Brightstar Care Founder: The Policy Holding Back The ‘absolute Game-changer’ Hospital-at-home Model

One home-based care veteran believes that the short-term funding waiver reimbursement structure is stymying hospital-at-home’s growth.

BrightStar Care Founder Shelly Sun Berkowitz called the hospital-at-home model an “absolute game changer” for patients and the health care system –  but has identified reimbursement barriers preventing these programs from accelerating.  

“The frustrating truth is, this incredible vision is constantly hitting a roadblock: long-term funding,” Sun Berkowitz wrote in a LinkedIn article on Tuesday. “We’re seeing amazing clinical outcomes, happier patients, and real cost savings from hospital-at-home programs. The data is clear. Yet, our federal policies continue to rely on short-term waivers, creating a cliff-edge every few months. In fact, the current CMS waiver program for Hospital at Home is set to expire this September. This isn’t a distant threat; it’s a rapidly approaching deadline.”

Chicagoland-based BrightStar Care offers personal home care, as well as supplemental staffing and home health care. It has over 400 franchise locations across the U.S.

The Centers for Medicare & Medicaid Services (CMS) first introduced the Acute Hospital Care At Home program in 2020. The waiver program was meant to increase hospital capacity amid the COVID-19 pandemic and allowed providers to gain access to reimbursement for delivering hospital-level care in the home. Initially set to expire at the end of 2024, the program was extended through March 2025 and then through Sept. 30, 2025.

Sun Berkowitz explained that it is difficult for home-based care leaders to throw their weight behind the hospital-at-home model when there is so much uncertainty.

“From my own experience, I know the level of commitment and investment it takes to build these programs,” she wrote. “When we piloted an acute care at home initiative, we made significant, brave investments in training and specialized equipment, believing deeply in its potential. But it’s nearly impossible to commit those kinds of resources – or for states to expand crucial Medicaid coverage – when you don’t know what the policy landscape will look like next year, let alone five years from now.”

Sun Berkowitz’s company BrightStar Care has collaborated with Medically Home, now known as DispatchHealth, to provide primary in-home clinician and transport services.

Ultimately, Sun Berkowitz urges policymakers to take action and health care stakeholders to increase their advocacy efforts.

“We have bipartisan support for this model, and the evidence is mounting,” Sun Berkowitz wrote. “What we need now is for our policymakers to act decisively. If you believe, like I do, that patients deserve the best care in the best place, it’s time for us to speak up. Let’s advocate for the long-term policy certainty that hospital-at-home desperately needs, not just to survive, but thrive and truly transform U.S. health care.”

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