December 5, 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

On December 1, the House of Representatives passed the Hospital Inpatient Services Modernization Act (H.R. 4313) . This bill would extend the Acute Hospital Care at Home (ACHAH) waiver for five years. The bill moves to the Senate for consideration. Read Rep. Buchanan’s (R-FL) statement here.

Moving Health Home continues to lead the charge on the five-year extension of hospital at home (HaH) and urge stakeholders to reach out to Senators, urging them to continue the momentum. 

Highlighted Coverage:

Bloomberg Government: Telehealth Providers Brace for Next Potential Shutdown Lapse (12/2) - The article describes the challenges of short-term extensions for programs like HaH and telehealth. When describing movement toward longer extensions, the article highlighted MHH’s 140 stakeholder sign-on letter as an advocacy tool that led to the House passage of the HaH five-year extension bill. This article underscored that, without action, HaH patients face another potential disruption in January when government funding expires, forcing caregivers to plan early wind-downs even before another shutdown begins.

Healthcare Finance News: House Votes to Extend Acute Hospital Care at Home (12/2) - In a move supporting a continuation of the initiative, in September more than 140 healthcare organizations, led by Moving Health Home and including more than 50 health systems, sent a letter to Congress urging inclusion of a five-year extension of the ACHAH waiver program in a government funding package.

Fierce Healthcare: House Votes to Pass 5-Year Hospital at Home Extension, Sending Bill to the Senate (12/2) - HaH providers have been mired in uncertainty for years. The House of Representatives unanimously voted to pass a bill that extends the Medicare HaH program for five years. If the bill passes the Senate, it would be the longest extension the at-home care program has had since it began in November 2020. Congress is also divorcing the extension of the program from the government funding deadline, which gives the program more stability.

Modern Healthcare: House Passes Acute Hospital-at-Home Funding Extension (12/2) - The House of Representatives took the first step toward extending Medicare’s authority to fund acute hospital-at-home services, passing a bill that would allow such services for five more years. While the bill is popular in the Senate and is likely to pass, it is not clear what path it may take. Popular bills often are included in packages of other measures, and passed as a block, frequently in government funding bills.

Politico: Politico Pulse Newsletter (12/2) - The House unanimously passed a bill to continue to allow increased flexibility for hospitals to care for some Medicare patients from their homes. Major health systems have been pushing Congress for the five-year extension. Some hospital-at-home programs closed during the recent government shutdown after the CMS waiver initially expired on Sept. 30, forcing some patients to return to brick-and-mortar hospital facilities. Hospital and telehealth advocacy groups applauded the House passage of the bill.

Techtarget: House Passes Bill Extending Hospital-at-Home Waiver for 5 Years (12/2) - In a significant win for virtual care proponents, the House of Representatives passed legislation that extends the AHCAH waiver through 2030. In addition to extending the waiver, the legislation requires CMS to conduct a new study assessing the quality of care and costs associated with the AHCAH program, comparing it to inpatient care.

Home Health Care News: House Passes Bill That Would Extend Hospital-at-Home Waiver Through 2030 (12/1) - The House of Representatives passed a bipartisan bill designed to protect the hospital-at-home waiver, which has thus far been extended through a series of short-term measures. The series of short-term extensions has deterred some organizations from participating in the program. If passed, the bill could assuage some of those concerns.

Becker’s Hospital Review: House Passes 5-Year Hospital-at-Home Extension (12/1) - The House of Representatives passed a bill that would extend the CMS waiver to provide acute hospital care at home for five years.

Without the passage of the five year extension, hospital at home waiver flexibilities will expire on January 30, 2026, as per the Continuing Appropriations, Agriculture, Legislative Branch, Military Construction and Veterans Affairs, and Extensions Act, 2026

Moving Health Home: Executive Director Speaks at the 2025 Hospital at Home Leadership Summit (12/3) – MHH Executive Director Krista Drobac spoke about the future of HaH policy at the 2025 Hospital at Home Leadership Summit. During her presentation, Krista discussed the current state of play, the standalone five-year extension bill, advocacy strategies, and policy opportunities (including the Rural Health Transformation Program and HHS’ chronic care focus).

Moving Health Home: Statement to House Ways and Means Hearing on Chronic Conditions (11/19) – Moving Health Home submitted a statement for the record for the House Ways and Means Health Subcommittee hearing on Modernizing Care Coordination to Prevent and Treat Chronic Disease. Care in the home is one of the most powerful drivers of effective coordination of chronic disease because it brings the clinical team into the patient’s daily reality: where chronic conditions are managed day to day. In particular, home-based care, such as AHCAH, brings together the full clinical team in a way that no traditional setting can, creating stronger coordination and better outcomes for people with chronic and complex needs. By caring for patients in their home environment, clinicians gain immediate insight into real-world factors that shape a patient’s health.

Administration  

Office of the Assistant Secretary for Planning and Evaluation (ASPE): Opportunities for Technology-Enabled Care: Economic and Payment Issues (12/4) – This Issue Brief explores opportunities that technology-enabled care offers to help meet patient and provider needs for high-valued coordinated care to improve health outcomes. It explores literature surrounding existing available tech-enabled care options, as well as economic and payment issues that influence whether this is taken up.

Centers for Medicare and Medicaid Services (CMS): Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model (12/1) – CMS announced the ACCESS Model, a 10-year voluntary model in Original Medicare that will test an outcome-aligned payment approach for technology-supported care. Participating organizations must enroll in Medicare Part B and CMS will accept applications starting in January 2026. Organizations may complete the ACCESS Model Interest Form to receive notification once the RFA is posted.

Veterans Affairs (VA): The VA Home Telehealth Program in West Texas Helps Veterans Stay Connected (11/28) – The VA published a story about the West Texas VA Health Care System’s Remote Patient Monitoring Program. Across the VA, Veterans in the program experienced a 41 percent reduction in hospital admissions and a 70 percent reduction in bed-days of care. The program has proven to transform rural health care for Veterans in western Texas.

CMS: MA Technical Changes (11/25) – CMS issued the Contract Year 2027 Policy and Technical Changes to the Medicare Advantage Program proposed rule, which proposes changes to the Medicare Advantage (Part C), Medicare Prescription Drug Benefit (Part D), and Medicare cost plan regulations. Notably for MHH’s chronic care at home work, CMS released an RFI around future policy directions in MA, focusing on opportunities for maximizing competition within the program, driving improvements in health outcomes, and maximizing the program’s value for beneficiaries and taxpayers. Comments on the rule are due January 26.

CMS: Updated Telehealth FAQs (11/20) – CMS issued an update on the processing of Medicare claims impacted during the government shutdown. The updated guidance confirmed that claims for telehealth services provided during the government shutdown would be paid retroactively. The update made permanent a provision that ensures providers who deliver telehealth services do not need to enroll every location from which they practice virtually. It also clarified guidance about virtual supervision and other telehealth questions, mostly stemming from the Physician Fee Schedule updates.

Department of Health and Human Services (HHS) Administration for Community Living (ACL): HHS Backs AI Innovation for America’s Caregivers (11/18) – HHS announced a $2 million Caregiver Artificial Intelligence Prize Competition to support caregivers for older adults and people with disabilities. The AI Prize Competition will fund and recognize innovators developing tools that support caregivers in providing safe, person-centered care at home and those who support employers by improving efficiency, scheduling, and training in the caregiving workforce.

Congress

Medicare Payment Advisory Commission (MedPAC): December 2025 Public Meeting (12/4) – MedPAC held its December meeting, during which commissioners presented on and discussed trends and key issues in post-acute care. This session touched on post-acute care delivery (such as SNFs and home health) as well as system-wide issues such as hospital capacity and boarding. MHH continues to work on a SNF at Home model that could test an innovative post-acute care method.

House Ways and Means Committee: Hearing on Modernizing Care Coordination to Prevent and Treat Chronic Disease (11/21) – The House Ways and Means Committee Health Subcommittee held a hearing that discussed chronic disease management and highlighted telehealth and remote patient monitoring as ways to improve care. Representatives also mentioned HaH.

Sen. Booker (D-NJ): In-Home Caregiver Assessment Resources & Education (CARE) Act of 2025 (11/20) – Sens. Booker (D-NJ) and Kim (D-NJ) introduced the In-Home Caregiver Assessment Resources & Education (CARE) Act (S. 3271), which would authorize grants for family caregiver support.

Sen. Markey (D-MA): Financial Services Improving Noble and Necessary Caregiving Experience (FINANCE) Act (11/20) – Sens. Markey (D-MA), Baldwin (D-WI), and Kim (D-NJ) introduced the Financial Services Improving Noble and Necessary Caregiving Experience (FINANCE) Act (S. 3233), which would provide financial planning services related to the needs of family caregivers. This bill is part of Sen. Markey’s larger legislative package to support caregivers.

Research and Polling

JAMA Network Open: Hospital-Level Care at Home for Adults Living in Rural Settings: A Randomized Clinical Trial (12/1) – This study assessed patients at three care sites in rural areas and found that rural HaH programs improved patient experience without increasing costs. Patients in HaH programs were more physically active and preferred it over brick-and-mortar hospital care. Researchers did not find significant differences in cost or readmission rates between traditional inpatient and HaH settings, which may have been caused by the late transfer from the hospital setting to the home. This study concluded that HaH is a feasible, popular model for rural patients.

Supportive Care in Cancer: Characteristics Associated with Accepting Hospital at Home Among Patients with Cancer and Their Caregivers: A Cross-Sectional Survey (11/22) – This study assessed the acceptability of a HaH program for cancer patients and their caregivers. Researchers found that most patients and caregivers would agree to receive hospital-level services at home. Those with advanced cancer were more likely to agree to HaH, while patients from underrepresented racial and ethnic groups were less likely to agree.

JAMDA: Stakeholder Perspectives on Development of a Home-Based Primary Care Practice Recognition Program (11/8) – This study aimed to assess stakeholder views about home-based primary care (HBPC) practice recognition. Focus groups revealed that about three-quarters of respondents thought their practice would engage in a practice recognition process if developed. They were concerned about financial, resource, and administrative burden for practices. HBPC employees were more likely to be engaged in a practice recognition program compared to practice owners.

National Alliance for Caregiving (NAC) and AARP: Caregiving in the US 2025 (11/13) – NAC and AARP’s annual report provides information about the experiences of family caregivers across the country. The 2025 report offers insights into the financial, emotional and workplace impacts of family caregiving, as well as the evolving needs and priorities of family caregivers nationwide.

NAC: Caregiving in the US (CGUS) Data Hub (11/13) – This resource allows users to engage with interactive national and state-level data reflected in the Caregiving in the US 2025 report. It also contains a resource library and family caregiver stories.

PHI: The Path Forward: Preserving, Strengthening, and Reimagining Care in the United States (11/6) – This policy research brief describes longstanding challenges for the direct care workforce. PHI provides recommendations for preserving the existing long-term care system and improve outcomes for caregivers and recipients alike. The brief argues that the long-term care system needs universal training and credentialing with portable credentials, fair compensation strategies, state-level workforce innovations, and reformed long-term care financing.

Bipartisan Policy Center: The Growing Cost of Inaction: A Practical Framework for Addressing the Long-Term Care Financing Challenge – The Bipartisan Policy Center convened a private roundtable discussion in May 2025 to discuss the challenges of long-term care. This report provides policy recommendations to prevent spend-down strategies for Medicaid eligibility, strengthen the long-term care insurance market, and encourage state and federal solutions.

Mayo Clinic Proceedings: The Impact of a Remote Patient Care Program on Health Care Costs and Utilization Among Medicare Patients with Chronic Disease (11/28) –Using Medicare claims data, this study assessed the impact of a remote patient care program. Researchers found that remote patient care resulted in a significant reduction in total cost of care ($1300 per patient per year) and lower hospitalization rates (about 27% reduction compared to control patients). These data highlight the potential for a nationwide RPC program to lead to significant cost savings and a reduction in health care utilization among Medicare patients at scale.

News and Market Developments

AJMC: Technology Drives Innovation, Accessibility When Treating Chronic Kidney Disease (12/4) – Panelists focused on home-based kidney care, specifically with hospital-at-home programs from both the payer and physician perspectives. Panelists from Intermountain Health described the benefits of care in the home, including relieving hospital bed shortages and saving money. Panelists explained the AHCAH waiver does not permit a patient receiving hospital-at-home care to undergo hemodialysis at a center.

Chief Healthcare Executive: Envisioning Nearly All Health Care at Home (11/28) – At the HLTH conference in October, former Centers for Disease Control and Prevention (CDC) director Susan Monarez predicts up to 90 percent of all care to take place in the home in 10 years. “That is the way that it's going to go. And so now we actually have the ability to consider, how do you move from a brick-and-mortar infrastructure base, to a virtual base for health care? It's not a surprise. It's going to happen.”

Becker’s Health IT: How Waiver Whiplash Disrupted Hackensack Meridian’s Hospital at Home (11/25) - When Hackensack Meridian Health learned the AHCAH waiver would expire due to the government shutdown, it had to stop taking new HaH admissions. When the waiver reactivated, Hackensack Meridian restarted the HaH program, a process that required extensive internal communication with providers and physicians, especially the health system’s ER physicians and chiefs of medicine.

Medscape: Hospital-at-Home Havoc as Waiver Ends (11/25) – When the AHCAH waiver expired during the government shutdown, patients who were once receiving hospital-level care in their homes had to be discharged to an outpatient plan or move back into the hospital. This article reviewed some of the real-world impacts of HaH program closures due to the shutdown, as well as provided policy options for waiver extension.

Home Health Care News: Bayada Rolls Out New AI Model To Prevent Falls, Reduce Hospitalizations (11/21) - Bayada Home Health Care rolled out an AI model to prevent falls and reduce hospitalizations among its personal care clients. The Enhanced Quality of Care Model assesses clients’ risk levels and enables Bayada to make faster interventions, improving outcomes and setting the stage for more successful negotiations with payers.

Home Health Care News: Place-Agnostic Models Signal New Era For Home-Based Care, Senior Living (11/20) - Home-based care has been part of a pivotal shift in the U.S. health care system: the blurring of lines between traditional facility-based care and in-home services. The divides between home-based care and other segments of the health care system are thinning. Non-medical home care providers have increasingly adapted to deliver care to more complex patients, branching into cancer care and chronic disease management, suggesting the erosion of boundaries between home health and personal home care.

Becker’s Health IT: 4 Health Systems Roll Out New Hospital-at-Home Programs in 2025 (11/19) - New York-Presbyterian, Nemours Children’s Health, Valley Health System, and St. Luke’s Health System announced the launch of their respective hospital at home programs, integrating home-based hospital care into their broader care-delivery strategies.

Modern Healthcare: Hospital-at-Home Programs Gripped by Uncertainty (11/17) – After the government shutdown, providers delayed the start of paused programs, delayed expansions of existing ones and tried to find other ways to deliver acute-level care to people where they live. Most hospitals either furloughed or redeployed hospital-at-home staff to other parts of their operations, said Dr. Pippa Shulman, Dispatch Health, an MHH member. The shutdown also created hospital bed shortages.

Becker’s Health IT: New York-Presbyterian Launches Hospital at Home (11/17) - New York-Presbyterian started a hospital-at-home program to treat acute care patients from two of its campuses at their homes. The health system is one of the first to launch the care model since CMS resumed reimbursing for hospital at home with the end of the 43-day government shutdown. The agency granted New York-Presbyterian a hospital-at-home waiver in March.

Forbes: Congress Restores Hospital-At-Home—For Safe, Comfortable Patient Care (11/14) - When HaH waiver funding expired on September 30, 2025, hospitals and patients were left navigating a far less efficient system. Programs had to discharge patients and move them back to facilities. This disruption caused breaks in care and operational issues for health systems. While clinically and economically sound, long-term authorization is needed to avoid wasting a model that is safer for patients, more efficient for hospitals, and sustainable for Medicare. HaH is no longer experimental—it is evidence-based, patient-centered, and growing in adoption

HealthLeaders Media: Healthcare Leaders Are Hamstrung by On-Again Off-Again Telehealth Waivers (11/14) – After Congress temporarily reauthorized the HaH program through continuing resolution funding, health care executives note the extension is too short (about 75 days) to support meaningful long-term planning or investments, leaving future care continuity uncertain. For patients. especially those who benefit from home-based acute care, this stop-and-start policy creates disruption, uncertainty, and a risk that access may again vanish, undermining the stability and scalability of hospital-at-home as a care model.

JAMA: Evolving Hospital-at-Home to Meet the Needs of Children (11/12) - HaH care models have evolved over time and typically include home delivery of equipment and supplies, daily nursing visits, virtual or in-person clinician visits, and an emergency response system. While the creation of the ACHAH waiver sparked HaH innovation for older adults in the past five years, the first pediatric HaH program was not launched until early 2025. This article describes barriers to pediatric HaH implementation, current opportunities for pediatric HaH programs, and policy changes needed to support their growth.

Becker’s Health IT: The ROI on Hospital at Home (11/12) – During the lapse in HaH waiver authority, health systems reviewed the program’s return on investment (ROI). Of the roughly 20% of health systems that offer hospital at home, over two-thirds say the programs increase access to care, boost patient satisfaction, lower lengths of stay, and cut avoidable readmissions.

Health Leaders: The (Continuing) Evolution of the Hospital at Home Strategy (11/10) – While the government shutdown furloughed HaH programs, providers continued to implement less-intensive programs primarily based on ambulatory care. Given the uncertainty of the HaH waiver, health systems and hospitals are trying many different strategies, with the common denominator being an effort to reduce length of stay – either by discharging patients earlier and continuing care in the home or getting to them before they go to the hospital.

Upcoming Events

December 9, The Hill, Undervalued & Overwhelmed, Fixing the Financial Crisis Facing Family Caregivers

December 18, SHM Hospital at Home Special Interest Group, Next Steps for Hospital at Home Legislation

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