The Centers for Medicare and Medicaid Services (CMS) has earmarked $50 billion to improve health care services in rural areas, and home health officials are calling for the program to prioritize home-based services.
In a letter to CMS Administrator Dr. Mehmet Oz last week, the National Home Care Alliance (Alliance) called on CMS to prioritize investment in the Rural Health Transformation Program (RHTP), calling it a “critical pillar” of rural health care access and sustainability.
“Agencies that provide home services are essential partners in delivering care to rural areas.
“For many older adults and individuals with chronic or critical illnesses, these health care providers are the only source of consistent clinical and support services in the home,” Dr. Stephen Landers, CEO of the alliance, said in the letter. As hospitals and clinics face closures and service cuts, home care fills a critical gap, enabling safe discharges, reducing preventable hospital readmissions, managing chronic conditions, and supporting end-of-life care with dignity and compassion. ”
The Rural Healthcare Transformation Program aims to improve healthcare outcomes and access in rural areas and is part of the 'One Big Beautiful Bill' (OBBB).
The Alliance highlighted the ability of home health care providers to address transportation barriers, enable continuity of care, and relieve pressure on hospital and emergency department capacity.
Although home care providers are well suited to provide care in rural areas, providers operating in these communities continue to face financial challenges.
“Many local agencies are facing increased financial instability due to declining Medicare reimbursements, continued challenges with Medicaid payment rates, persistent workforce shortages, and increased administrative requirements,” Landers said. “The RHTP provides a significant opportunity to stabilize and expand home care capacity, ensuring rural residents have access to appropriate, high-quality services in the most clinically effective and cost-effective environment.”
The Alliance's letter also includes a number of recommendations for CMS. The group asked CMS to ensure funding includes support for home care agencies, staffing, technology and telehealth infrastructure.
Like the Alliance, home care leaders have also expressed the need for providers to be part of the solution.
“As lawmakers work to distribute local health funds, it is critical that home health care be prioritized, especially in rural areas where many hospitals and nursing homes are closed due to lack of support,” David Totaro, president and executive director of Bayada advocacy group Hearts for Home Care, previously told Home Health Care News. “We are working with industry partners in state legislatures to ensure that home care is not forgotten when state legislators apply for funding.”
According to LTM Group CEO David Kearns, the Rural Healthcare Transformation Program also opens the door to partnership opportunities.
“What's really interesting about this is that home health agencies may be able to partner with these health systems and state associations to create alternative payment methods,” he previously told HHCN. “Hospitals and home health agencies can combine in-person visits with chronic care management, virtual care, and care navigation to create a composite solution that eliminates traditional barriers within the walls of rural hospitals.”
Looking to the future, the Alliance sees this program as an opportunity to revamp local health systems and expand legacy hospitals.
“Strengthening access to home-based services can reduce unnecessary hospitalizations, improve outcomes for chronically ill and critically ill patients, support family caregivers, and keep health care costs within rural communities,” Landers said. “Evidence consistently shows that home care reduces costs, improves quality, and is a key component of sustainable rural healthcare transformation.”
