$50 Billion Initiative Prioritizes In-Home Care for Rural Communities
Table of Contents
A new $50 billion investment from the U.S. Centers for Medicare and Medicaid Services (CMS) aims to bolster healthcare access in rural areas, with stakeholders strongly advocating for a central role for home-based care services.
The National Alliance for Care at Home (the Alliance) last week formally requested that CMS’ Rural Health Transformation Program (RHTP) prioritize funding for in-home care, framing it as a “key pillar” of sustainable and accessible rural healthcare. The request was delivered in a letter to CMS Administrator Dr. Mehmet Oz.
“Agencies that provide in-home services are essential partners in delivering care to rural communities,” a senior official with the Alliance stated in the letter. “For many older adults and individuals with chronic or serious illness, these providers represent the only available source of consistent clinical and supportive services in the home.” As rural hospitals and clinics grapple with closures and service reductions, in-home care is increasingly vital for safe patient discharges, preventing readmissions, managing chronic conditions, and providing dignified end-of-life care.
The Rural Health Transformation Program and the “One Big Beautiful Bill”
The RHTP, a component of the broader “One Big Beautiful Bill” (OBBB), is designed to improve health outcomes and access for residents of rural communities. The Alliance emphasized the unique ability of home-based care providers to overcome obstacles like transportation limitations, ensure continuity of care, and alleviate pressure on overburdened hospitals and emergency departments.
However, despite being ideally positioned to serve rural populations, in-home care providers in these areas face significant financial challenges.
“Many rural agencies face increasing financial instability due to declining Medicare reimbursement, ongoing challenges with Medicaid payment rates, persistent workforce shortages, and escalating administrative requirements,” the Alliance’s CEO explained. “The RHTP presents an important opportunity to stabilize and expand home-based care capacity, ensuring that rural residents have access to appropriate, high-quality services in the most clinically effective and cost-efficient setting.”
Calls for Comprehensive Funding and Infrastructure Support
The Alliance’s recommendations to CMS include guaranteeing that RHTP funding specifically supports home-based care agencies, as well as investments in staffing, telehealth infrastructure, and essential technology.
Echoing these concerns, a leader at Hearts for Home Care, Bayada’s advocacy organization, stated, “As lawmakers work to distribute the Rural Health Fund, it is critical that home health care be prioritized – especially in rural communities, where many hospitals and nursing homes are closing due to lack of assistance.” They added that collaborative efforts with industry partners in state capitals are underway to ensure legislators recognize the importance of home care when allocating funds.
Partnership Opportunities and Innovative Payment Models
The RHTP also presents opportunities for innovative partnerships, according to a CEO of LTM Group. “What’s really exciting about this is the ability for home health agencies to potentially partner with these health systems and the state associations to create an alternative payment method,” they noted. This could involve combining in-person visits with chronic care management, virtual care, and care navigation, effectively breaking down traditional barriers within rural hospital settings. .
Looking forward, the Alliance envisions the program as a catalyst for a broader overhaul of rural health systems, extending care beyond the confines of hospitals.
“Strengthening access to home-based services will reduce unnecessary hospitalizations, improve outcomes for chronically and seriously ill patients and support family caregivers, all while keeping health care dollars within rural communities,” the Alliance’s CEO concluded. “Evidence consistently shows that home-based care lowers costs and improves quality, making it a critical component of sustainable rural health transformation.”
