Colleagues,

For years, home care medicine delivered value ahead of recognition. We cared for patients with extraordinary complexity, built longitudinal relationships, and demonstrated outcomes—often while policy and payment lagged behind the work.

That gap is finally narrowing. And it narrowed because this field showed up.

AAHCM members invested years in advocacy—often with little certainty that it would pay off—making the case that home-based care is not only compassionate, but accountable. That work is now being recognized in concrete, meaningful ways.

One clear example is G2211 in the home. While a fee-for-service code, G2211 is different from traditional volume-based payment. It is paid based on capability and patient complexity, not the number of visits delivered. In that way, it represents a true step toward accountable care—supporting practices that are built to manage risk, continuity, and longitudinal responsibility. Its expansion into the home has unlocked nearly $100 million nationally for practices doing this work.

That progress builds directly on the foundation established through Independence at Home, a shared-savings model that demonstrated how accountable home-based care could lower total cost while improving outcomes. IAH informed ACO REACH, and REACH, in turn, shaped the design of the LEAD ACO, launching in 2027. Through sustained engagement with CMMI, AAHCM had a seat at the table as LEAD was designed—pressing for a model that reflects the realities of complex patients and the practices that serve them.

We have also made targeted system-level gains. Working with aligned stakeholders, including the Complex Care Alliance, AAHCM helped advance long-overdue reform in skin substitute payment—another example of policy catching up to clinical reality.

At the same time, Hospital-at-Home has matured into a clinically credible, patient-preferred model of advanced care in the home. Congress has taken important short-term steps to maintain continuity, but the work is not finished. Permanent authorization and stable payment for Hospital-at-Home remain essential goals, and AAHCM will continue to press for them. This is an active front, not a closed chapter.

Recognition, however, is not an endpoint—it is a responsibility.

As payment improves and attention grows, the field will expand. Our obligation is to ensure that growth strengthens quality rather than diluting it. That means clear practice standards, published outcomes, sustained engagement with policymakers and like-minded organizations, and mentoring clinicians entering the field.

It also requires discipline in how we evaluate accountable care. The right question is not only whether a model shows savings in a given year, but whether payment reliably supports practices built to deliver better care and lower total cost over time—especially when early adopters carry the upfront work of proving the model.

AAHCM is the professional home for this work. If you are a member, your engagement helped make this moment possible—and it matters more than ever now. If you share these commitments but are not yet a member, I invite you to join us as we shape what comes next.

This is a moment we earned. Let’s keep building.

Respectfully,
Tom

Tom Lally, MD
AAHCM Board President
Bloom Healthcare, CEO