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Homecare Homebase Urges CMS to Rethink 2026 Proposed Rule

Homecare Homebase (HCHB), a premier provider of software for home-based healthcare services, has recently voiced significant concerns regarding the Centers for Medicare & Medicaid Services (CMS) proposed rule for the Home Health Prospective Payment System for the calendar year 2026. Through a detailed comment letter, HCHB cited urgent issues affecting providers and patients, aiming to advocate for necessary adjustments to the proposed regulations.

According to HCHB, which serves nearly half of all Medicare home health visits across its extensive client network, the changes introduced in the proposal bear severely negative implications that could exacerbate access challenges, cost strains, and workforce pressures within the home health sector.

Key Concerns Raised by HCHB

The letter identifies several critical areas of concern:
1. Access to Care: HCHB reported a drastic 13% drop in referral conversions since 2018, equating to over 4.2 million patients turned away from receiving vital home health services in 2024.
2. Misguided Behavioral Assumptions: The organization's data contradicts CMS's assertions that agencies could simply adjust coding or therapy practices to adapt for payments under these new rules. HCHB emphasizes that this assumption does not hold true against empirical evidence collected from its operational data.
3. Rising Operational Costs versus Reduced Payment Rates: Since 2018, inflation has surged by 27%, but the revenue per patient has only grown by 13%. Such discrepancies put a strain on service providers attempting to maintain standard levels of care while facing dwindling compensation.
4. Challenges with Medicare Advantage: An overwhelming majority of home health patients are now under Medicare Advantage plans, which tend to offer lower payment rates, impose additional administrative tasks, and ultimately compromise the financial stability of providers.
5. Issues with Cost Reporting During the Pandemic: HCHB pointed out that CMS relies on inconsistent cost reports influenced by anomalies from the pandemic, leading to misguided policymaking. They propose resetting baseline assessments based on a clearer 2023 standard.

Luke Rutledge, the president of HCHB, emphasized the utmost necessity of home health care in the healthcare landscape, while drawing attention to the widening gap between operational costs and the reimbursements that providers receive.

"Home health has never been more essential to the healthcare system, but the gap between costs and reimbursement continues to widen," stated Rutledge. "Our goal is to partner with CMS and the broader industry to ensure that regulatory decisions sustain access to this vital benefit for patients and families across the country."

The Financial Impact of the Proposed Changes

The letter from HCHB highlights that CMS's proposed payment reduction of 6.4% for 2026 is likely to exacerbate existing financial challenges faced by home health agencies. The organization’s dataset, which covers 47.1% of the home health workforce, reveals significant differences between CMS’s understanding of industry dynamics versus the realities faced by providers. Issues such as declines in patient referrals due to staffing shortages and stagnant revenues amidst rising inflation complicate the situation even further.

Earlier this year, HCHB launched a Home Health Impact Model along with Advocacy Dashboards within HCHB Analytics. These tools allow providers to assess the specific financial and operational impacts of proposed regulations on their agencies, thereby equipping them with necessary data to advocate effectively for improvements. The dashboards facilitate the emergence of trends relating to referral conversions, inflation against reimbursement comparisons, and clinical behavior data—allowing agencies not only to prepare for potential changes but also to bolster their advocacy initiatives.

As the home health sector stands on the brink of awaiting CMS's final decision, HCHB's commitment to advocacy and innovative solutions is clear. The organization is devoted to utilizing extensive data to inform public policy while assisting its clients in making evidence-based decisions.

In conclusion, Homecare Homebase’s recent outreach signifies a strong stance focused on preserving the quality and accessibility of home-based care for patients. By emphasizing the pressing nature of these regulatory changes, HCHB is striving to keep both patient and provider needs at the forefront of healthcare policymaking. To learn more about HCHB's advocacy efforts, interested parties can visit hchb.com.

About Homecare Homebase

Founded in 1999 by industry professionals, HCHB is a Dallas-based leader in providing software solutions for home-based care. Its tailored mobile technology enhances real-time communication among healthcare providers, resulting in improved care delivery and better financial management. Each year, over 300,000 HCHB users care for nearly one million patients on a daily basis, accounting for over 121 million home health visits annually. HCHB is a part of Hearst Health, an organization dedicated to improving the healthcare landscape for all.

With a commitment to innovation and excellence, Homecare Homebase aims to navigate the evolving challenges in the home health industry while ensuring quality service for every patient.