Alliance Urges Cms To Prioritize Home-based Care In $50b Rural Funding Program

The U.S. Centers for Medicare and Medicaid Services’ (CMS) has earmarked $50 billion to improve health care offerings in rural communities – and home health stakeholders are calling for the program to prioritize in-home offerings.

The National Alliance for Care at Home (the Alliance) called for CMS’ Rural Health Transformation Program (RHTP) to prioritize investment in home-based care in a letter to CMS Administrator Dr. Mehmet Oz last week, describing it as a “key pillar” of rural health access and sustainability.

“Agencies that provide in-home services are essential partners in delivering care to rural

communities,” Dr. Steven Landers, CEO of the Alliance, said 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 hospitals and clinics face closures or service reductions, home-based care fills critical gaps, enabling safe discharges, reducing preventable readmissions, managing chronic disease and supporting end-of-life care with dignity and compassion.”

The Rural Health Transformation Program aims to improve health care outcomes and access in rural communities and is part of the “One Big Beautiful Bill” (OBBB).

The Alliance highlighted home-based care providers’ ability to address transportation roadblocks, enable care continuity and ease capacity pressures on hospitals and emergency departments.

Despite in-home care providers being well-suited to provide care in rural areas, providers that operate in these communities continue to face 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,” Landers said. “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.”

The Alliance’s letter also included a number of recommendations for CMS. The organization urged CMS to guarantee that funding includes home-based care agencies, supports staffing, technology and telehealth infrastructure and more.

Similar to the Alliance, home-based care leaders have also voiced the need for providers to be part of the solution.

“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,” David Totaro, president and executive director of Hearts for Home Care, Bayada’s advocacy organization, previously told Home Health Care News. “We are working alongside our industry partners in state capitols to ensure legislators don’t forget about home care as they apply for funding.”

The Rural Health Transformation Program also opens the door for partnership opportunities, according to David Kerns, 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,” he previously told HHCN. “You can create a combined solution where the hospital and the home health agency combine in-person visits with chronic care management, virtual care and care navigation, eliminating the traditional barriers within rural hospital walls.”

Looking ahead, the Alliance sees the program as an opportunity to revamp rural health systems and extend past 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,” Landers said. “Evidence consistently shows that home-based care lowers costs and improves quality, making it a critical component of sustainable rural health transformation.”

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