Home-based Care Providers Vie For Part Of $50b Cms’ Rural Health Fund

The Rural Health Transformation Program — which includes $50 billion in funding — is being positioned as a possible solution to the access to care challenges that plague rural communities across the U.S. Home-based care providers believe that they should be part of the solution.

The rural health care funding is part of the “One Big Beautiful Bill” (OBBB). The funding is designed to improve health care outcomes and access in rural communities. The program also aims to strengthen workforce development, facilitate the growth of innovative care and promote the use of innovative technologies.

David Kerns, CEO of LTM Group, considers the CMS funding a major opportunity for home-based care providers that serve rural areas.

“Some of the biggest needs are in these rural areas, caring for some of the sickest patients,” he told Home Health Care News. “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. 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.”

Dayton, Ohio-based, the LTM Group includes several home health, personal care, hospice and rehab companies with more than 500 employees across Indiana, Ohio and Michigan.

In September, states will be able to apply for the funds and determine how to spend based on the list of permissible uses. As part of the Centers for Medicare and Medicaid Services’ (CMS) application process, states will need to include a detailed plan. These applications are due in early November.

The $50 billion will be distributed to approved states over the course of five years, and $10 billion of funding will be available each year, starting in 2026.

In general, individuals living in rural communities often face barriers to health care services.

“If you think about the infrastructure, not only do the doctors not live there, but there’s much less broadband connectivity, much less public transportation, the roads are fewer and far between, and often in worse conditions than they are in urban areas,” Dr. Jennifer Schneider, CEO and co-founder of Homeward, previously told HHCN. “That makes receiving care for individuals really difficult.”

Homeward is a tech-enabled home-based primary care provider.

The combination of fewer health care providers and transportation challenges often leads to patients with complex diseases or illnesses when they finally receive care, according to Dr. Binoy Singh, chief medical officer at Gentiva.

Kerns confirmed that LTM Group plans to work with its state associations in the markets where the company serves rural communities on the Rural Health Transformation Program. He believes that this opportunity plays to home health’s strengths.

“We can make the biggest impact on reducing health care expenditures,” Kerns said. “I think we’re the most cost-efficient health care provider, and we’re a great partner to health systems. There’s no better way to take care of somebody in a rural community than through home care.”

LTM Group isn’t alone. Andwell Health Partners is working with state associations to get involved in the program.

“Andwell is committed to collaborating with the State of Maine to secure funding through the Rural Health Transformation Program,” Kenneth Albert, president and CEO of Andwell Health Partners, told HHCN in an email. “We are in communication with state officials who are soon beginning the process of defining program details and operations for Maine.”

The program’s limits

Though some providers have thrown support behind the program, some industry advocates have pointed out the ways it falls short.

“HR 1’s $1 trillion-plus in reductions to federal contributions to the Medicaid program over 10 years will have a significant impact on state budgets, on providers, including our nonprofit and mission-driven members, and on older adults’ ability to access needed care and services,” Nicole Fallon, vice president of integrated services and managed care at LeadingAge, told HHCN in an email. “The Rural Health Transformation Fund will only fill about 5% of that hole and has restrictions on its use for limited purposes.”

Still, Fallon pointed out that older adults make up 20% of rural America.

“States’ plans should examine what types of services their rural residents need access to, such as home health care, and how home health agencies can be key partners in local and regional health care partnerships,” she said. “The [program] notes that one of the permissible uses of the funds is to help ‘rural communities in right-sizing their health care delivery systems by identifying needed services, including post-acute care.’ Ensuring access to home health care should be part of this conversation.”

Bayada Home Health Care was also critical of the program.

“When that fund disappears after 2030, the deepest cuts will continue indefinitely,” David Totaro, president and executive director of Hearts for Home Care, Bayada’s advocacy organization, told HHCN in an email.

Ultimately, Totaro pointed out the importance of home health’s involvement in the program.

“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,” Totaro said. “We are working alongside our industry partners in state capitols to ensure legislators don’t forget about home care as they apply for funding.”

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