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At Home Health Care News’ FUTURE conference in August, Paul Kusserow argued that home health needs to expand beyond episodic clinician visits. He described a model combining skilled services with trained family caregivers, technology, support for daily needs and accountability for longer-term outcomes.
Paul Kusserow, CEO and executive chairman of Careforth and chairman of Elara Caring, said home health providers should move beyond episodic, clinician-led visits toward longer-term models that combine skilled care, trained caregiver support, technology and value-based accountability. He made the case at Home Health Care News’ FUTURE conference in August, arguing that the traditional approach may not meet the needs of people living with chronic illness.
Kusserow said providers will need to combine clinical services with help from family members, personal care workers and community resources. That includes attention to activities of daily living (ADLs) and social factors that affect health, alongside care for higher-acuity and disease-specific needs. He said supporting those needs is part of managing medically complex patients over a longer period, particularly if providers take financial risk for outcomes.
He pointed to Careforth’s caregiver-support model as one example. The Boston-based company works with caregivers in nine states, offering training, technology, clinical backup and other resources. Kusserow said it identifies family members or other people in the home of someone receiving a Medicaid waiver, trains them and pays them. He described compensation of $50 a day for 24/7 care, with support and breaks also available.
Kusserow also said data could help providers recognize when a patient needs more involvement and which actions may be appropriate. As an example, he described the potential value of drawing on information about thousands of people with congestive heart failure. He said technology can support continuity and individualized data collection, but did not provide outcome results or specify a particular technology platform.
A Broader Model for Chronic Care
The proposal matters because it reframes home health as more than a series of clinical visits. People living with chronic conditions may need sustained help at home, including practical assistance and caregiver support alongside skilled services. Kusserow argued that combining those resources could help providers care for people outside hospitals and other institutions, though he did not present evidence that this model has already reduced admissions or costs.
The approach also speaks to the economics of long-term care. Kusserow said repeated hospitalizations can be economically unsustainable for government payers and health plans when people live with diseases for years. A move toward more home-based, disease-specific care could give providers a larger role in managing those needs, especially as payment arrangements increasingly hold them accountable for outcomes. The scale and financial effects of that shift remain unquantified in his remarks.
Family caregivers are a major part of the picture. AARP’s latest estimate, cited in the source report, valued adult caregiving by family members at $1.01 trillion in 2024. It estimated that 59 million people helped an adult family member, neighbor or friend with daily activities that year; 63% provided care each month. Those figures describe the unpaid caregiving contribution, not the results or reach of Careforth’s specific program.
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Kusserow’s Home-Care Roles
Kusserow has held leadership positions across home-based care and the broader health industry. He led Amedisys as CEO and chairman from 2014 to 2025. UnitedHealth acquired the company in a $3.3 billion deal that closed in August 2025. Kusserow became Careforth’s CEO in June 2026 and joined Elara Caring’s board in August, while serving as executive chairman of Careforth and chairman of Elara Caring.
Careforth provides payment and support for home-based caregivers across nine states. Elara Caring, based in Dallas, provides skilled home health, hospice, behavioral health and personal home care across 18 states. The companies operate across different parts of home-based care; the source report does not say that Elara has adopted Careforth’s caregiver-payment model.
In his conference remarks, Kusserow described the proposed direction as the “next version” of home health. His argument is that providers should build a longer-term care structure around clinical services rather than treating visits as the whole model. He called for providers to move up the acuity chain and develop specialized approaches for particular diseases, while equipping caregivers to handle non-clinical tasks.
““That’s going to be a combination of skilled care and unskilled care.””
— Paul Kusserow, speaking at HHCN’s FUTURE conference
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Evidence and Implementation Questions
Kusserow described a direction for the industry, not a detailed rollout plan. His remarks did not specify how providers should finance broader caregiver compensation, what payment arrangements would support the proposed services or how programs would measure whether they improve patient outcomes. The source report also provides no comparative evidence on hospital use, costs or quality for Careforth’s approach.
The $50 daily payment he cited applies to Careforth’s described arrangement for 24/7 care; the report does not detail eligibility rules, the number of caregivers or participants covered, or how the amount varies by state. It is also unclear how widely the model could be applied beyond Medicaid waiver settings. The potential role of technology and large-scale patient data remains a proposal in the remarks, with no specific tools, privacy safeguards or implementation timetable identified.
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Provider Models and Payment
The next steps depend on whether home health providers, payers and public programs turn the ideas Kusserow outlined into operating and payment models. Providers would need to define how clinical teams work with trained family caregivers, how they address ADLs and social needs, and how they take responsibility for more complex, disease-specific care. Payers and policymakers would also have to determine what services and caregiver support they will fund.
No launch, policy change or timetable was announced in the source report. The developments to watch are whether providers expand caregiver training and compensation, publish evidence on patient and cost outcomes, and adopt data systems that support care beyond individual visits. Until those details emerge, Kusserow’s remarks are best understood as an industry vision rather than confirmation of a sector-wide change.
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Key Questions
What did Paul Kusserow propose for home health?
He called for a model that combines skilled care with caregiver support, technology and longer-term accountability, rather than relying mainly on episodic clinician visits.
What does Careforth provide to family caregivers?
Kusserow said Careforth offers caregiver training, technology, clinical backup and other resources. He described a program that can identify, train and pay family members or others in the home of a person receiving a Medicaid waiver.
What payment amount did Kusserow cite?
He said Careforth pays $50 a day for 24/7 care in the model he described. The report does not give details on eligibility, enrollment or how the payment varies across its service area.
Did Kusserow announce a new industry program or policy?
No. He outlined his view of home health’s future at an August conference. The report did not announce a new program, regulatory change or sector-wide implementation plan.
What remains unknown about the proposed model?
The remarks did not establish whether the approach improves outcomes or lowers costs, how providers would fund expanded support, or what technology and data protections would be used.
Source: rss
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