Visit the website of Ness County Hospital in Ness City, KS, and you’ll see a sobering “Update” pinned to the Home Health Department’s homepage.

The update states that rising financial and operational demands have led the hospital to discontinue its Home Health Skilled service line. The hospital promises a “smooth and compassionate transition” for affected individuals.

Sadly, Ness County Hospital is not the only home health provider in the nation struggling to fulfill its mission to serve vulnerable patients in their own homes.

On July 8, 2026, Cattaraugus County announced that New York State had approved a request to close its certified home care agency after the 2025 county budget slashed wages by half. The county health department explained that “efficiently operating a Certified Home Care Agency remains unduly burdensome due to outdated and unchanged insurance reimbursement rates and heavy pressure from competition within the market.”

Two months later, on September 1, Altru Health System in Grand Forks, ND, cited regulatory pressures when it announced it would discontinue its home health services, according to Becker’s Hospital Review.

There are some bright spots, however fleeting. In January, for example, Northwest Colorado Health in Steamboat Springs, CO, announced it was losing $1 million annually while serving 300 patients at home. Rather than closing, the nonprofit launched a campaign to raise $3 million over three years. Almost a year later, it’s still providing services while hosting fundraisers and lobbying for higher reimbursement rates.

Anyone reviewing these stories should have serious concerns about the future of home health services nationwide. Taken together, the stories should prompt a simple question:

What’s wrong with this picture? In my view, many things are wrong.

At a time when health care costs are rising—and home health agencies are struggling to serve a growing older population—we must ask why government funders are making it so difficult for aging services providers to serve vulnerable individuals in their preferred setting: their own homes. Does it make sense to cut funding for home health care when demand for these services is already high and expected to grow exponentially?

Inadequate funding has been top of mind for LeadingAge for as long as I can remember, and it has become increasingly challenging and dangerous over the years. We’re proud of our work, particularly last year’s success in persuading the Centers for Medicare and Medicaid Services (CMS) to reverse some of the significant negative payment adjustments it had imposed over the past four years. Even with those reversals, CMS maintains that home health providers still “owe back” $4.9 billion to Medicare. This creates an unstable operating environment for many home health providers, including LeadingAge members.

We continue to make a strong case for CMS to reverse even more of these negative adjustments in the CY 2027 final home health rule, which will be released in November. Once we reach this important goal, we intend to spark a broader conversation about home health—one focused on redesigning the home health benefit to better meet the needs of an aging America.

We need your help with this challenging mission. We want to hear your stories about the people you serve, the cost of the care you provide, and the challenges—including staffing issues—you face in fulfilling your mission. We also want to know which services your government reimbursement allows you to provide—and which services you’d like to offer but can’t due to insufficient payments or regulatory restrictions.

To find these answers, we’d like to meet with as many home health providers as possible during the LeadingAge Annual Meeting, Oct. 25-28 in Philadelphia. We’re hosting a special breakfast for these providers on Sunday, October 25, at 10 a.m. In addition, we’ll discuss Medicare’s home health benefit during several conference sessions that I hope you will attend: “Surviving Uncertainty to Fulfill the Home Health Promise” on Monday, October 26, at 4:30 p.m., and “Long-Term Care Financing Reform: Has the Moment Arrived?” on Tuesday, October 27, at 3 p.m. 

I also invite you to connect with other home health providers and LeadingAge team members through the LeadingAge Home Health Network and to share your thoughts on our 2027 Policy Platform, which is currently in development.

As you might expect, our team of policy experts has many ideas about what a redesigned Medicare home health benefit might include. But before we develop an actionable policy agenda, we must ensure our ideas are grounded in the reality of your caregiving experience. That’s why we’re seeking your input.

At LeadingAge, we believe it’s time to reset the Medicare home health benefit. But we can’t achieve that goal without your help. We look forward to hearing from you.