Home-Based Care

CMS’s nationwide six-month moratorium on new Medicare enrollment for home health agencies and hospices signals a sharper Trump administration fraud-control posture in home-based care and could constrain market entry while advantaging established operators with compliant infrastructure (CMS enrollment moratorium). At the same time, value-based home-care models remain under pressure to prove scalability: the Independence at Home experience points to persistent challenges in expanding intensive home-based primary care beyond select high-need populations, even as the Home Health Value-Based Purchasing Program is being linked to reduced dementia-care disparities. For ACOs and payer strategists, the strategic tension is clear: home-based care remains central to managing frailty, avoidable utilization, and total cost of care, but CMS is pairing payment innovation with tighter program-integrity controls and evidence demands (IAH scaling problem.