Care at Home News Review
Read on for the Alliance’s regular round up of the top news reporting on the care at home community.
Home care stakeholders to testify before congressional committee
Home care leaders and advocates are scheduled to testify about the value of quality post-acute care before the US House Committee on Ways and Means Tuesday.
Johnathan Fleece, JD, president and chief executive officer of Empath Health, a home care, home health and hospice provider, will be one of five witnesses at the hearing, “After the Hospital: Ensuring Access to Quality Post-Acute Care.” …
Alliance warns Congress to ‘be extremely careful’ when considering Medicaid changes
The National Alliance for Care at Home, the leading home care advocacy organization, has weighed in on a House budget resolution that threatens to cut billions of dollars from Medicaid.
“Medicaid is a complex program and changes to one part of the statute may have unanticipated negative outcomes on other aspects of services, financing, or reimbursements,” the Alliance said Wednesday in a statement. “We encourage Congress to be extremely careful to avoid making changes that could lead to unintended outcomes. We stand ready to provide our expertise to help strengthen Medicaid for all individuals and providers.”
MACPAC recommendations to extend renewal period for HCBS waivers do not go far enough, providers say
In its latest report to Congress, the Medicaid and CHIP Payment and Access Commission (MACPAC) issued two recommendations to improve home- and community-based services. Although HCBS stakeholders are generally in support of MACPAC’s ideas, some are calling for more wide-reaching policy changes.
MACPAC recommended in its March report that the Department of Health and Human Services issue guidance about how states can use provisional plans of care to expedite HCBS delivery. It also advised Congress to extend renewal periods for 1915(c) and 1915(i) waivers (which are used for HCBS) from five to 10 years.
The National Alliance for Care at Home, which represents HCBS providers, said that MACPAC’s recommendations could go further.
Menu Of Medicaid Cuts Draws Pushback From Home-Based Care Defenders
The ongoing budget wrangling on Capitol Hill has centered largely around potential cuts and changes to Medicaid, prompting pushback and concern about potential effects on home-based care.
“Our members will not support any policies that reduce access to essential home and community-based services for eligible individuals,” the National Alliance for Care at Home (the Alliance) stated Wednesday, in a comment on recent Congressional budget and reconciliation activity. “As Congress continues to assess options to reduce federal spending, we encourage leaders to continue to look favorably on high-value services that reduce costs and improve participant satisfaction.”
CMS rescinds state guidance for key social support programs, prompting outcry from Medicaid stakeholders
The Centers for Medicare & Medicaid Services last week rescinded guidance that helped states apply for Medicaid funding to support individuals’ health-related social needs (HRSN). While this action may help rein in government spending, it could also make it harder for Medicaid beneficiaries to access services such as transportation, nutrition and housing assistance, according to Damon Terzaghi, senior director of Medicaid advocacy at the National Alliance for Care at Home.
“It’s unlikely we see an easy, smooth approval process for such services moving forward,” Terzaghi told McKnight’s Home Care Daily Pulse Monday. “The [press] release did say that they would continue to evaluate requests on a one-off basis, but I think that the bar to getting it approved will be higher. States are going to have to make individualized decisions around where their priorities are and where they want to continue to focus on expansion — and maybe focus a little bit more on cost constraint and financially effective services under the new administrative priorities.”
Home Health Community Responds to DEA’s Proposed Telehealth Rule
A proposed rule by the U.S. Drug Enforcement Administration (DEA) could impede timely access to medications for patients, according to members of the home health community.
The DEA proposed a rule in the final days of the Biden administration that could change the game for prescribing controlled substances via telehealth, including some common hospice medications. If finalized, this proposed rule would require prescribers to register with the DEA before they are allowed to prescribe schedule II-V controlled substances, along with some monitoring and other requirements. …
Implementation of the proposed rule would have adverse consequences for patients, according to the National Alliance for Care at Home.
MedPAC Calls for 2026 Hospice Rate Freeze
The Medicare Payment Advisory Commission (MedPAC) has recommended to Congress a freeze on hospice payment increases starting in 2026.
In its annual report to Congress, MedPAC urged policymakers to eliminate hospice base-rate increases for 2026. The commission made a similar recommendation last year.
MedPAC commissioners maintained that hospice payment levels were “favorable,” due to increases in utilization and length of stay, sufficient access to capital, investor interest in the space and margin data.
Underlying Causes of Health Issues
Underlying causes of health issues are common. Not all health issues come directly from infections, medical conditions, or genetics. Lifestyle, environmental factors, and social determinants can cause and/or increase the severity of health issues. Beginning in the winter of 2023, the Centers for Medicare and Medicaid Services posted guidance on approving coverage for these social needs, acknowledging that they contribute to poor health outcomes. CMS named the social needs that could be covered by Medicaid, CHIP, Section 1115, and Home and Community Based Services. These include help finding new housing, one-time moving costs, eviction prevention, respite care, sober centers, home improvements, meals, and case management.
Senators Grill CMS Nominee Dr. Oz On Medicaid Cuts
Dr. Mehmet Oz, President Donald Trump’s choice to take the helm of the Centers for Medicare and Medicaid Services (CMS), faced questions on Capitol Hill about his stance on future cuts to Medicaid. These are cuts that could result in reduced access to Medicaid-funded home and community-based services.
On Friday, Oz testified before the Senate Finance Committee. After the hearing, members of the committee will schedule a vote. Trump first nominated Oz for the role back in November.
Home Health Leaders Optimistic for 2025
Leaders from Pennant Group, Inc. (Nasdaq: PNTG), the parent company of a network of home health, hospice, and senior living services in 13 states, discussed the current state of their business on Tuesday at the 2025 Oppenheimer Co. Annual Healthcare MedTech & Services Conference.
Echoing its Q4 earnings report released in February, Pennant highlighted significant anticipated growth for 2024, projecting a 30% increase in both revenue and net income. Additionally, company leaders discussed significant acquisitions, including the $80 million acquisition of Signature Health at Home’s Oregon assets.
State Legislators Propose New Bill to Combat Hospice Fraud in Hotbed Region
Nevada lawmakers have introduced a bill to curb hospice fraud in that state.
Nevada is among the four hotbed states seeing escalating program integrity issues in recent years, joined by Arizona, California and Texas. Sponsored by Assemblymember Rebecca Edgeworth (R-Las Vegas, District 35), the newly proposed bill introduced a number of measures that could widen the scope of state enforcement activity.
Among the significant changes that the legislation proposed was having newly licensed hospice programs in Nevada undergo enhanced regulatory oversight for the first two years of operations. Goals of the legislation include an aim to decrease fraud and improve hospice care statewide, according to Edgeworth. But the path toward progress comes with several considerations, she indicated.
2 Tailwinds Shaping Hospice Growth, Care Delivery
Rising demand for end-of-life care is pushing hospice growth opportunities to the forefront in value-based reimbursement. More payers in this arena are increasingly recognizing the depth of potential beneficial outcomes when it comes to collaborative hospice partnerships.
Swelling aging populations have fueled rising health care costs across the country, with payers and providers alike seeking ways to ensure affordable access and sustainable services. Hospices play an integral role in future health care delivery trends as more seniors reach the end of life, according to David Jackson, CEO and founding partner of Choice Health at Home. The Texas-headquartered company provides hospice, home health and rehabilitation services.
The Rise of Hospice Nurses as Authors, Social Media Influencers
Several hospice nurses have emerged as social media influencers and authors who aim to demystify death and dying for the general public.
Individually and collectively, these nurses have amassed millions of social media followers on platforms such as TikTok, Facebook, Instagram and YouTube. A number have also written books about their experiences as hospice nurses and the lessons they’ve learned about the end-of-life experience for many families.
Hospice nurse Penny Hawkins Smith, author of the book Influencing Death: Reframing Dying for Better Living, was among the first to venture online. She began exploring TikTok during the COVID-19 shutdown. Today, she has more than 4.2 million followers across four platforms.
Report: Home healthcare visit delays higher in disadvantaged neighborhoods
Even though there are requirements and proven benefits for starting home healthcare on time, about 30% of people’s care is delayed. People living in the most underserved areas had a 13% higher risk for delayed care compared to those in the least disadvantaged areas, according to findings from a new study.
Compared to patients who received a timely visit (within 48 hours after hospital discharge), those with delays were more likely to be over 80 years old, non-Hispanic Black or Hispanic and living in more disadvantaged neighborhoods, the data showed.
The Case for a Palliative Care Medicare Carve-Out
The future of palliative care payment is reaching an uncertain, but potentially promising time in the Medicare landscape. Trends that have taken shape in the value-based insurance design (VBID) demonstration and other payment models may be among the driving forces.
Though unlikely to take shape anytime soon, the potential for a palliative care carve-out in Medicare has been building in recent years, according to Rory Farrand, vice president of palliative and advanced care at the National Alliance for Care at Home.
Lawmakers worry DOGE firings could erode care access for Medicare, Medicaid beneficiaries
Members of the Senate committees on finance and health last week denounced mass federal layoffs led by Elon Musk’s Department of Government Efficiency, which they argue will leave the Centers for Medicare & Medicaid short-staffed and endanger beneficiaries’ access to care.
“We are concerned that these firings will have a direct and negative impact on the healthcare of millions of Americans,” Sens. Ron Wyden (D-OR) and Angus King (I-ME) said last week in a letter to CMS Chief of Staff and Acting Administrator Stephanie Carlton. “Cuts to this already understaffed agency will undermine the ability of CMS to effectively serve taxpayers and carry out its statutory obligations established by legislation passed by Congress. Given the wide-ranging impact that the work of CMS has on Americans’ access to health care, it is critical that the American people have accurate information about the staffing cuts at CMS and the agency’s current capacity to carry out its important work.”
State of home care in 2025
The home care industry is undergoing significant transformation as we enter into 2025, driven by demographic shifts, technological advancements and changing healthcare policies. Here is a snapshot of the state of the industry.
Increasing demand for home care services
The demand for home care services continues to rise dramatically in 2025. This growth is primarily fueled by the aging baby boomer generation, with projections indicating that by 2029, there will be approximately 71.4 million Americans aged 65 and older. About 70% of this population is expected to require some form of care during their lifetime, creating an unprecedented need for home care services.
Palliative Care Integration Expanding, Diversifying Across Continuum
Potential is mounting for deeper integration of palliative care delivery across the continuum, with some health care settings better poised than others for evolving opportunities.
Palliative providers need more avenues to reach seriously ill patients with unmet physical, emotional and psychosocial needs, particularly those in rural areas across the country, said Shelby Moore, executive director of Heartlinks. The Washington-based provider offers adult and pediatric hospice, palliative care, grief support and senior living services.
Older Americans Step Up To Support Peers Amid Caregiver Shortages
As the number of older Americans continues to rise, a growing trend sees seniors stepping in as caregivers for their peers.
With about 70% of the 73 million individuals aged 65 and older projected to require home care by 2025 and a shortage of professional caregivers, organizations like Caretech and Seniors Helping Seniors are tapping into the invaluable resource of experienced senior caregivers to meet the increasing demand for home support.
