Telehealth flexibilities, Hospital at Home get much wished-for extensions

Good news for telehealth advocates: Congress has finally provided some certainty around two popular areas of remote care with funding extensions enshrined into law.  

In the latest tussle over government appropriations, telehealth was a clear winner with a two-year extension of the COVID-era Medicare telehealth flexibilities and a five-year extension of the Medicare Hospital at Home program. 

Both programs suffered significantly during the historically long government shutdown toward the end of 2025, reinvigorating calls for meaningful extensions that could allow providers to confidently invest in remote and home-based care. 

“At a time of political volatility, telehealth continues to stand out as a core bipartisan priority, demonstrating the strength, credibility, and persistence of our sustained advocacy efforts. Our priorities were reflected throughout the funding package and I’m proud of the role ATA Action has played over the past five-plus years,” added Alexis Apple, vice president of public affairs at the American Telemedicine Association (ATA) and deputy executive director of ATA Action. “These extensions provide critical stability and certainty for patients and healthcare providers but also underscore the work still ahead.” 

Telehealth flexibilities expand availability of virtual care until 2027 

It’s been a bumpy road for telehealth in Medicare since the start of the pandemic, when CMS adopted certain flexibilities designed to compensate for the lack of in-person care.  

The flexibilities included removing geographical restrictions on originating sites for telehealth services, expanding the type of providers who are eligible to deliver telehealth services, removing barriers to the delivery of mental and behavioral healthcare services, and allowing audio-only telehealth services if patients can’t or don’t want to use video. 

Providers have advocated again and again and again for a permanent extension of these new rules, since they significantly ease burdens and allow for a broader range of care to be delivered to more patients. But Congress has been reluctant to commit, offering only short-term funding when forced to it by looming deadlines.  

The latest action would give providers another two years of certainty, with the new rules set to expire again on December 31, 2027. It’s not everything that advocates have hoped for, but it should be enough to catalyze additional investment in a care delivery modality that has remained extremely popular with patients, especially those in rural areas and those with health or socioeconomic issues that limit their ability to receive in-person care.  

Hospital at Home gets solid five-year extension to build upon 

In the same appropriations package, Congress granted the Medicare Hospital at Home program a five-year reprieve, which will give providers and policymakers more time to refine the program and collect data on its safety, efficacy, and potential for cost savings. 

More than 413 hospitals in 39 states have launched their own versions of the program, which enables patients with acute but stable conditions to receive inpatient-level care at home via remote patient monitoring.  Early data from CMS indicates that at-home hospital care can show positive clinical and cost outcomes along with high patient satisfaction rates. 

The American Hospital Association (AHA) has been among the initiative’s biggest supporters, asserting that high-quality in-home care is essential for freeing up scarce resources in the inpatient setting while keeping patients more comfortable in their own homes.  

The extension will be essential for generating additional evidence about the utility of at-home acute care, which may in turn encourage other payers, including Medicaid, to invest in similar initiatives, the AHA has said. 

What it means for healthcare providers and health systems 

With a reliable foundation of Medicare funding for remote care, providers can ramp up investment in virtual technologies with a greater degree of certainty that the spending will generate appropriate revenue.   

This could spark a new wave of innovation in remote monitoring devices and comprehensive home care systems, especially as artificial intelligence continues to drive advanced capabilities in patient-facing and provider-facing clinical tools.  

If health systems can take advantage of the more stable funding environment to create a strong digital foundation for enhanced remote care, the results could be transformative for patients while significantly reducing administrative and clinical burdens on providers who are simply running out of time, space, and staffing to address the continuously rising needs of an aging population. 

Jennifer Bresnick is a journalist and freelance content creator with a decade of experience in the health IT industry.  Her work has focused on leveraging innovative technology tools to create value, improve health equity, and achieve the promises of the learning health system.  She can be reached at [email protected].