The federal government must invest further in home-based care, Empath Health CEO Jonathan Fleece told lawmakers at a hearing with the U.S. House of Representatives Ways & Means Health Subcommittee.

Fleece was among several post-acute care leaders who appeared at the hearing, representing home health, hospice, skilled nursing facilities, rehabilitation hospitals and other stakeholders. In opening remarks, Fleece pointed to the benefits of home-based care for patients and families, as well as the sector’s ability to reduce health care costs.

“Home-based care isn’t just for those actively dying. It supports people managing chronic illness, recovering from surgery and navigating terminal diagnoses,” Fleece said during the hearing. “Patients want it. Families need it, and taxpayers benefit. Keeping patients at home prevents costly hospitalizations and reduces strain on the health care system. Today, in a time of financial and workforce challenges, we should be expanding access to care at home, not cutting it.”

Empath Health has grown into one of the largest hospice providers in the nation. The organization currently provides home health care, palliative care, grief services, Program of All-Inclusive Care for the Elderly (PACE), adult day services, primary care services and more. It also operates 17 affiliates and two philanthropic foundations.

Empath now serves 1 in 5 hospice patients in its home state, the company reported. All told, the organization cares for 5,000 patients daily, employs more than 5,000 staff and 3,000 volunteers.

Fleece called out a range of threats to patients’ access to home-based care, including industry headwinds, regulatory snafus and malfeasance in the space.

“Today, access to this type of care is at risk. Hospice providers face immense pressure, thin margins, excessive audits and ineffective fraud enforcement. Bad actors exploit gaps in oversight, while high quality providers face excessive scrutiny,” Fleece said. “The flawed hospice Special Focus Program was built on incomplete data and risks destabilizing trusted providers instead of targeting those who truly abuse the system.”

He pointed to hospice programs in the United States that receive Medicare dollars but refuse to submit their quality and survey data to the U.S. Centers for Medicare & Medicaid Services (CMS).

“That practice should not be tolerated and fuels greater fraud and abuse by allowing some hospices to profit while avoiding transparency and regulatory scrutiny,” Fleece said.

He called on lawmakers to pursue three goals — expand government investment in home-based care, expand pay-for-performance models to “reward the high quality providers and hold those who evade accountability responsible,” and third, to enhance value-based care models.

“These are not just policy decisions,” Fleece told the subcommittee. “They are urgent threats to access quality and patient choice. Decisions here will shape the future of care at home. Let’s protect and expand access before it’s too late.”