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Paul Kusserow said home health providers need to move beyond episodic clinician visits toward longer-term models combining skilled care, family caregivers, technology and support for daily needs. He pointed to caregiver training and payment, disease-specific services and better use of patient data as parts of that approach. The report does not describe a new policy or formal Careforth program announcement.
Paul Kusserow, the CEO and executive chairman of Careforth and chairman of Elara Caring, said home health providers should move beyond a model centered on episodic clinician visits and build longer-term care that combines skilled services, caregiver support, technology and value-based accountability. He made the case at HHCN’s FUTURE conference in August, arguing that a broader approach is needed to support people living with chronic illness at home.
Kusserow said that longer-term home care has to address more than clinical needs. It also depends on support with activities of daily living (ADLs), social determinants of health and the people who provide routine help in the home. “That’s going to be a combination of skilled care and unskilled care,” he said, adding that these needs matter when providers take on responsibility for patients over time and assume financial risk for their care.
He pointed to Careforth’s caregiver-support model as one example. The Boston-based company works with family members or others in the home of people receiving Medicaid waivers, training and paying them to provide care, Kusserow said. He described compensation of $50 a day for 24/7 care, alongside resources, clinical backup and breaks. Careforth operates across nine states, according to the report.
Kusserow also called for providers to develop services for people with higher-acuity and disease-specific needs, rather than rely only on recurring visits. He said data from large groups of people with the same condition could help providers identify risks and decide when to intervene. Technology, he added, can support continuity and help caregivers and clinicians track changes in an individual’s condition.
Care Models Beyond Clinician Visits
The proposal matters because home health providers face a mismatch between a visit-based business model and the prolonged support many people with chronic conditions may need. Kusserow argued that relying on repeated hospital or institutional care is not economically sustainable for health plans or government payers, while better-supported care at home could help manage conditions outside those settings. That is his assessment, not a measured outcome or a forecast backed by results in the report.
Bringing family caregivers into a formal care plan could also make their work more visible and supported. AARP estimated that 59 million family caregivers helped an adult family member, neighbor or friend with daily activities in 2024, assigning that care an economic value of $1.01 trillion. These figures describe caregiving in that year; they do not establish how much care a particular payment model could shift or what results it would produce.
For providers, the approach would mean taking responsibility for a wider set of needs, including non-clinical assistance and caregiver training. It would also require the ability to manage higher-acuity patients and use data in ways that inform timely care. The report does not provide evidence that Kusserow’s suggested model has been adopted across the industry or quantify its effects on costs or health outcomes.
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Kusserow’s Home-Care Roles
Kusserow has held leadership roles across home-based and broader health care. He led Amedisys as CEO and chairman from 2014 through 2025. UnitedHealth acquired the company in a $3.3 billion deal that closed in August 2025. He became Careforth’s CEO in June 2026 and joined Elara Caring’s board in August, according to Home Health Care News.
Careforth supports home-based caregivers through payment, resources and services. Elara Caring, based in Dallas, provides skilled home health, hospice, behavioral health and personal care in 18 states. The distinction between these businesses is relevant to Kusserow’s comments: his proposal spans both clinical home health and the non-clinical assistance that family and other caregivers may provide.
The conference remarks came as the sector considers how to serve an aging population and people who live for years with chronic conditions. AARP’s 2024 caregiving estimate offers a measure of the scale of unpaid adult care, but it does not show the share that could be covered by paid programs or the costs of expanding them.
“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 Rollout Remain Unclear
The report presents Kusserow’s views and describes Careforth’s approach, but it does not provide comparative data showing whether caregiver payment and training reduce hospital use, improve patient outcomes or lower total spending. It also does not specify how widely the described $50-a-day arrangement is offered, how eligibility is determined, or how the amount relates to care costs in different states.
It remains unclear how other providers would finance and staff a broader model, how clinical responsibility would be divided between professionals and family caregivers, and what data or technology standards would be needed. No new regulatory change, industry-wide commitment or formal expansion plan was announced in the report.
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Provider Decisions and Evidence
The next steps are for providers and payers to decide whether and how to expand caregiver training, compensation, clinical backup and disease-specific home services. They would also need to set clear boundaries around which tasks caregivers can perform and how clinicians respond when patient data indicate a need for care.
Further information about Careforth’s program scope, its results and any planned changes would help show how Kusserow’s example works in practice. The report does not name a launch date, new initiative or follow-up milestone. For now, the development is a public case for a broader model, rather than a confirmed industry shift.
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Key Questions
What change is Kusserow calling for?
He said home health should move beyond episodic clinician visits and combine skilled care, daily support, family caregivers, technology and accountability for longer-term outcomes.
What does Careforth do for family caregivers?
Kusserow described Careforth as training and paying family members or others in the home of some people receiving Medicaid waivers, with resources, clinical backup and breaks. He cited $50 a day for 24/7 care; the report does not detail the program’s full eligibility rules or reach.
Why does Kusserow say home care needs to change?
He argued that chronic conditions require support over time and that repeated hospitalizations are not economically sustainable for payers. Those points are his rationale; the report does not provide outcome data proving a particular model will reduce costs or hospital use.
Has the home health industry adopted this model?
The report does not say that the industry has adopted it. It describes Kusserow’s recommendations and Careforth as an example of caregiver support, without announcing an industry-wide change.
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