Hospices are facing a sea of uncertainties in the wake of Wednesday’s presidential election results.

Donald Trump has been elected as the 47th president of the United States. The former president received the majority of popular and electoral votes over Vice President Kamala Harris.

Hospice and home health providers will need to work with policymakers to address the needs of seriously and terminally ill populations, said Tom Koutsoumpas, CEO of the National Partnership for Healthcare and Hospice Innovation (NPHI) in an announcement shared with Hospice News. But for now, unanswered questions persist.

“With President-Elect Trump returning to the White House and a Republican majority in the Senate, we anticipate a shift in policy direction across several areas, as well as the introduction of new initiatives,” Koutsoumpas said. “The potential continuation of House leadership (still uncertain at the time of this writing) will also play a significant role in shaping the direction of health care efforts. The final makeup of Congress will directly influence which legislative priorities are most likely to advance.”

Top issues to address

Hospice and home health providers are traversing through many uncertainties as the impacts of the election results unfold, said Katie Smith Sloan, president and CEO of the senior care advocacy group LeadingAge.

“There are still many unknowns,” Smith Sloan said in a press release shared with Hospice News. “Near-term, we will focus on working with the Trump transition teams to share LeadingAge’s agenda and to gain a clear understanding of the new administration’s housing, aging, health- and long-term care goals. As we learn more, we’ll have a better understanding of their potential impact on our members and those they serve — wherever they call home. That’s our top priority in the short term.”

Among the crucial issues that the incoming administration will likely need to address are the program integrity concerns that have been heating up, according to Dr. Steve Landers, CEO at the National Alliance for Care at Home.

Poor, negligent and fraudulent operators in the space have led regulators to bolster federal and state oversight. Some of these hospice regulatory changes have “gone wrong” and “hurt access” to care, Landers stated in an Axxess webinar on Wednesday. Among them is the Special Focus Program (SFP), which the U.S. Centers for Medicare & Medicaid Services (CMS) implemented through its 2024 home health rule. While industry organizations have voiced support for the SFP as a concept, they have raised questions about the execution. The largest hospice industry organizations have urged congressional lawmakers to revamp the algorithm, including the Alliance, LeadingAge and NPHI.

A new administration has the opportunity to make meaningful changes from both quality and business sustainability standpoints, Landers indicated.

“In the hospice world, we have a Special Focus Program that was intended to identify poor quality providers and support continuous improvement, but the approach has been toxic,” Landers said. “The methodology is not aligned with the goal of the [hospice] program, and there’s regulatory failure. I’m optimistic that maybe this is a chance on the regulatory front … for us to make sure that organizations that are committed to care at home are supported and empowered in the way they should be, because we can make a difference. We are in the right spot for creating value for families and for the health care system.”

The health care issues percolating in this year’s presidential election signal that seniors nationwide have grown increasingly concerned about their ability to receive care in the home as they age, said E.J. Dionne, senior fellow, at the Brookings Institution. Dionne is also a columnist at The Washington Post and professor in the foundations of democracy and culture at Georgetown University.

As the election results pan out, another uncertainty is whether there will be substantial cuts to Medicare funding on the horizon, Dionne stated. Higher rates of Medicare spending in recent years have ignited conflicting views around future reimbursement rate increases, and political climates can have direct impacts on the payment outlook, he added.

“Long-term care and home care are issues that are going to be with us as baby boomers age,” Dionne said during the webinar. “Substantial cuts to Medicare are not popular [but] we may see some big fights in that area. There’s a possibility of a big debate over health care in the coming Congress. The combination of long-term care and home care is definitely on the table for our future. It’s going to be a very interesting and complicated path to navigate.”

Weighing the opportunities

This year’s election results could propel policies that focus on less regulation and greater business accountability and scalability in the health care industry, according to Ander Crenshaw, senior advisor of government advocacy and public policy at legal firm King & Spalding. Former Rep. Crenshaw (R- Florida) previously served in the U.S. House of Representatives from 2001 to 2017.

The next administration will need to explore greater opportunities for more cost-effective health care delivery, Crenshaw indicated. Access to affordable quality care will in part hinge on how legislators approach policies related to technology utilization, he stated.

Opportunities exist for bipartisan support around improved health care policies, including those related to home care and hospice access, according to Crenshaw.

“There’s an opportunity to deliver health care services that are very critical but in a more efficient way,” Crenshaw said during the Axxess webinar. “To a large extent technology has helped us get there. There’s a great opportunity to not only help solve the health care crisis, but also help deal with our solvency crisis [and] how we get a handle spending. It’s very easy to see this is an area that you can still deliver quality health care and make it more accessible and actually make it less expensive. We can solve two problems for the price of one, the access problem as well as the cost problem.”

Accessibility will be at the forefront of future health care policies, said Jason Lee, CEO of the Home Care Association of America (HCAOA).

The home care trade association recently issued a statement highlighting potentially beneficial policies outlined by President-Elect Trump. Some of the policy initiatives proposed include creating a tax credit for family caregivers, expanding home care options for veterans and their families, and introducing new immigration policies designed to bolster the health care workforce, according to the HCAOA.

“HCAOA is committed to making home care more accessible and affordable and looks forward to collaborating with all policymakers, including President-elect Trump and Congress, to enact or enhance policies that efficiently and effectively meet the needs of seniors and those in need,” Lee said in a statement emailed to Hospice News.