April 4, 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.

Hospital-at-Home Extended to September 30, 2025

Congress narrowly averted a government shutdown and passed a funding bill to fund the federal government until September 30, 2025. The bill was signed into law by President Trump on March 15. The package extended Medicare telehealth and acute hospital at home, among other provisions, until September 30, 2025.

While Moving Health Home and the community of advocates had pushed for a longer extension of the full five years, Congress was only able to do a short extension.

What's Next? Moving Health Home will continue to advocate for continued access to the Acute Hospital Care at Home waiver.

Moving Health Home Updates

McKnights Home Care: Continuing Resolution Would Temporarily Extend Hospital-at-Home, Telehealth (3/11) - Moving Health Home founder Krista Drobac shared thoughts on the six month extension of the hospital-at-home waiver: 

“We’re always hopeful for a longer extension given that short-term extensions keep many potential participants on the sidelines,” Krista Drobac, a partner at healthcare consulting firm Sirona Strategies and founder of Moving Health Home, told McKnight’s Home Care Daily Pulse. “However, given these times, we will take what we can get. Given the widespread support for hospital-at-home in Congress, we are hopeful that whatever version of the continuing resolution that passes will include an extension.”

Moving Health Home: MHH Responds to W&M Subcommittee on Post-Acute Care (3/11) - Moving Health Home responded to the House Ways & Means Health Subcommittee Hearing on After the Hospital: Ensuring Access to Quality Post-Acute Care. MHH outlined five-year waiver for a demonstration of skilled nursing facility services available at home, which will expand Medicare’s post-acute options, free up hospital’s limited facility capacity, reduce stress on family caregivers, and allow patients to recover faster at home.

Administration

Department of Health and Human Services (HHS): HHS Announces Transformation to Make America Healthy Again (3/27) - HHS Secretary Kennedy announced a major restructuring of the agency, including the reorganization of the Administration for Community Living (ACL) to be integrated into other HHS agencies, including the Administration for Children and Families (ACF), ASPE, and the Centers for Medicare and Medicaid Services (CMS). This announcement follows directives set in President Trump’s Executive Order, Implementing The President’s “Department of Government Efficiency” Workforce Optimization Initiative. Additional information can be found in the fact sheet.

Centers for Medicare and Medicaid Services (CMS): Year Nine Evaluation Findings (3/20) - CMS released Year 9 findings of the Independence at Home model. The report found a reduction of $322 per beneficiary per month on gross total Medicare spending in Year 9. Before accounting for incentive payments, the estimated aggregate gross total spending reduction in Year 9 was $8.0 million. CMS paid IAH practices about $9.7 million in incentive payments, or roughly $1.6 million more than they achieved in estimated gross spending reductions.

CMS: CMS Innovation Center Announced Model Portfolio Changes to Better Protect Taxpayers and Help Americans Live Healthier Lives (3/12) - The CMS Innovation Center announced changes to its model portfolio to align with its statutory obligation and strategic goals. CMS identified models that will end early by December 31, 2025 including the ESRD Treatment Choices. The model intended to encourage greater use of home dialysis and kidney transplants for Medicare beneficiaries with ESRD, while reducing Medicare expenditures and preserving or enhancing the quality of care furnished to beneficiaries with ESRD.

Congress

Senate: Confirmation of Dr. Mehmet Oz to be CMS Administrator (4/3) - On April 3, the Senate confirmed Dr. Mehmet Oz as CMS Administrator by a vote of 53-45. Dr. Oz’s key health policy priorities include addressing chronic disease through preventative health care; strengthening Medicare Advantage; reducing administrative costs, fraud, and wasteful spending; and driving efficiencies in federal health programs. Dr. Oz also mentioned support for telemedicine during his nomination hearing with the Senate Finance Committee.

House of Representatives: Comprehensive Alternative Response for Emergencies (CARE) Act (4/1) - Reps. Carey (R-OH), Doggett (D-TX), Miller (R-WV), and Ryan (D-NY) introduced the Comprehensive Alternative Response for Emergencies (CARE) Act (H.R. 2538), which would allow for reimbursement of Emergency Medical Service (EMS) providers delivering at-home emergency medical services to treat minor medical incidents for Medicare patients. Bill Text

Congress: Ensuring Access to Specialty Care Everywhere (EASE) Act (4/1) - Reps. Arrington (R-TX), Salinas (D-OR), and LaHood (R-IL) introduced the Ensuring Access to Specialty Care Everywhere (EASE) Act (H.R. 2533), which would require the Center for Medicare and Medicaid Innovation to test a model to improve access to specialty health services for certain Medicare and Medicaid beneficiaries. On April 2, Sens. Mullin (R-OK), Padilla (R-CA), and Tillis (R-NC) introduced companion legislation (S. 1248) in the Senate.

House of Representatives: Seniors’ Access to Critical Medications Act of 2025 (3/31) - Reps. Harshbarger (R-TN), Wasserman Schultz (D-FL), Miller (R-WV), Soto (D-FL), Crenshaw (R-TX), and Davis (D-NC) introduced the Seniors’ Access to Critical Medications Act of 2025 (H.R. 2484), which would allow Medicare patients to receive essential medications by mail or have caregivers and family members pick them up on their behalf.

House of Representatives: Alleviating Barriers to Caregivers Act (ABC Act) (3/31) - Reps. Cammack (R-FL) and 20 bipartisan cosponsors introduced the Alleviating Barriers to Caregivers Act (ABC Act) (H.R. 2491), which would require the Centers for Medicare and Medicaid Services (CMS), Social Security Administration (SSA), and Children's Health Insurance Program (CHIP) to review their eligibility, processes, procedures, forms, and communications to reduce the administrative burden on family caregivers. Sen. Markey (D-MA) and 17 cosponsors introduced companion legislation (S. 1227) in the Senate.

House of Representatives: Preserving Patient Access to Home Infusion Act (3/18) - Reps. Buchanan (R-FL), Dingell (D-MI), Harshbarger (R-TN), and Sewell (D-AL) introduced the Preserving Patient Access to Home Infusion Act, which would preserve patient access to home infusion therapy under the Medicare program.

House of Representatives: Introduction of the Credit for Caring Act (3/11) - Rep. Sanchez (D-CA), Carey (R-OH) and Sens. Capito (R-WV) and Bennet (D-CO) introduced the Credit for Care Act (H.R. 2036/S. 925), which would provide a tax credit for working family caregivers. 

House Ways & Means Committee: Hearing on Ensuring Access to Quality Post-Acute Care (3/11) - The House Ways & Means Committee Health Subcommittee held a hearing that examined the post-acute care landscape and the challenges and opportunities to improve access to such care for Medicare beneficiaries. Rep. Adrian Smith (R-NE) highlighted work on a bill that would create a SNF at Home option, modeled after the success of the Hospital at Home demonstration. Rep. Sanchez (D-CA) also noted the introduction of the bipartisan Credit for Caring Act. 

Senate: Introduction of the Bipartisan Health Care Act (3/6) - Sens. Wyden (D-OR) and Sanders (I-VT) introduced the Bipartisan Health Care Act, which includes provisions from the dropped December funding package, which included the two-year extension of Medicare telehealth and the five-year extension of the acute hospital at home waiver. While language from this bill was not incorporated into the final funding package that passed, it is notable that a small opportunity remains for the standalone bill to move forward on its own. 

Research and Polling

Alzheimer’s & Dementia: A Look at Caregivers for Community-Living Persons with Dementia: Implications for the GUIDE Model (3/29) - Caregiver identification and assessment standards under GUIDE may overlook a significant number of caregivers. To maximize impact, innovative models like GUIDE should align caregiver engagement and services with the unique realities of care networks for people with dementia.

Journal of the American Geriatrics Society: Practice Standards for Acute Hospital Care at Home (3/29) - This article presents the first national practice standards for Hospital at Home. Final practice standards included 31 standards in 7 domains: leadership; education and training; human resources management; quality and quality improvement; safe practice and environment; and clinical standards and protocols. The majority of HaH practices self-rated that they met or exceeded standards.

Journal of Alzheimer’s Disease: The Costs of Dementia Care: Medical Spending and Cost of Unpaid Caregiving (3/20) - There are 5.5 million people living with dementia in the United States (US), with the cost of unpaid care making up a significant portion of the care costs. The annual cost of care attributable to dementia in 2019 was $53,502 (95% uncertainty interval [UI] 46,135–60,594) per case. The contribution of unpaid care to total costs varied by state, ranging from 70.2% (95% UI 64.3–75.4) in the District of Columbia to 89.9% (95% UI 87.8–91.5) in Arizona. We found that higher costs of unpaid care were associated with lower medical spending on nursing facility care.

Health Affairs: Hospital Boarding In The ED: Federal, State, And Other Approaches (3/12) - While there remains a persistent perception that crowding is due to “overutilization” of the ED, there is expert consensus that it is “the inability to move the patient out of the department once the ED evaluation and treatment has been completed [that is] the major contributor” to ED crowding. Once ED crowding occurs, it may exacerbate itself by slowing down ED throughput and increasing hospital length-of-stay, further constricting inpatient bed availability. Tools to address boarding include CMS actions such as increasing flexibility for the Acute Hospital Care at Home Program to provide services outside hospitals and within patients’ homes, expanded Medicare telehealth flexibilities, investigation into reimbursement incentives, and a charge to the AHRQ to convene a “Director’s Roundtable.”

CBS News: Why Hospitals Are Increasingly Treating Patients at Home

There are more than 380 approved hospital-at-home programs in 39 states, according to the Centers for Medicare & Medicaid Services. In overcrowded hospitals, the programs can help free up needed beds -- a persistent issue in facilities such as Mass General Brigham. Mark Strassmann reports.

News and Market Developments

Healthcare Innovation: Maribel Health CEO on Trends in Home-Based Care Model Adoption (4/2) - Maribel Health designs and operate home-based clinical care models to help expand total health system capacity. Adam Groff, CEO of Maribel Health, spoke with Healthcare Innovation about the growth of home-based care, the recent merger between two hospital-at-home vendors, and the short-term extension of the acute hospital-at-home waiver by Congress.

Modern Healthcare: Providers Expand Pediatric Home Care Amid Possible Medicaid Cuts (4/2) - Pediatric home health care companies are gearing up to meet skyrocketing demand for services aimed at chronically ill children and adolescents. Companies that provide pediatric home health care services, including Bayada Home Health Care, Aveanna Healthcare and Alliance Homecare are planning acquisitions and expansions to new states this year as demand increases for private duty nursing and home healthcare services for patients under age 18.

Healthcare IT News: In Search of a Long-Term Approach to Telehealth and Hospital-at-Home (3/31) - While the waiver extensions for both telehealth and hospital-at-home have bipartisan support, health care executives are deeply concerned the tangible benefits of each initiative will be lost, or not fully realized, if a long-term solution is not codified and executives are further stymied in their planning efforts. The result of this ongoing uncertainty is a limited appetite for the meaningful investments required to scale telehealth initiatives and hospital-at-home and make them a permanent part of a health system's care delivery ecosystem.

Home Health Care News: Home-Based Pediatric Care A Leap For Patients, A Struggle For Providers (3/27) - Hospitals continue to be at the forefront of pushing toward more advanced pediatric home health. Earlier this year, health system Atrium launched the nation’s first pediatric hospital-at-home program. However, at-home care providers interested in expanding into the pediatric market must contend with some serious challenges.

Modern Healthcare: Atrium Health Rolls Out First Pediatric Hospital-at-Home Program (3/24) - Atrium Health is seeing early success with the nation’s first pediatric hospital-at-home program, but it could take longer for other health systems to follow its lead.

McKnights Home Care: Wave of Long-Term Care Insurance Claims Growing Faster than Age Wave, Expert Says (3/23) - Long-term care insurance claims will increase 260% from $16 billion to $42 billion dollars in claims paid through 2041. Comfort Long Term Care has seen numerous home care claims denied because of ambiguity in written policies. Many of them involve confusion with coverage for activities of daily living (ADLs), which include bathing, dressing and eating. 

Modern Healthcare: Hospitals Establishing Hubs for Digital Health Operations (3/21) - Health systems are moving forward with investments in virtual care despite dealing with continued uncertainty over reimbursement. Medicare reimbursement for telehealth remains temporary after Congress passed a six-month extension of COVID-19-era waivers in March. Questions about what happens long term haven't hampered enthusiasm for virtual care at health systems. Instead, organizations are figuring out how to be smart about their telehealth and remote patient monitoring investments and centralizing their operations with digital health hubs.

Health Leaders: Virtual Nursing Looks at Innovation Through the Eyes of the Nurse (3/21) - Virtual nursing is one of the more popular concepts in healthcare these days, with health systems and hospitals trying out a wide variety of technologies and strategies focused on reinventing care delivery. Chief nursing executives said the “hospital of the future” will center on a virtual care platform that handles data and administrative tasks and allows care teams to work with patients on their care journey.

Modern Healthcare: Health Systems Struggle to Manage Emergency Department Overflow (3/19) - Emergency department boarding strains limited hospital capacity, contributes to nurse and physician burnout and can lead to unhappy patients and worse care outcomes. Health systems are trying to expedite the discharge process to free up inpatient beds, more efficiently transfer patients in the emergency department to other hospitals and work closely with community health and social workers to head off emergency department visits.

Modern Healthcare: Patina Offers New In-Home Program to Medicare Advantage Members (3/18) - Patina Total Health will provide health assessments, medication management, primary care, urgent care and behavioral health services to older adults in their homes through in-person and telehealth visits.

Fierce Healthcare: Texas Oncology Partners with Canopy on Remote Patient Monitoring (3/18) - Canopy is launching a multiyear partnership with Texas Oncology, a community-based cancer care providers. The collaboration builds upon a successful pilot project held at one of Texas Oncology’s clinics and will extend Canopy’s digital platform across a network that spans nearly 1,000 providers and 280 locations in the state.

Fierce Healthcare: DispatchHealth and Medically Home Merge, Creating One of Nation's Largest Hospital-at-Home Providers (3/18) - DispatchHealth and Medically Home, two leaders in the hospital at home industry, are merging, the companies announced. The companies leverage telehealth, virtual call centers and devices in patients' homes to provide high-complexity care, including for oncology patients and organ transplant patients. Additional coverage can be found in Modern Healthcare, Health Leaders, Healthcare Dive.

Modern Healthcare: Post-Acute Providers Roll Out Game Plans for TEAM Demo (3/17) - Post-acute providers are eager to show hospitals how they can help with a Medicare payment demonstration model that goes into effect early next year. Compassus, Elara Caring, ArchCare and other post-acute providers said careful coordination of patient care from the hospital through the post-acute system is essential for hospitals to succeed in the Transforming Episode Accountability Model, or TEAM.

Health Leaders: Does Our Healthcare System Support Healthy Aging? (3/17) - How does the role of supplemental benefits and Special Needs Plans in the aging-care healthcare ecosystem of the country’s fourth-largest MA plan? HealthLeaders interviewed Dr. Ali Khan, Chief Medical Officer of Medicare at Aetna, a CVS Health company. Khan is also a practicing physician providing primary care for older adults on Chicago’s west side at Oak Street Health, also a part of CVS Health.

McKnights Home Care: New Partnership Supports Dementia Caregivers Participating in GUIDE Model (3/16) - Waiting is common for people with medical conditions. But for personal caregivers with dementia patients, the national average wait time to see dementia specialists is especially long. Try approximately 36 months, according to RAND.

KFF Health News: Sent Home To Heal, Patients Avoid Wait for Rehab Home Beds (3/12) - Staffing shortages at post-acute facilities around the country led to a 24% increase over three years in hospital length of stay among patients who need skilled nursing care, according to a 2022 analysis. With no place to go, these patients occupy expensive hospital beds they don’t need, while others wait in emergency rooms for those spots. Offering intensive services and remote monitoring technology in the home can work as an alternative.

Real Clear Health: Is Medicare Ready for an Aging America? Home-Based Care Offers Hope (3/12) - Access to Medicare-covered home health and hospice is at risk due to reimbursement cuts, workforce shortages, and administrative barriers. Congress must act to reverse harmful policies and ensure vulnerable seniors receive care at home.

Skilled Nursing News: ‘Future Of Medicine’: SNF-at-Home Gains Traction as Alternative to Nursing Homes Amid Access Crisis (3/12) - SNF-at-home programs are gaining traction as a viable solution to address the shortage of nursing home and rehabilitation facility beds, with the goal of reducing bottlenecks at hospitals.

Health Leaders: More Hospitals are Treating Patients at Home to Reduce Overcrowding. Here's How it Works (3/11) - There are more than 380 approved hospital-at-home programs in 39 states, according to CMS. In overcrowded hospitals, the programs can help free up needed beds — a persistent issue in facilities such as Mass General Brigham. Last year, nearly 3,000 patients were treated in the voluntary program.

MedCity News: When Dialysis Comes Home, Patients and Care Partners Flourish (3/10) - Home hemodialysis can improve patients’ length and quality of life, including the ability to maintain employment and enjoy meaningful time with family. Home hemodialysis also eliminates driving, rigid clinic schedules and contagious disease risk. But it does require a committed care partner – typically a spouse, relative or close friend of the patient – to help with treatment.

Upcoming Events

April 23, The American College of Healthcare Executives, “The Future of HaH: Implications of the CMS Waiver Extension

June 9-11, Hospital@Home Leadership Summit, "Accelerate the Impact of Hospital at Home Nationwide." 

June 30-July 1, RISE, "The RISE of Home Care Summit." 

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

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