One of the most important transformations in American healthcare is taking place outside hospitals and nursing homes.
Advances in artificial intelligence, telehealth, remote monitoring, home health services, and new care delivery models are making it possible for more Americans to receive high-quality care in the place they most want to be: their own homes.
For seniors, this transformation represents an extraordinary opportunity. Most older Americans want to remain in their homes, maintaining their independence and connection to family and community. Aging in place is not simply a personal preference. It is a matter of dignity and quality of life.
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President Donald Trump recognized this reality when he pledged to help seniors remain in their homes longer. Since returning to office, his administration has taken meaningful steps toward this goal. Earlier this year, President Trump signed legislation extending Medicare’s Acute Hospital Care at Home program through 2030, allowing eligible seniors to receive hospital-level care without leaving their homes. His administration has continued implementation of the GUIDE dementia model, helping patients with Alzheimer’s disease and related conditions remain at home longer while supporting family caregivers. It has also preserved Medicare telehealth flexibilities that allow more care to be delivered directly to patients rather than requiring unnecessary trips to hospitals and clinics.
Together, these initiatives point toward a broader vision for healthcare: bringing care to the patient rather than forcing patients into institutions. For many seniors, this means receiving care in a more comfortable setting while maintaining greater independence and stronger family connections.
Yet the success of home-based care depends on public confidence that these programs are operating as intended. Unfortunately, recent years have revealed that some of the very programs designed to help seniors remain independent have become attractive targets for fraud. Home health services, hospice care, personal care services, and other home-based benefits have increasingly been exploited by bad actors seeking to profit from Medicare and Medicaid.
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The examples are troubling. In Los Angeles County, investigators identified an extraordinary concentration of hospice and home health providers, including more than 100 hospices operating from a single office building. Investigators have also uncovered sophisticated home health fraud networks that repeatedly cycled the same Medicare beneficiaries among multiple agencies to generate new rounds of federal payments while avoiding traditional fraud detection systems.
While its not specific to eldercare, the recent announcement that more than 1 million people signed up for Obamacare benefits without valid Social Security numbers is alarming.
Every major expansion of healthcare benefits depends on public trust. If taxpayers conclude these programs are vulnerable to widespread waste and abuse, support for continue
