Issue #5 · October 20, 2026
Big changes are brewing in how care gets delivered and paid for. Here's what families need to know.
Two big stories caught our attention over the past couple of weeks, and both have real implications for families dealing with elder care.
First, Israel's Sheba Medical Center is building what it hopes will be the first fully AI-based hospital by 2030. If you walk into their emergency room today, the first clinician taking your history may already be an AI avatar, with a physician reviewing and signing off on every recommendation. This is not science fiction anymore. It is happening in real time, and American health systems are watching closely. For families caring for aging loved ones, this matters because AI tools are increasingly showing up in home health and hospice settings too, from remote monitoring systems to symptom tracking apps. The technology is moving fast, and the conversation about where human judgment remains essential is one we should all be part of.
Second, KFF released updated Medicaid fact sheets for every state, along with a refreshed look at the status of Medicaid expansion decisions across the country. If your loved one relies on Medicaid for home health services or nursing facility coverage, these resources are worth a look. Medicaid is the single largest payer for long term care in the United States, and even small shifts in eligibility or state policy can have an outsized effect on families. We are keeping a close eye on several states where expansion status or budget pressures could change what services are available in the months ahead.
With flu season approaching and updated vaccines rolling out this fall, KFF's latest polling reveals something families should pay attention to: public trust in health information sources is shifting, and confusion about vaccines remains widespread. About half of parents mistakenly believe that spacing out vaccines is healthier for children, even though medical evidence does not support that claim. While this particular finding focuses on childhood vaccines, the broader trend around health misinformation affects older adults too. Seniors and their caregivers are increasingly turning to social media and even AI tools for health guidance, and the quality of that information varies wildly.
If you are helping a parent or grandparent make decisions about flu shots, COVID boosters, RSV vaccines, or pneumonia vaccines this fall, stick with their primary care doctor or hospice care team as the go-to source. These conversations are too important to leave to an algorithm or a social media post. Ask the care team directly what is recommended, and do not hesitate to bring a list of questions. Good providers welcome that.
Since we are talking about Medicaid this issue, let's get specific about why it matters so much for elder care. Medicaid covers roughly six out of ten nursing home residents nationally. It also funds a growing share of home and community based services that allow seniors to stay in their own homes longer. But eligibility rules, income limits, and covered services vary dramatically from state to state. In states that have expanded Medicaid under the Affordable Care Act, more adults have access to coverage, which can include home health aide visits, personal care assistance, and certain therapies. In states that have not expanded, families often face tighter eligibility windows and longer waiting lists for home and community based services.
If your loved one needs long term care and you are unsure whether Medicaid might help, the first step is checking your state's specific eligibility requirements. KFF's state fact sheets are a helpful starting point. Keep in mind that applying for Medicaid can take time, sometimes weeks or months, so it is best to start early rather than waiting for a crisis. And remember that Medicare and Medicaid are two different programs. Medicare covers hospice care with little to no out of pocket cost for eligible patients, but it does not cover long term custodial care. Medicaid often fills that gap, so understanding both programs is key to avoiding surprise bills.
October is flying by, and we know that for many of you, this season brings difficult conversations and hard decisions about a loved one's care. We want you to know that you do not have to figure it out alone. Best Hospice and Home Health is a completely free service for families, connecting you with verified hospice and home care providers in your area. If someone you know is struggling to find the right care, please share this newsletter or send them to our website. Sometimes the most helpful thing you can do for someone is point them toward a good starting place.