The AHA submitted a statement Sept. 17 for a House Ways and Means Committee markup session on a series of health care and other bills. Specifically, the AHA expressed support for the Hospital Inpatient Services Modernization Act (H.R. 4313), legislation that would extend certain Medicare waivers authorizing the hospital-at-home care program.

JAMA Pediatrics: The Family Caregiver Act—Safeguarding the Human Care Chain (9/15) – This article explains an Illinois law that took effect on January 1, 2025, that prohibits employment discrimination against family caregivers in the workforce. The article also analyzes the slow pace of national adoption of comparable state legislation.

Newsweek: How Health Systems Are Turning Living Rooms Into Hospital Rooms (9/10) – Because of the growing adoption of hospital at home services, people with critical illnesses—old and young—have been receiving care in their living rooms that was once unfathomable outside of a medical clinic. Studies show that the unfamiliar setting of a hospital can have adverse effects on patients’ health. Using technology such as telehealth and remote patient monitoring, hospital care at home is high-quality, safe, and achievable.

ACEP Now: Hospital at Home Is Here: An Opportunity EM Can’t Ignore (8/25) - As hospital-at-home expands, emergency medicine must confront two critical questions: What role should it play, both in terms of shaping and operationalizing hospital-at-home? Can the hospital-at-home model relieve the ED boarding crisis plaguing hospitals nationwide? The emergence of hospital-at-home may require a profound shift—not just in how EM is practiced, but also in how it is defined.

Future of Personal Health: America’s Unseen Workforce: The New Reality of Family Caregiving – Informal caregiving is one of America’s fastest growing workforces, but is an unpaid and largely untrained field. More than 63 million family caregivers provide over $600 billion worth of services annually. America’s family caregiving landscape has often been measured by the “caregiver support ratio,” or the number of potential caregivers (ages 45–64) available for every person age 80 or older. This ratio was 7:1 in 2010 but is projected to fall to 4:1 by 2030 and to 3:1 by 2050.

Upcoming Events

October 5-8, AdvaMed, The MedTech Conference

October 16, Hospital @ Home Users Group, "2025 Annual Meeting." 

October 19-22, HLTH

October 20, Sirona Strategies, Health IT Reception at HLTH

October 20-21, Home Care Association of America, "2025 National Home Care Conference." 

November 5-6, National Alliance for Caregiving, 2025 Caregiver Nation Summit

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.