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Paul Kusserow said home health providers should expand beyond episodic clinician visits and combine skilled care with trained family caregivers, technology and support for daily needs. He argued that this broader approach could help providers care for people with chronic illnesses at home over longer periods, but the financial and operational details of scaling it remain unclear.
Paul Kusserow, Careforth’s CEO and executive chairman and Elara Caring’s chairman, said home health providers should move beyond episodic clinician visits toward a longer-term model combining skilled care, paid family caregiving, technology and support for daily needs. Speaking at HHCN’s FUTURE conference in August, he argued that a broader approach is needed to care for people living with chronic illnesses and to support value-based arrangements that hold providers accountable for outcomes.
Kusserow described the traditional home health framework as organized around clinician-led visits, a structure he said may not meet the needs of people living for years with chronic disease. He said a new model should combine clinical care with help from family members, friends, personal care workers and community resources. That would include support with activities of daily living (ADLs) and social determinants of health, alongside clinical services for people with more complex conditions.
He pointed to Careforth as one example of a caregiver-support model. The Boston-based company operates in nine states and provides payment, training, technology, clinical backup and other resources to home-based caregivers. Kusserow said Careforth identifies family members or others in the home of a person receiving a Medicaid waiver, trains them, and pays them $50 a day for 24/7 care, while also offering support and breaks. That description reflects the company’s model as he presented it; the source report does not give details about eligibility, local payment rules or how the daily amount is calculated.
Kusserow also argued that providers need to build more disease-specific capabilities and care for higher-acuity patients at home. He said technology and data could help teams identify risks and decide when intervention is needed, citing congestive heart failure as an example: information gathered across many patients could inform care for an individual. He did not describe a particular data system or present outcome measurements supporting the example.
Care Models Beyond Clinician Visits
The proposal concerns how home-based care could respond to a growing population with chronic conditions and support people who need help over extended periods. If providers take on more responsibility for patients’ ongoing health, relying only on scheduled clinical visits may leave important daily needs unmet. Kusserow’s model treats caregiver training, practical support and clinical oversight as connected parts of care rather than separate services.
There is also a financial dimension. Kusserow said recurring hospitalizations are economically difficult for health plans and government payers when people live for years with illness. He sees an opportunity for home-based providers to manage conditions and help people remain at home, while taking on greater accountability for care. Whether that approach reduces costs or improves outcomes at scale is not established by the conference comments.
Family caregivers already provide substantial unpaid support. AARP’s 2024 estimate, cited in the report, put the economic value of adult caregiving at $1.01 trillion that year, with an estimated 59 million people helping an adult family member, neighbor or friend with daily activities. The report also said 63% of those caregivers provided help each month. Those figures illustrate the scale of caregiving, but do not establish how many caregivers would participate in paid programs or what a sustainable funding model would cost.
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Kusserow’s Home Care Roles
Kusserow has held leadership positions across home-based care and health care. 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. He became Careforth’s CEO in June 2026 and joined Elara Caring’s board in August, later serving as its chairman, according to the report. He is also executive chairman of Unified Women’s Healthcare and serves on the board of Matrix Medical Network.
Careforth supports home-based caregivers across nine states. Elara Caring, headquartered in Dallas, provides skilled home health, hospice, behavioral health and personal home care across 18 states. Their different service footprints give context to Kusserow’s comments, but the report does not say that Elara has adopted the Careforth payment approach or that the companies are implementing a shared care model.
The conference remarks build on a broader debate about how home-based providers can support people who need sustained care rather than a short episode of treatment. Kusserow’s central argument is that providers must treat clinical services as one part of a longer-term arrangement, with family caregivers and technology helping address needs between professional visits.
“That’s going to be a combination of skilled care and unskilled care.”
— Paul Kusserow, speaking at HHCN’s FUTURE conference
Funding and Results Still Unclear
Kusserow outlined a direction for the industry, not a detailed implementation plan. The conference report does not specify how providers would fund caregiver compensation and support across different payer arrangements, what payment rates would be sustainable, or how responsibilities would be divided between professional clinicians and nonclinical caregivers.
It is also unclear how widely Careforth’s described arrangement can be applied. The $50-a-day figure was presented in connection with people receiving a Medicaid waiver; the report does not provide state-by-state terms, program eligibility details or evidence that the payment covers the full value of round-the-clock care. No comparative outcome or cost data were provided to show whether the model reduces hospital use or improves health outcomes.
Kusserow’s technology example was illustrative. The report does not identify a specific platform, data-sharing method or privacy framework, nor does it say whether Careforth currently has a dataset of 10,000 people with congestive heart failure. Those operational and evidence questions remain open.
Proof Will Depend on Implementation
The next steps depend on whether providers and payers turn the proposed model into funded, measurable programs. Providers would need to determine which caregiver tasks can be supported safely, how training and clinical backup will work, and how services for ADLs and social needs fit alongside skilled home health. Health plans and public payers would also need to decide how to pay for longer-term support and assess whether it changes costs or care outcomes.
The source report does not announce a new Careforth or Elara program, a rollout schedule or a formal evaluation tied to Kusserow’s remarks. For now, his comments offer a strategic view of the direction he believes home health should take. Evidence from operating programs, including information on caregiver participation, patient outcomes and total costs, will be needed to show how far that approach can be applied.
Key Questions
What change did Paul Kusserow propose for home health?
He called for providers to move beyond episodic clinician visits and combine skilled care, caregiver support, technology and help with daily needs in longer-term care models.
What does Careforth provide to caregivers?
Kusserow said Careforth offers payment, training, technology, clinical backup and other support. He described a program in which some caregivers of people receiving a Medicaid waiver are paid $50 a day for 24/7 care, with resources and breaks also provided.
Why does Kusserow emphasize family caregivers?
He argues that relatives and other people close to a patient can help with nonclinical needs and daily activities between professional visits, provided they receive appropriate training and support.
Did Kusserow announce a new program or prove the model works?
No new program or rollout was announced in the report, and it did not provide comparative results showing the model’s effect on costs or patient outcomes. His remarks described a proposed direction and a Careforth example.
Source: rss
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