What Beneficiaries Say About Home Health

Medicare’s home health benefit provides skilled nursing, or care delivered by or under the supervision of licensed nurses, and therapy services like physical therapy to eligible homebound beneficiaries. However, the Medicare home health benefit‘s availability, scope, and duration are not well understood, and services can be difficult to access, according to new interview-based research with beneficiaries and caregivers.

Who Qualifies for the Medicare Home Health Benefit

Both traditional Medicare and Medicare Advantage beneficiaries are eligible for home health benefits. They may be referred for such services following a hospitalization or skilled nursing facility admission, or they may be referred from the community to manage chronic conditions at home. In addition to covering skilled nursing care and physical therapy, the Medicare home health benefit also covers occupational therapy, speech-language pathology services, and home health aides for personal care services. For traditional Medicare beneficiaries, there is no cost sharing for these services, while Medicare Advantage enrollees may have cost sharing.

How Beneficiaries Are Supposed to Choose an Agency

Beneficiaries referred for home health services after hospitalization have the freedom to choose an agency from a list of Medicare-certified home health agencies in their area. Hospitals are required to present a list of agencies to patients discharged home and referred for home health services as part of their discharge planning requirements. CMS also provides online home health information and tools like Medicare Compare to help beneficiaries select a quality-rated agency.

How Researchers Studied the Medicare Home Health Benefit

Researchers conducted 20 interviews with beneficiaries who had received a Medicare home health referral or with their caregivers, exploring their real-world experiences with the Medicare home health benefit. Interviews took place via Zoom in English or Spanish between October 15 and October 29, 2025, with participants representing a mix of traditional Medicare and Medicare Advantage enrollees across region, gender, race and ethnicity, language, and health conditions.

Home Health Was Viewed as Highly Valuable

Most interviewees reported positive experiences and described home health as pivotal to recovery. Almost all provided the top rating for their home health services, with physical therapy and nursing care cited as the most valuable. “[I give it] 10/10 because it got me off the couch [and] got me moving again, which I definitely needed… I highly recommend it,” said one Black male beneficiary in his 60s.

Emotional Value Woven Into the Medicare Home Health Benefit

Beyond clinical care, beneficiaries highlighted the emotional and psychological value of the Medicare home health benefit. Several expressed emotional vulnerabilities, including fear of falling and rehospitalization, depression, anxiety when left alone, and trauma from prior hospitalizations. “I felt safer in my home. It’s something mental, but that also influences the recovery process,” said a Hispanic female beneficiary in her 50s.

Limited Awareness of What the Benefit Covers

Prior to referral and even after starting services, most beneficiaries were not aware of the full range of services covered under the Medicare home health benefit. Most reported that they didn’t seek out home health services themselves but were instead told by hospital staff or their physician that they “needed” it, with few recalling any explanation of the benefit’s scope and duration.

Agency Selection Often Left to Providers, Not Patients

Beneficiaries generally did not independently choose an agency or evaluate its quality beyond the provider’s direction. Few mentioned getting a list of home health agencies from the hospital, and those who did received little context about it. “They told me which one that they commonly used… I just went with whatever they suggested that I use,” said one Black female beneficiary in her 60s.

Provider Endorsement Shaped Trust in the Medicare Home Health Benefit

Provider endorsement, such as a hospital saying “we work with them all the time,” was a major factor shaping agency selection and was viewed as a sign of quality, though it remains unclear whether this provider-directed selection always complied with Medicare rules around financial ties disclosure.

Continuity of Care Affected Satisfaction With the Medicare Home Health Benefit

Satisfaction with home health agencies was closely linked to how beneficiaries viewed the quality of staff and care delivered. Some experienced staff turnover and lacked continuity of care, with rotating aides, multiple physical therapists, or inconsistent nursing visits causing frustration and reduced trust. “Why is the same person not here?… But when he found the person that he liked, then that was great,” said one white female caregiver of a parent in her 90s.

Mental Health Needs Often Went Unaddressed

A recurring gap in the Medicare home health benefit involved mental health support. Several beneficiaries reported feelings of depression and emotional vulnerability while recovering but didn’t receive care for those concerns. “[I would have liked] somebody to really pay attention right now to how sad I was feeling… and how I’m feeling a little desperate here,” said one white female beneficiary in her 70s.

Policy Priorities for Improving the Medicare Home Health Benefit

Based on these interviews, researchers identified four areas for policy improvement to strengthen the Medicare home health benefit: strengthening beneficiary education and navigation, supporting and enforcing choice of home health agency, improving care coordination and provider education, and addressing quality and access gaps through workforce investments.

What These Priorities Would Mean in Practice

CMS could create more user-friendly resources explaining the full array of covered services, modernize tools like Medicare Compare to reflect how consumers seek information today, and increase oversight of hospital compliance with agency choice and financial disclosure requirements. Workforce investments like higher wages and better benefits could also help reduce staff turnover and improve continuity of care for beneficiaries relying on the Medicare home health benefit.

What This Research Means Going Forward

The findings suggest that while the Medicare home health benefit delivers meaningful clinical and emotional value to those who receive it, significant gaps remain in how beneficiaries learn about, access, and navigate the program. Addressing beneficiary education, agency choice, care coordination, and mental health support could meaningfully improve outcomes for the millions of beneficiaries who rely on home health services each year.