Government Shutdown disrupts Home Healthcare, Threatens Patient Access
Table of Contents
- 1. Government Shutdown disrupts Home Healthcare, Threatens Patient Access
- 2. Telehealth Services Face Immediate Restrictions
- 3. “Hospital at home” Program Put on Hold
- 4. Other Impacts and Delays
- 5. Uncertain Timeline for Resolution
- 6. The Future of Home-Based Care
- 7. Frequently Asked Questions
- 8. What is the impact of the government shutdown on telehealth?
- 9. What is the “Hospital at Home” program?
- 10. Will the CY 2026 home health rule be delayed?
- 11. How long is the government shutdown expected to last?
- 12. What can home healthcare providers do during the shutdown?
- 13. What specific telehealth flexibilities, previously available during the public health emergency, are now impacted by the government shutdown?
- 14. Telehealth and Hospital-at-Home Waivers Suspended by Government Shutdown, Endangering Home Health Industry
- 15. Understanding the Suspended Waivers: A Deep Dive
- 16. Impact on Patient Access and Care Quality
- 17. Financial Strain on the Home Health Industry
- 18. The Future of Telehealth and HaH: What’s Next?
- 19. Benefits of Hospital-at-Home Programs
- 20. Practical Tips for Patients and Providers
Washington D.C. – The United States government entered a shutdown late Tuesday, immediately impacting the rapidly growing home-based care sector. The closure is halting key initiatives and creating a ripple effect of uncertainty for providers and patients alike.
Telehealth Services Face Immediate Restrictions
One of the most immediate consequences of the shutdown is the suspension of expanded Medicare telehealth flexibilities. These allowances, which were initially implemented during the COVID-19 pandemic, permitted a wider range of services too be delivered remotely, expanding access to care, notably in rural areas. As of October 1st,these flexibilities have lapsed,reverting to pre-pandemic limitations. This change impacts services outside of behavioral and mental health, including restrictions on in-home consultations and hospice recertifications.
Providers are reacting differently to the abrupt change. Some are continuing to provide telehealth services, anticipating retroactive reimbursement if the flexibilities are reinstated, while others have ceased offering these services to mitigate financial risk. Alexis Apple,director of federal affairs for ATA action,noted that this is the first time such flexibilities have lapsed since 2020,creating widespread disruption.
“Hospital at home” Program Put on Hold
The Acute Hospital Care at Home (AHCAH) program, which allows hospitals to provide acute-level care to patients in their homes, has also been significantly affected. The Centers for Medicare and Medicaid Services (CMS) has directed that all patients currently receiving hospital care at home be discharged to a customary hospital setting immediately. While programs operating outside the waiver-through managed care or commercial contracts-can continue, the pause jeopardizes the expansion of this innovative care model. According to a report from the American Hospital Association, roughly 10% of U.S. hospitals were participating in hospital-at-home programs.
Dr. bruce Leff, a professor of medicine at Johns Hopkins University School of Medicine, expressed concern that the disruption could erase the momentum gained by the program, possibly leading to a “death by extensions” if the shutdown persists. mass General Brigham acknowledges the setback but maintains its commitment to at-home care, having proactively prepared for potential disruptions.
Other Impacts and Delays
The shutdown’s effects extend beyond telehealth and hospital-at-home. The release of the highly anticipated CY 2026 home health final rule is likely to be delayed, adding further uncertainty for providers. Medicare and Medicaid enrollment processes may also face delays, and Medicare certification surveys could be postponed.Programs such as the Older Americans Act and the Social Services Block Grant, which support vulnerable populations, could experience reduced funding or service interruptions.Here’s a breakdown of key impacted areas:
| Area | Impact |
|---|---|
| Medicare Telehealth | Suspension of expanded flexibilities; return to pre-pandemic limitations. |
| Hospital at Home | Immediate discharge of current patients to hospitals; potential program delays. |
| CY 2026 Home Health Rule | Delayed release, creating uncertainty for providers. |
| Medicare/Medicaid Enrollment | Potential delays in processing applications. |
Did You No? The hospital-at-home model has demonstrated positive outcomes, including reduced hospital readmission rates and improved patient satisfaction.
Pro Tip: Home healthcare agencies should proactively communicate with patients and stakeholders about potential service disruptions and explore contingency plans.
Uncertain Timeline for Resolution
As of today, October 2nd, 2025, there is no clear end in sight for the government shutdown. Legislative efforts are stalled, and a resolution is not anticipated in the immediate future, according to reports. Apple estimates the shutdown could last anywhere from one week to a month or more.
The Future of Home-Based Care
The events unfolding during this government shutdown highlight the growing importance of home-based care as a viable and increasingly essential component of the U.S. healthcare system. Despite the current challenges, the demand for in-home services is expected to continue rising, driven by an aging population and a desire for more convenient and personalized care. Innovations in telehealth and remote patient monitoring will play a significant role in shaping the future of this sector.
Frequently Asked Questions
What is the impact of the government shutdown on telehealth?
The shutdown has led to the suspension of expanded Medicare telehealth flexibilities, restricting access to remote care for many patients.
What is the “Hospital at Home” program?
The Acute Hospital Care at Home program allows hospitals to treat patients with acute conditions in their homes, potentially reducing hospital stays and improving patient outcomes.
Will the CY 2026 home health rule be delayed?
Yes, the government shutdown is expected to delay the release of the final rule, creating uncertainty for home health agencies.
How long is the government shutdown expected to last?
The duration of the shutdown is currently uncertain, with estimates ranging from one week to a month or more.
What can home healthcare providers do during the shutdown?
Providers should proactively communicate with patients, explore contingency plans, and stay informed about developments in the government shutdown.
What do you think the long-term effects of this shutdown will be on the home healthcare industry? how will it influence patient care and access to services?
Share your thoughts in the comments below and help us continue this importent conversation.
What specific telehealth flexibilities, previously available during the public health emergency, are now impacted by the government shutdown?
Telehealth and Hospital-at-Home Waivers Suspended by Government Shutdown, Endangering Home Health Industry
The recent government shutdown has triggered a suspension of crucial telehealth and Hospital-at-Home (HaH) waivers, sending ripples of concern through the home health industry. This disruption threatens patient access to care, strains hospital capacity, and jeopardizes the continued growth of innovative care models. This article details the implications of these suspensions, explores the waivers affected, and outlines potential impacts on patients and providers.
Understanding the Suspended Waivers: A Deep Dive
The waivers in question were largely implemented during the COVID-19 public health emergency to expand access to care and alleviate pressure on customary healthcare settings. Key waivers now impacted include:
* Telehealth Flexibilities: These waivers broadened the scope of telehealth services covered by Medicare and Medicaid, allowing for remote patient monitoring, virtual check-ins, and expanded geographic coverage. Specifically, waivers regarding the use of asynchronous telehealth (store-and-forward) and audio-only visits are considerably affected.
* Hospital-at-Home (HaH) Waivers: The Acute Hospital at Home waiver program, allowing hospitals to provide acute care services in patients’ homes, is facing disruption. this program relies on waivers related to Medicare reimbursement and regulatory requirements.
* relaxations of Stark Law and Anti-Kickback Statute: Temporary relaxations designed to facilitate collaborative care during the pandemic have also been paused, impacting care coordination and value-based care arrangements.
These suspensions aren’t permanent, but the uncertainty surrounding their reinstatement is causing significant operational challenges.The MRAC (Medicare Benefits Schedule Review Advisory Commitee) published a Telehealth Post-Implementation Review Draft Report in September 2023, and the final report was released in June 2024, outlining recommendations for the future of telehealth.however, the shutdown halts any immediate implementation of these recommendations.
Impact on Patient Access and Care Quality
The suspension of these waivers directly impacts patient access to essential healthcare services.
* Rural and Underserved Communities: Telehealth proved invaluable in reaching patients in rural areas and those with limited mobility. The loss of these flexibilities disproportionately affects these vulnerable populations.
* Chronic Disease Management: Remote patient monitoring and virtual check-ins are critical for managing chronic conditions like diabetes, heart failure, and COPD. Interruptions to these services can lead to disease exacerbations and increased hospitalizations.
* Post-Discharge Care: HaH programs offer a smoother transition from hospital to home, reducing readmission rates and improving patient outcomes. The suspension of these waivers jeopardizes this continuity of care.
* Mental Health Services: Teletherapy has become a vital component of mental healthcare access. Reduced telehealth coverage limits options for individuals seeking mental health support.
Financial Strain on the Home Health Industry
The home health industry is bracing for significant financial repercussions.
* Reduced reimbursement Rates: Without the waivers, reimbursement rates for telehealth and HaH services may revert to pre-pandemic levels, making these services financially unsustainable for many providers.
* Operational Disruptions: Providers are forced to reassess staffing models, cancel scheduled appointments, and possibly reduce service offerings.
* Investment Uncertainty: The uncertainty surrounding the future of telehealth and HaH discourages investment in these innovative care models.
* Potential for Job Losses: Reduced revenue and operational disruptions could lead to job losses within the home health sector.
The Future of Telehealth and HaH: What’s Next?
while the current situation is concerning, several factors suggest a path forward.
* Bipartisan Support for Telehealth: There is growing bipartisan recognition of the value of telehealth, increasing the likelihood of legislative action to reinstate key waivers.
* Ongoing Research and Data Collection: The MRAC’s review and ongoing data collection efforts will inform future policy decisions regarding telehealth and HaH.
* Advocacy Efforts: Industry organizations are actively lobbying Congress and the management to restore the suspended waivers.
* State-Level Initiatives: Some states are taking proactive steps to maintain telehealth access within their borders, autonomous of federal action.
Benefits of Hospital-at-Home Programs
Hospital-at-Home programs offer a compelling choice to traditional hospital care, with demonstrated benefits including:
* Improved Patient Satisfaction: Patients often prefer receiving care in the comfort of their own homes.
* Reduced Healthcare costs: HaH programs can be more cost-effective than traditional hospital stays.
* Lower Infection Rates: Patients are less exposed to hospital-acquired infections in a home setting.
* Increased hospital Capacity: HaH programs free up hospital beds for patients requiring acute inpatient care.
Practical Tips for Patients and Providers
For Patients:
* Stay Informed: Monitor updates from your healthcare providers and insurance companies regarding telehealth coverage.
* Advocate for Yourself: Contact your elected officials and express your support for telehealth and HaH.
* Explore Alternative Options: if telehealth is unavailable, discuss alternative care options with your doctor.
