[Updated] Landmark Choose Home Bill Introduced in the House

The Choose Home Care Act of 2021 was introduced in the U.S. House of Representatives early Friday morning.

The legislation was previously introduced in the Senate at the end of July.

If enacted, the landmark Choose Home legislation would create an add-on payment to the traditional Medicare Home Health Benefit, allowing providers to mix in telehealth, transportation, personal care and other services. The goal of the concept is to give nursing home-eligible Medicare beneficiaries more options as to how and where they recover following a trip to the hospital.


The House version of Choose Home was sponsored by U.S. Reps. Henry Cuellar (D-Texas) and James Comer (R-Ky.).

Since being introduced in the Senate, Choose Home has received “an outpouring of support from America’s home health community as well as consumer and patient advocates,” National Association for Home Care & Hospice (NAHC) President William A. Dombi said in a statement released shortly after the bill’s introduction.

“[We believe that] demonstrates how important it is to increase access to safe, cost-effective care at home for Medicare beneficiaries after hospitalization,” Dombi continued. “We commend Reps. Cuellar and Comer for their leadership on issues impacting the delivery of home care and are excited to see this bill introduced in the U.S. House.”


So far, the House version of Choose Home is also co-sponsored by Reps. Sanford Bishop, Jr. (D-Ga.), Brendan Boyle (D-Pa.), Buddy Carter (R-Ga.), Dwight Evans (D-Pa.) and Vicente Gonzalez (D-Texas). Lawmakers Brian Higgins (D-N.Y.), Clay Higgins (R-La.), Eleanor Holmes Norton (D-D.C.), Mike Johnson (R-La.), Tom O’Halleran (D-Ariz.), Tom Suozzi (D-N.Y.) and Paul Tonko (D-N.Y.) also have backed the legislation.

U.S. Sens. Debbie Stabenow (D-Mich.) and Todd Young (R-Ind.) are the lead sponsors of the Senate version, which also has drawn plenty of co-sponsors and bipartisan support.

In addition to NAHC, Choose Home is supported by AARP, LeadingAge, Allies for Independence, the National Council on Aging, Moving Health Home, the Council of State Home Care & Hospice Associations and the Forum of State Associations.

The Partnership for Quality Home Healthcare (PQHH) is likewise a major advocate for Choose Home.

“We applaud Reps. Cuellar and Comer, and all the original co-sponsors, for recognizing the value of home health and the importance of advancing legislation to increase seniors’ care options after hospitalization,” PQHH Executive Director Joanne Cunningham said in a statement. “With their support, we are hopeful we will see the Choose Home Care Act enacted this year in order to help us better protect our nation’s vulnerable aging and sick populations while also modernizing the Medicare Home Health Benefit.”

‘It’s the right move’

If it makes it out of Congress, Choose Home would generate an estimated $247 million in annual savings to the Medicare system, with the majority of that coming from reduced skilled nursing facility (SNF) utilization, a Dobson DaVanzo & Associates analysis found.

In its design, Choose Home is meant for beneficiaries who require no more than 360 hours of medical supervision, support or care over the course of a 30-day home health stay.

By allowing providers to utilize all of the tools in their toolbox, including a mix of medical and non-medical services as well as social determinants of health support, Choose Home would take home health care to the next level, industry leaders believe.

“I’m excited about the legislation,” Dorothy Davis, the president and CEO of Visiting Nurse Health System (VNHS), said at the Home Health Care News FUTURE conference. “I think it’s the right move for consumers.”

The Atlanta-based VNHS is a nonprofit home health, hospice and home care organization that cares for roughly 6,500 patients across all of its service lines.

Also speaking at FUTURE last week, LHC Group Inc. (Nasdaq: LHCG) Chairman and CEO Keith Myers suggested a House introduction of Choose Home was imminent.

“There are about 2 million patients a year that are admitted to SNF,” Myers said at FUTURE. “And we believe that roughly 35% of those could be cared for under Choose Home.”

The word in Washington

As far as what’s next for Choose Home, the legislation will eventually need to be scored by the Congressional Budget Office (CBO).

CBO is currently swamped with 15 to 25 requests per day associated with the ongoing reconciliation package that Democrats are attempting to pass, however. Realistically, CBO will have more time to start looking at Choose Home in three to four weeks.

After that, Choose Home could be passed into law a few different ways.

While the current reconciliation package is perhaps unlikely for a variety of reasons, some foresee another reconciliation attempt early next year. This year, there’s the end-of-year budget package around December, along with the upcoming Medicare Extenders package.

A big advantage Choose Home has is its bipartisan support.

In fact, one long-time Washington insider told HHCN Choose Home’s list of co-sponsors is one of the most diverse groups he’s ever seen, with backers from the far left and the far right, plus multiple lawmakers who are more moderate.

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