Telehealth, Hospital at Home at stake during government funding debate

Expanded telehealth and home care access was one of the few good things to come out of the COVID pandemic, with providers and patients alike benefitting from a series of rule changes that allowed for more consistent, flexible use of home-based technologies and modern audio, video, and online chat tools. 

But with the usual political tug-of-war unfolding around special interest demands for the new year’s governmental budget, a series of well-liked initiatives could be at risk of expiring. 

This year, the Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act of 2025 includes provisions that would extend certain temporary telehealth flexibilities, such as: 

• Allowing Medicare patients to receive telehealth in their homes  

• Removing previous restrictions that limited the originating site and provider types eligible to deliver telehealth services 

• Allowing cardiopulmonary rehab services to be provided via telehealth at a Medicare beneficiary’s home during 2025 and 2026 

• Removing the requirement for an in-person visit within six months of an initial behavioral/mental telehealth service (and annually thereafter) 

Also at stake are extensions of key programs related to remote care, most notably a 5-year extension of the Acute Hospital at Home program, which has captured interest from patients – as well as from some leading professional societies and high-profile health systems who have devoted significant resources to shifting care out of the inpatient setting.  

Some research indicates that Hospital at Home programs can reduce costs and ease labor constraints without compromising on the quality of care, which has sparked interest from overburdened hospitals looking for ways to improve efficiency. On the other hand, skeptics point to the challenges of scaling these strategies and have expressed concerns that initial financial results won’t necessarily carry through in the long-term.  

Other remote care provisions include a 5-year extension of the Medicare Diabetes Prevention Program (MDPP) Expanded Model, which allows beneficiaries to participate in diabetes coaching and prevention activities both virtually and in person. The bill would also enact the SPEAK Act, which requires HHS to share best practices on providing accessible telehealth services to non-English speakers.  

Telehealth advocates like the American Telehealth Association (ATA) applauded Congress for considering extending and expanding remote care access and urged lawmakers to move quickly to enact the changes before the end of the year. 

“This Telehealth Super Bowl is going right down to the wire,” said Kyle Zebley, SVP of public policy at the ATA and executive director of ATA Action. “The extensions in this proposed legislation are very meaningful for countless Americans and would give our healthcare providers and hospital systems some certainty and the confidence needed to continue to invest in needed telehealth services. 

“This has been years in the making, and we must ensure that these extensions are kept intact as they go to vote in both chambers of Congress and then on to President Biden for signature.”  

Generally, telehealth has received strong bipartisan support, which bodes well for the programs in question, some of which have already been extended after COVID’s main public health emergency declaration was ended.  

However, anything can happen in a deeply divided and tumultuous political environment, and it is possible that these initiatives could serve as bargaining chips in a larger game.  

Hopefully, lawmakers will recognize the benefits of continuing down the path of remote care delivery and quickly secure extensions for the flexibilities that have made high-quality care more accessible to vulnerable and underserved Medicare beneficiaries.  

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 jennifer@inklesscreative.com.