What Congress Gets Wrong About Home-Based Care

Описание: Care at home advocacy and hospice policy are at a pivotal moment. Care at home advocacy and hospice policy are shaping how home health policy and telehealth flexibilities will determine access, quality, and cost of care across America.

In this episode of Who Cares, hosts Elyssa Katz and Dr. Steve Landers, CEO of the National Alliance for Care at Home, take listeners inside the Alliance’s first-ever Advocacy Week, where more than 240 advocates held nearly 300 meetings on Capitol Hill to fight for the future of care at home.

This conversation breaks down why care at home advocacy is no longer optional—and why showing up matters now more than ever. Elyssa and Dr. Landers reflect on the power of uniting hospice, home health, Medicaid HCBS, and private-duty care under one movement, amplifying the voice of providers, patients, and families in Washington.

The episode explores the four key policy priorities advocates brought to Congress:

Protecting access to home health policy and preventing further Medicare reimbursement cuts
Keeping hospice policy out of Medicare Advantage
Strengthening Medicaid funding for home and community-based services (HCBS)
Making pandemic-era telehealth flexibilities permanent

Dr. Landers explains why hospice does not belong inside Medicare Advantage plans, detailing how prior demonstrations failed patients, providers, and payers alike. The conversation highlights how hospice already delivers high-value, cost-effective care—and why introducing prior authorizations and utilization management threatens something that is already working.

The episode also tackles Medicaid HCBS funding pressures, including workforce shortages, waitlists exceeding 700,000 people, and why underfunding front-line care puts vulnerable populations at risk. Elyssa and Dr. Landers emphasize that investing in Medicaid HCBS isn’t just compassionate—it’s fiscally responsible.

A critical portion of the discussion focuses on telehealth flexibilities, especially for hospice and home health certifications. With provider shortages growing and rural access shrinking, the hosts explain why telehealth is essential for maintaining access to care—and how government shutdowns and temporary extensions jeopardize patients today.

Throughout the episode, the hosts return to one central truth: numbers don’t inspire movements—stories do. From frontline nurses to caregivers and clinicians, advocacy works best when policymakers hear directly how policy decisions affect real people.

The episode closes with a hopeful look ahead to 2026, where demographic shifts, technology, and voter priorities make care at home not just relevant—but inevitable. Elyssa and Dr. Landers make a clear call to action: if you care about patients, families, and sustainable healthcare, advocacy isn’t someone else’s job—it’s yours.

0:00 Introduction
0:22 Advocacy Week Recap
3:44 The Power of Frontline Stories
7:42 Key Advocacy Issues
8:39 Keeping Hospice Out of Medicare Advantage
11:35 Medicaid Funding Challenges
14:18 Telehealth Flexibilities
19:43 Looking Ahead to 2026