Home Health on the Brink: Navigating Looming Medicare Cuts and Industry Challenges
The home health care landscape is bracing for impact. Providers and advocates are anxiously awaiting the final 2026 Medicare Home Health rule, a decision poised to dramatically reshape the industry. As Dr. Steven Landers, CEO of the National Alliance for Care at Home (the Alliance), puts it, the situation has reached a “war room” level of intensity.
This isn’t simply another regulatory update. The proposed rule includes the largest payment cut in the history of home health, a consequence of methodologies many believe are fundamentally flawed. The potential fallout? Delays in care, agency closures, and severely limited access, notably in rural communities.
Understanding the Threat: A Deep Dive into the Proposed Cuts
At the Alliance’s 2025 Annual Meeting and Exposition, Landers underscored the gravity of the situation. Despite extensive efforts to oppose the proposed cuts, the Alliance is simultaneously preparing for a worst-case scenario – a final rule mirroring the initial proposal.
Several factors contribute to the uncertainty:
* MedPAC Recommendations: The Medicare Payment advisory commission (MedPAC) continues to advocate for cuts.
* Fiscal Pressure: the current administration faces pressure to identify areas for budgetary reduction.
* Methodological Concerns: CMS acknowledged potential issues with the proposed methodology, yet released the rule anyway, raising concerns about its accuracy.
“It’s still possible they’re going to get this wrong,” Landers cautioned. “They put out a proposal knowing some of these issues, and got it wrong. So there’s a risk that this isn’t fixed.”
Fighting Back: Legislative Efforts and Industry Unity
Fortunately, the industry isn’t standing still. the Home Health Stabilization Act of 2025, introduced by Representatives Kevin Hern (R-Okla.) and Terri Sewell (D-Ala.), offers a critical lifeline. This bipartisan bill would pause the proposed cuts for 2026 and 2027, providing much-needed stability.
However, the current government shutdown presents a significant obstacle. With Congress adjourned,legislative action is stalled. this underscores the need for continued vigilance and a rapid response should the final rule prove unfavorable.
What you can do: Stay informed and be prepared to mobilize quickly to contact your representatives.
Beyond the Payment Rule: Other Critical Issues
The challenges facing home health extend beyond the Medicare payment rule.The Alliance is actively addressing several other pressing concerns:
* Medicare Advantage (MA) hospice Carve-in: The proposed carve-in,which shifts hospice benefits to Medicare Advantage plans,is facing strong opposition.
* Telehealth flexibilities: The government shutdown has paused crucial telehealth flexibilities, threatening access to remote care.
These issues, combined with the looming payment cuts, highlight the complex environment facing home health providers.
The Power of Collaboration: A United Front for Home-Based Care
Landers emphasized a crucial element for navigating these challenges: unity. A fragmented approach weakens the industry’s voice.
“We’ve got to work together to amplify our voice, find common ground so that we’re not contradicting one another and stepping over one another to make sure that message is heard,” he stated. “We’re in it to win it, but we’ve got to stick together, because we’re a small sector and if we’re contradicting one another, God save us.”
For home health agencies, this means: actively participating in industry advocacy, collaborating with peers, and presenting a unified message to policymakers.
The coming months will be pivotal for the home health industry. by staying informed, advocating for sensible policies, and fostering collaboration, you can help ensure continued access to vital care for patients in the comfort of their homes.
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