This article is part of the HHCN+ membership
Following last week's federal government shutdown, traffic congestion in Washington, D.C. continues to complicate care delivery for the home care industry.
With this in mind, home care providers are making noise about the impact of the government shutdown on their industry.
While the loss of telemedicine flexibility has gotten a lot of attention from home health leaders, there are other concerns as well. Potential delays to the 2026 Home Health Final Payment Rule, expiration of federally funded programs, and administrative gridlock are just some of the areas home health leaders highlighted.
Home Healthcare News recently spoke to seven industry leaders to get their thoughts on the government shutdown and what it means for their businesses and access to care.
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Given the bipartisan support for telehealth flexibility, its expiration during the government shutdown unnecessary and significantly disrupted access to care for critically ill patients, particularly in home health and hospice settings. The requirement for in-person visits by a limited number of health care workers means that health care providers can only serve a portion of the patients they normally serve. This directly limits access to timely medically necessary care for vulnerable populations, especially in rural and underserved areas.
Unlike other Medicare-certified services, the use of telehealth in home health and hospice is associated with eligibility requirements. If telehealth benefits are reinstated after the fact, providers will not be able to retroactively adjust claims, creating a dangerous gap in continuity of care.
Home health care requires a necessary face-to-face meeting before services can begin. Medical institutions often rely on independent doctors to perform these examinations, and if that doctor is not available, patients cannot be admitted to the hospital or, in the worst case scenario, have to be discharged. This particularly impacts rural health care providers, where physician access is already limited, leaving patients without essential care.
Accent Care proactively completed required in-person visits prior to closure to minimize disruption to both home health and hospice patients. However, the administrative nature of these encounters highlights the need for permanent telehealth flexibility. Congress should act to make this benefit permanent. The uncertainty surrounding these extensions risks diversion of an already limited workforce and disruption of care for those who need it most.
— Dr. Bal Natarajan, Chief Medical Officer, Accent Care
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The closures are already creating major challenges for patients and health care providers.
The biggest concern for home health care is that the closure could delay the release of 2026 payment rules. Years of cumulative rate reductions have already forced agencies to turn patients away and reduce services. Further delays in clarity from CMS will only increase uncertainty for health care providers regarding care planning, staffing, and transitioning patients from the hospital to the home.
VNS Health, along with policymakers and health care providers across the country, is urging CMS to act to correct the flawed methodology driving these cuts and restore stability to home health benefits. CMS has the power to fix this. Congress doesn't have to act to do the right thing.
Shutdown is temporary. However, the harm caused by inaction, even in the short term, can lead to loss of access, delays in treatment, avoidable hospitalizations, and unnecessary deaths, all of which can have harmful repercussions that can last for years. Our patients cannot afford to wait.
— Dan Savitt, CEO and President, VNS Health
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Although the closure will not immediately halt Medicare and Medicaid billing, it poses serious financial and patient care risks. Medicare is already communicating with fiscal intermediaries and MACs about potential disruptions. If the shutdown continues and quotas are not met, MAC's reserves could be depleted, leading to reimbursement delays and financial burdens and impacting providers' ability to maintain services.
The bigger, less visible risk is to the patient's health. Programs like Meals on Wheels, which rely on funding from the Older Americans Act, will face budget cuts when it expires. Past closures have left thousands of seniors without their daily meal deliveries, resulting in malnutrition, emergency department visits, and avoidable hospitalizations. These pressures are compounded when transportation and caregiver support are lost.
We are focused on resiliency, exercising financial stewardship, carefully managing resources, and strengthening community partnerships to ensure patients continue to receive uninterrupted care.
— David Kearns, LTM Group CEO
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Although the federal government shutdown currently does not impact Bayada's ability to provide compassionate and reliable care to the medically complex and vulnerable populations we serve, we are closely monitoring the situation and hope for a speedy resolution. We urge policymakers to avoid closures that disrupt access to care for medically vulnerable children, adults, and older adults who rely on specialized one-on-one care to stay safe and healthy at home.
At the same time, our biggest concern right now is the ongoing state budget debate, particularly in North Carolina and Pennsylvania, which is already impacting individuals' ability to access the care they need to stay safe and healthy at home.
— Dave Totaro, Chief Government Affairs Officer, Bayada Home Health Care, President and Executive Director, Hearts for Home Care
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One week into the shutdown, the home care industry faces pressing challenges around Medicare and Medicaid reimbursement processing, accreditation renewal, and regulatory oversight. American Advantage Home Care has not yet had its operations directly impacted, but is closely monitoring the situation and expects it to be resolved by the middle of this month.
But uncertainty itself requires action. Patients and their families need reassurance during this uncertain time. So we have to step up as an organization. We are taking a more proactive role in communicating directly with the people we serve, not only about potential disruptions, but also about our unwavering commitment to them. We are proactively communicating with our patients to advocate for their needs and reassure them that we will continue to provide uninterrupted care regardless of federal delays. This could mean changes to care plans and increased reliance on home caregivers if closures last longer.
This moment highlights why trust and relationships are so important in home care. Our responsibilities extend beyond clinical services. We must be a stable presence for our patients to rely on when external situations cause anxiety. With prayer and hope, we are preparing to navigate payment complexities, maintain stability for caregivers, reduce administrative burdens, and ensure patients never have to wonder if their care will continue.
Our message is clear. At American Advantage Home Care, we are committed to our patients today and always, and we believe in America's promise.
—Cleamon Moorer Jr., President and CEO, American Advantage Home Care
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While the government shutdown creates short-term uncertainty, the home care industry is largely immune to immediate disruption. Because Medicare is an entitlement program, claim processing and reimbursement will continue during the closure. Core CMS functionality is considered essential and no near-term cash flow impact is expected.
The bigger risk lies in administrative stagnation. Due to furloughs of federal employees, provider registration renewals, appeals, eligibility verification, and other non-essential operations may be delayed. If the closure continues, it could put a strain on Medicare's administrative contractors and ultimately slow the reimbursement cycle.
At LiveWell Partners, we are closely monitoring developments and expect stability in redemptions. The big picture is that moments like this highlight the need for continued policy focused on home care access and efficiency.
Regardless of the situation in Washington state, our mission remains the same: ensuring patients and their families receive reliable, high-quality care at home.
— Jason Grow, LiveWell Partners CEO
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The government shutdown has exacerbated the challenges for home health and hospice providers. Telehealth flexibilities expire on September 30th, and with no enforcement discretion from CMS, agencies must conduct all in-person interactions. This sudden change increases administrative burden and disrupts patient access, especially in rural and underserved areas. Swift action by Congress to restore telehealth flexibility is critical to avoid unnecessary delays and burdens on health care providers.
— David Jackson, CEO of Choice Health at Home
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