Policy & Advocacy
Focused Advocacy.
Meaningful Progress.
AAHCM takes a deliberate approach to policy — working on a small number of priorities at a time, going deep rather than wide, and measuring success by what actually changes for patients and practices.
Why We Advocate
The Patients Policy Forgets
Home-based medical care reaches people that the traditional healthcare system was not designed to serve. Patients who are homebound, medically complex, and aging in place — who cannot easily get to a clinic, who need care that comes to them, who depend on longitudinal relationships with providers who know them and can manage the full picture of their health.
For decades, policy and payment were built around buildings. The office visit. The hospital bed. The assumption that care happens somewhere patients go, not somewhere care comes to them. That assumption has never matched the reality of millions of Americans — and the cost of that mismatch is paid in avoidable hospitalizations, fragmented care, and patients who fall through the gaps.
The good news is that this is changing. The gap between the value home-based care delivers and the recognition it receives is finally narrowing. Payment models are beginning to reflect the complexity of what we do. Acute care is beginning to follow patients home. And policymakers are beginning to understand that the home is not a workaround — it is often the right place for care.
AAHCM's job is to accelerate that shift. Not by pushing on every front at once, but by being strategic — choosing the battles where we can win, building the relationships that make change possible, and showing up with the evidence and persistence it takes to move policy in a field that has waited long enough.
Our Strategy
AAHCM's approach to advocacy is intentional. We work on one or two things at a time, go deep on those priorities, and measure success by what actually changes — not by how many positions we've staked out. This focus is what allowed us to win on G2211, to help shape the design of the LEAD ACO, and to stay engaged through the years-long effort to secure Hospital at Home's future. We'd rather move one thing meaningfully than talk about ten things abstractly.
2025 Highlight
A Major Win: G2211 Comes Home
G2211 Now Available for Home-Based Primary Care
G2211 is a complexity add-on code that recognizes the longitudinal, comprehensive nature of primary care — the kind of care that home-based practices deliver every day. When CMS introduced G2211 in 2024, it applied only to office-based settings. Home-based primary care was explicitly excluded.
AAHCM spent the better part of a year making the case that this exclusion made no clinical sense. Home-based providers manage the same complexity — often more of it — and serve as the primary point of contact for some of the most medically fragile patients in the country. With the final 2026 Medicare Physician Fee Schedule rule, CMS agreed. G2211 is now billable during home visits, effective January 1, 2026.
This is not a volume-based payment. It is paid based on the capability of the practice and the complexity of the patient relationship — a meaningful step toward recognizing what home-based care actually does.
Current Focus Areas
Where We're Working Now
1
Sustainable Payment for Home-Based Visits
Fee-for-service payment that reflects what home-based care actually is
Home visits are not simpler versions of office visits. They require more time, more clinical judgment, and more coordination — often with patients who have nowhere else to go. For too long, payment rates have not reflected that reality.
G2211 is a significant step forward, and we intend to build on it. Our focus here is ensuring that fee-for-service payment for home-based evaluation and management — including home-based primary care — keeps pace with the complexity and value of what these practices deliver.
2
Value-Based Care Models Built for Our Patients
Accountability that reflects the realities of high-risk, home-based practice
Home-based primary care practices are natural candidates for value-based care — we manage risk, reduce hospitalizations, and build the longitudinal relationships that lead to better outcomes. But not every VBC model is designed with our patients in mind.
AAHCM has engaged directly in the design of the LEAD ACO model, which launches in 2027. We pushed for a model that accounts for the extraordinary complexity of homebound and near-homebound patients — because accountability models calibrated to average-risk populations don't work for practices whose patients are anything but average. We will continue to engage as LEAD is implemented and future models are designed.
Context: The path to LEAD runs through Independence at Home, which demonstrated that accountable home-based care could lower total cost while improving outcomes — and through ACO REACH, which carried those lessons into broader practice.
3
A Permanent Home for Hospital at Home
Turning a temporary waiver into a durable part of American healthcare
The Consolidated Appropriations Act, 2026 extended the CMS Acute Hospital Care at Home waiver through September 30, 2030.
But 2030 will come. The work of the next several years is to use this window to build the evidence base, establish quality standards, and make the policy case for Hospital at Home as a permanent feature of Medicare — not a recurring emergency extension. The clock is running, and the field needs to be ready.
Our role: AAHCM advocates for Hospital at Home as part of our broader commitment to home-based medical care, and works closely with the Hospital at Home Users Group on shared priorities.
Help Shape What Comes Next
Advocacy is most effective when practitioners are part of it. AAHCM members can make their voices heard.