Don’t cut what works: Home health care saves lives and taxpayer dollars | Viewpoint

Home health serves as a lifeline in communities across the country.

It allows patients to receive treatment for an illness or injury in the comfort of their own home. For patients, it means better outcomes from the comfort of their own home. For taxpayers, home health saves money by keeping people out of costlier facilities when they can be cared for safely in their own environment. These benefits are all at risk if a dangerous new government proposal goes into effect.

As a physician and home health executive, I’ve witnessed the incredible power of home and community-based care for aging Americans. Early in my career, I provided house-call medical care. Any physician who has the opportunity to serve in home settings knows that care is most effective when it meets patients and families where they are. That is why I’ve devoted my career to ensuring that front-line providers, patients, and their families have a voice as we continue to fight for access to home care and against an increasingly concerning trend of attacks.

Home health has absorbed cuts year after year, and over the next decade, funding is projected to be reduced by over $25 billion, undercutting care for those who need it most and risking home health agency service area reductions and closures. This cycle of cuts began when the Biden Administration used flawed methodologies to implement Congress’s plan for home health reform.

Now, compounding these errors, the Centers for Medicare & Medicaid Services (CMS) is proposing an additional $1.1 billion cut to Medicare home health payment rates for 2026. This amounts to cutting the payment rate by 9% for home health agencies and will be an unprecedented blow to their ability to provide person-centered care.

When home health agencies face this type of cut, difficult decisions around staffing, technology, types of patients served, and service areas will all need to be considered.

Home health frequently delivers better outcomes at a lower cost, and these are stories I hear time and time again as a home health advocate. In upstate New York, a patient who suffered a stroke was able to recover with the help of home health. That patient went from a wheelchair to walking again and was able to return to work he loved. In Texas, a patient was able to start crocheting again, just in time to make a blanket for her new grandchild.

When home health is underfunded and faces repeated reductions, there are detrimental impacts to America’s healthcare system. Since 2019, over 1,000 home health agencies have closed their doors, and 80% of counties are treating fewer patients. Urban communities, and rural communities in particular, face delays in receiving care and provider shortages, at a time when more people are seeking home-based options.

With additional cuts on the horizon, the burden will further shift to ERs, hospitals, and the Medicare program, continuing to weaken an already fragile delivery system. Putting essential home health services at risk puts patients in a position without access to care. And when patients have nowhere else to turn, they will seek care in hospitals, ERs, and nursing homes, spiking overall costs of care for taxpayers. In 2024, for patients who were referred but did not receive home health care, hospital readmissions went up by 35 percent and mortality rates increased by 43 percent.

The nation’s providers who deliver care in the home and the patients they serve across the United States understand what is at risk. The National Alliance for Care at Home and the thousands of providers we represent are resoundingly committed to supporting patients with safe, affordable home care.

Instead of cutting what works, we are strongly urging CMS to listen to the thousands of providers who serve on the front lines. CMS must end these reckless cuts and look to solutions that protect home health care, taxpayer dollars, and patients’ lives.

Steve Landers, MD, is CEO of the National Alliance for Care at Home.