The Memory Care Innovation Awards program is designed to recognize passionate and innovative industry members who are shaping the future of cognitive care across behavioral health, home health and home care, hospice and palliative care, senior housing and senior living, and skilled nursing. To become a Memory Care Innovation Award winner, an individual must be nominated by their peers. The candidate should be a high-performing employee who knows how to put vision into action, serving as an advocate for those living with memory-related disorders and the committed professionals who ensure their well-being.

Weissberg sat down with Home Health Care News to share her journey caring for patients and residents with cognitive care needs, her thoughts on the future of cognitive care in senior housing & senior living, and much more. To learn more about the Memory Care Innovation Awards and view this year’s winners, visit https://innovation.memorycarebusiness.com/.

HHCN: How long have you been working in the home health & home care industry, and what has your career journey looked like?

Weissberg: I’m a board-certified Nurse Practitioner with over 10 years of experience in urgent care, outpatient medicine, and home-based care. For the past six years, I’ve been part of the leadership team at Emerest, where I’ve worked closely with our team to build programs and processes that help reduce hospitalizations, support people in their day-to-day lives, and keep them safely at home whenever possible.

I’ve always enjoyed caring for older adults, and over the years I found myself especially drawn to memory care. It’s a field that challenges you clinically, but it also reminds you how important patience, empathy, and human connection are. Being able to support both patients and their families through such a difficult journey is what makes the work so meaningful to me.

HHCN: What inspired you to focus on caring for individuals living with memory-related conditions?

Weissberg: My passion for memory care is both professional and personal. In my early 20s, my grandmother was diagnosed with dementia and lived with me as her condition progressed over four years. Serving as her primary caregiver gave me firsthand insight into the emotional, physical, and practical challenges that families experience when caring for a loved one with cognitive decline. That experience profoundly shaped my perspective as a clinician and inspired my commitment to helping individuals with memory-related conditions maintain dignity, independence, and quality of life for as long as possible.

HHCN: If you could describe the current state of memory care in home health & home care in one word, what would it be and why?

Weissberg: Evolving.

Memory care has advanced significantly in recent years, with greater recognition of the importance of early detection, caregiver support, interdisciplinary collaboration, and evidence-based interventions. Programs, like the CMS GUIDE Model, are helping move the industry toward a more coordinated and proactive approach, but there is still tremendous opportunity to continue improving access, education, and support for families navigating dementia care. 

HHCN: What is the most important lesson you’ve learned in your career caring for individuals with cognitive needs?

Weissberg: The most important lesson I have learned is that successful memory care is never just about treating the patient. It is about supporting the entire care ecosystem.

Family caregivers often carry an enormous burden, and when we provide them with education, resources, and guidance, we improve outcomes for everyone involved. Compassionate caregiver support is just as important as clinical intervention when it comes to patients with cognitive decline.  

HHCN: What is one change you would most like to see across the memory care landscape in home health & home care today?

Weissberg: I’d like to see broader access to dementia-specific care programs that bring together medical care, caregiver education, behavioral health support, and community resources.

Too often, families are left trying to navigate a complicated and fragmented system on their own. A more coordinated approach can help people stay safely at home longer, reduce unnecessary hospital visits, and ease some of the burden on caregivers.

At Emerest Mind and Memory, we’ve built our program with those challenges in mind, and we’ve seen firsthand how meaningful that kind of support can be for both clients and their families. 

HHCN: Looking ahead five years, what do you think will have the greatest impact on your ability to deliver innovative, high-quality cognitive care?

Weissberg: The greatest impact will come from combining earlier identification of cognitive changes with data-driven, coordinated care models. Advances in technology, analytics, and dementia-specific care programs will allow clinicians to intervene sooner, personalize care plans more effectively, and provide greater support to caregivers. These innovations have the potential to significantly improve both quality of life and clinical outcomes. 

HHCN: If you could give yourself advice on your first day serving the cognitive care needs of your home health & home care patients, what would it be and why?

Weissberg: I would tell myself to spend as much time listening as possible. Every person’s experience with cognitive decline is different, and every family has its own story.

Clinical expertise is important, but understanding someone’s background, daily routines, support system, and what matters most to them is what really helps you provide meaningful care. The more we listen — to our patients, their caregivers, and the teams supporting them, the better care we can deliver. 

HHCN: In your view, what qualities define a Memory Care Innovation Award winner?

Weissberg: A Memory Care Innovation Award winner combines clinical excellence with genuine compassion and a commitment to continuous improvement. They should challenge traditional approaches, embrace evidence-based practices, advocate for patients and caregivers, and find creative ways to improve quality of life for those living with cognitive impairment. Most importantly, they should recognize that innovation is not just about new technology or programs, it is about creating meaningful, lasting impact for the individuals and families we serve.

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Plans and providers both need to adapt to changing MA trends, according to experts at Home Health Care News’ PAYER Summit. For providers, that could mean prioritizing collaborative payer relationships and, in some cases, shrinking their operations to build more sustainable businesses.

“Medicare Advantage is here to stay,” Allison Rizer, chief growth and innovation officer at ATI Advisory, said on a panel. “But the program is facing significant headwinds right now. There are just fewer dollars. We’re seeing plans exit markets, which is putting pressure on the plans that remain. It’s creating a change in the negotiating power that providers have. If there are fewer plans, you may have less negotiating power.”

Medicare Advantage patient acuity has also increased, Rizer added, causing costs to increase even as payments decrease. This trend requires organizations to do some “soul searching,” taking a hard look at their margins and determining where they can make concessions or pull down on administrative overhead.

Negotiating power may continue to decrease, Rizer said, as Medicare Advantage plans shift out of the PPO space, where people can go out-of-network, and into HMO.

Founded in 2014, ATI Agency is a health care research and advisory services company based in Washington, D.C.

Being selective with payer partners

h/care CEO and Founding Principal Ryan Haller noted that providers may need to consider reducing their census or payer networks to focus on profitable contracts. For example, h/care acquired a home health agency with a census of 400 patients and a -20% EBITDA margin. Following the acquisition, leadership shrank the agency’s census to 120 patients but brought the EBITDA margin up to 8%.

After h/care acquired the agency, a 95-year-old Ohio-based provider, a margin analysis showed that 80 out of its 100 active payer contracts were losing money.

“In any market, [and] this one in particular, Cleveland, there are certain parts where you have a higher penetration of Medicare Advantage than others. We typically see a higher Medicare Part B type penetration rate in some of the higher-earning zip codes. We made decisions that for 95 years [of] being known in that particular market as kind of the leading provider in the area, to really [shrink] our size.”

The decision to shrink patient census can be a difficult one for not-for-profits, Haller said, as these organizations are brought up on the concept of serving as many patients as possible. Still, less is more, he said.

Nashville, Tennessee-based h/care is a health care management organization. The company provides home health, hospice, palliative care and pediatric care at home.

Merz Photography Merz Photography

Providers should be selective about their payer partners, Coreen Dicus-Johnson, Network Health president and CEO, said.

“That’s how we’ve been contracting at Network Health for the last 10 years,” Dicus-Johnson said. “As we take cost out, as we improve quality, as we’ve been able to get the bonus, we share in that. … So looking at your payer as your partner, and maybe eliminating some of those who don’t act like partners … can be a game changer.”

Network Health is a provider-owned Medicare Advantage plan offering health plans to individuals, families and employers in Wisconsin.

Becoming better partners

One way Network Health is working to become a better partner is by improving its hospital discharge process, Coreen Dicus-Johnson said.

“One of the frustrations I think everyone has is that we don’t do enough planning early in the process related to a discharge,” Dicus-Johnson said during the panel. “We’re discharging at the last minute. Hospitals want to get the patient out because their average length of stay is starting to climb. We haven’t done it early enough to be able to prepare the family, to prepare the patient and to prepare either the school nursing or the payer.”

“This is an issue. It is a big issue because expectations are not being met, because we’re not setting them earlier on in the process,” Dicus-Johnson added.

For providers working to improve their payer strategy, or their relationship with a specific payer, one key method could be focusing on fraud, waste and abuse, Rizer said.

“This is a huge issue keeping health plans up at night, especially on the Medicaid side. We’ve got the federal government really coming down hard, in particular on home care,” she said. “So any places where you can be a partner to a health plan on fraud, waste and abuse, maybe it’s leaning into [electronic visit verification] (EVV) systems a little bit differently, or more, that’s going to give them a better value story for the state. It’s going to work better for everyone.”

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“We needed a partner who could attack all of those at once, at the scale we operate at,” says Joanna Ciampaglione, Senior Vice President and GM of AccentCare. “Caribou has delivered.”

“Delivered” is no small potatoes. AccentCare’s results with Caribou included a 40% reduction in shift-booking time and a 20% increase in 90-day caregiver retention.

And then there’s this.

“Since deploying their platform, we’ve seen over 640% ROI, with measurable gains in retention, EVV compliance, and coordination efficiency,” Ciampaglione says.

Here is a look at how they did it.

Why AccentCare turned to Caribou: data from over 250,000 caregivers — and verifiable results

The New York City-based Caribou Health Technologies isn’t the only provider of technology solutions for home-based care. But there were two edges that Caribou brought to AccentCare’s needs. One was what Ciampaglione said: attacking all of those problems at once, and at scale.

The second was something that Ciampaglione knew was rare, if it was even available elsewhere: verified data.

“What ultimately sealed the deal for us to partner with Caribou were the results and the fact that we could verify them,” she says. “Caribou had a track record with other enterprise, multi-state home care operators, and when we talked to those operators, the outcomes held up. That mattered to us. A lot of vendors can show a deck. Far fewer can put us on the phone with peers who’ve already lived the implementation.”

Data verification wasn’t simply coming from a handful of satisfied customers. Caribou’s system, called “Conductor,” draws from over 170 million touchpoints with caregivers over the past eight years — a pool of more than 250,000 caregivers nationwide, including more than 50,000 using Caribou’s shift booking solution. When a home-based care provider needs to tackle one of the challenges that Ciampaglione laid out, such as filling a shift, the Caribou Conductor produces a list of recommended caregivers and handles the booking of that shift from end to end.

“Shift coordination impacts everyone in the home care ecosystem,” says Alex Oosterveen, Co-Founder and CEO of Caribou. “When it works well, agencies, caregivers and families thrive. When it’s broken, it hurts everyone at once.”

Caribou knows what care coordinators face. They’re managing open shifts, trying to maintain client relationships, and doing it all while manually calling down a list of caregivers they hope are available. It’s reactive, time-consuming, and mentally exhausting. Context gets lost. Calls go unanswered.

Caregivers feel it too.

“Most want more stable hours, with quality shifts that match their skills, their schedule and their preferences,” Oosterveen says. “But they don’t always know how to get them. The best thing an agency can do for a caregiver is hand them a shift that fits their preferences. Many agencies don’t have a system to do that at scale.”

That’s what Caribou did for AccentCare. Caribou Conductor has multiple parts, all working together, such as Caribou Shift Booking and Caribou Rewards, the latter of which consistently achieves over 95% frontline engagement.

“We know what motivates caregivers, how they communicate, and what makes them show up,” Oosterveen says.

At AccentCare, adoption was swift. With so many caregivers, schedulers and families affected, that ease matters.

“Easy adoption means clean data, and clean data means we actually trust what the platform is telling us,” Ciampaglione says. “Caribou’s operating mindset was the final piece. They think like operators, not like a software vendor.”

Inside the numbers: what AccentCare gains from Caribou

AccentCare has had a game-changing experience from Caribou’s Conductor system. The numbers back it up, with measurable results across several metrics:

• Caribou referrals have brought in over 750 new hires
• Shift booking time dropped by more than 40%
• 90-day caregiver retention increased by as much as 20%
• In one state, training rewards powered by the Caribou-Nevvon integration increased training completion percentage by 30%
• Because Caribou Rewards and Caribou Shift Booking operate together, AccentCare can seamlessly offer incentives for hard-to-fill shifts, like last-minute call-outs or weekends

“We haven’t seen another partner move the needle the way Caribou has across all four of engagement, retention, EVV and coordination,” Ciampaglione says.

“Caribou is different because we started with the caregiver,” Oosterveen says. “Home care is heading toward a future where demand outpaces the workforce. Agencies that win will retain the caregivers they have, fill shifts before they become a crisis, and do more without growing their back office. That requires AI that understands caregivers at a deep level.”

“What excites us most is where Caribou is going,” Ciampaglione says. “Their technology takes on some of the genuinely hard, operationally complex problems in home care — the kinds of things we’ve historically had to throw headcount and process at. They’re building toward solutions we want to be early on. We’ve already seen meaningful results from what’s deployed today, and we see Caribou helping us continue to grow without expanding our back office.”

This Views article is sponsored by Caribou. To learn more, visit caribou.care.

The post How AccentCare Gained 640% ROI with New Workforce Tech appeared first on Home Health Care News.

That’s the strategy of Kathy Poland, who stepped in as interim CEO following the death of New Day’s G. Scott Herman in February. She became permanent CEO on June 18, after serving as the firm’s chief operating officer for over four years. 

Texas-based New Day provides home health, hospice and personal care services in Texas, Missouri, Kansas, Illinois, New Mexico and Indiana.

Poland spoke with Home Health Care News to discuss her transition into permanent CEO, what difficulties she sees in the forthcoming year, New Day’s growth strategies and what she’s learned as a health care industry veteran for the past 25 years.

Before joining New Day, Poland served in senior vice president roles at the home health care companies Elara Caring and Jordan Health Services.

This conversation has been lightly edited for length and clarity.

After serving as both Chief Operating Officer and interim CEO of New Day, what are your top priorities for the next year as you permanently lead the organization?

I always feel like I need to tell a story before I answer that question.

Scott and I worked together for 14 years. We put New Day together. We actually put this company together at his dining room table. We worked together at Jordan Health Services and at Elara Caring.

When we made the decision to leave and put together New Day with a really defined purpose, Scott and I had always had this yin and yang to us, where Scott was the visionary. He would set the course. And then my job was the one to always say, ‘Okay, here’s how we’re going to get there,’ as a COO, then measure the results. That worked beautifully between Scott and me for all those years.

And he passed away. It’ll be four months this Saturday, the 27th. He’s missed immensely. But what we’re doing here at New Day is we’re carrying on that legacy and that vision.

We grew quickly through a lot of organic growth and buying companies. Tightening things up and getting that discipline around our operations is what our primary focus is right now, but no change in the vision.

Can you describe the strategy for specific home-based care service lines that New Day has?

We have home health, hospice, personal care, private pay; we take care of pediatric children, and we’ve got CDS. So [our strategy is] consumer-driven, and we’re in six different states.

When you look at a patient’s journey, my mom passed away on our hospice services, but she wasn’t always on hospice. She was on home health at one time. And we believe strongly at New Day that a patient has a journey in their health care. As their needs change, we need to be there to hold their hand through that change. In my mom’s situation, she had knee problems first. She needed therapy and home health, and then as her care changed, she actually needed hospice eventually, and she passed away from dementia.

We at New Day have created a company where the strategy is to encompass a patient and make sure we’re there to hold their hands through their care journey.

What are your plans for growth for home-based care service lines in the next two years?

Medicare Advantage, obviously, is a big part of that. A large part of our population is Medicare Advantage. We have lots of contracts with Medicare Advantage payers. When I say lots, it’s in excess of 30, where we are partnered with these managed care payers.

You’ve got to be able to go in and talk to these referral sources, these hospital systems, those acute settings, and say ‘We’re ready to not only take all of your Medicare Advantage payers, we’re here to take care of your traditionals.’

It’s one thing to get the referral, it’s another thing to actually have caregivers, nurses and therapists to actually care for the patients. So the other part of the puzzle is that you’ve got to have a culture and a recruiting system in place where you can attract people and retain people. On our caregiver side, we retain most of our clinicians. We have a very low turnover rate.

What characteristics make an acquisition attractive to New Day, and have those changed over, say, the last three years?

First thing we look at is culture. Is it a good match? Is the company compliant? What do the outcomes look like? Do they hire where the service area is? All those things that you would look at, but is it a good culture match first? And if it’s not, we usually stop. In fact, we had a deal just recently that we walked away from that was linked to a culture mismatch.

So you have got to look at culture. Then the next thing you do is you go deeper on compliance, you go deeper on your financial piece, you understand if they can scale and if you can you tuck it in your operation.

We’ve done 16 acquisitions since 2020. We’ve been pretty busy, but we’ve slowed down a little bit right now. We all were trying to understand the [Centers for Medicare & Medicaid Services] moratorium and trying to understand “What does it mean?”

We have Bill Dombi on our advisory board, and so with his level of expertise, he sat down with us as a group and gave us some advice on what we should be doing on the moratorium, what we can do as far as M&A. Things have slowed down in the M&A world.

How do you expect the CMS’ home health and hospice moratorium to impact your plans for growth?

We don’t expect it will have much impact, except [for] what I just mentioned. What we immediately did was we laid out a plan for each one of our states, and what we would like to do as far as how we can expand or M&A opportunities.

Then we laid that out in front of people smarter than us, and said, “Make sure you read the moratorium, make sure we’re not tripping on ourselves here.” And they gave us that guidance, along with Bill, to make sure that we could do what we were planning on doing in each one of our states.

[It was a] little bit concerning when it first came out. I think we all had to pause, not knowing if it’s going to be six months or if it’s going to be longer. We don’t know just yet. From what we understand and what we’re trying to do strategically, it’s not going to impact us. We’re going to be in a good spot.

What’s on your regulatory wish list this year?

If those that are committing fraud could just be dealt with, and the bad actors are gone, and the good actors — the ones that are doing it for the right reasons — are here and are recognized, and our industry is not harmed.

We provide such an important service in the home that we don’t want our industry to be looked on negatively.

What would you say is a key trend that you’ve seen change in the home-based care operating space in the last five years?

Clearly, what’s happening with fraud. Any organizations that may have not set up their organization in a compliant way, front and center.

Even though that’s more than five years, Medicare Advantage really got a stronghold in the last six years, and Medicare Advantage went from something that was maybe 20% of our population, even lower than that when I started, to well over 50%.

The average length of stay of hospice patients has dropped dramatically. We’re seeing that across all of our states, where patients are coming into the hospice benefit later, they’re getting the benefit later for a variety of reasons.

On the personal care services side, there’s been some pressure with reimbursement budgets in some of our states, where they can’t maybe hold those rates. In some other states, we put in a lot of pressure from the provider side that we need additional help because of the wage pressures that are coming from the caregivers.

As the economy has been under this additional pressure, if you think about gas prices in the last year, that’s flowing through to wage pressures on a caregiver side. When you’re having to pay $4 a gallon for gas, it hurts your business.

Looking into the future, if we were to have this conversation, say a year from now, what accomplishments would make you feel like you’ve had a successful first year as a full-time permanent CEO of New Day?

Step one, that the team remains intact. Scott was a big personality. Scott was a big part of our culture. Scott, if you knew him, he could light up a room. He can make everyone laugh in some crazy ways. He learned how to make people feel really comfortable bringing out the tough stuff, because humor was something he excelled at.

So when you lose someone like Scott, there’s an uneasiness at first. What does this mean? What is new for our company? What does it mean for our team?

That dust has settled. Everybody’s in a good spot. Now, from everything that we have done together, is just building on that momentum. Keeping Scott top of mind, keeping the legacy top of mind, celebrating the wins.

And then overall it’s about, ‘Are we taking good care of patients, do your outcomes remain exceptional, are we taking care of more that need our help, are our caregivers staying here with us and are we performing as expected?’

If all those things happen over the next 12 months, then it’s been a good year.

The post New Day CEO Kathy Poland Prioritizes Operations Over M&A appeared first on Home Health Care News.

To become a Future Leader, an individual is nominated by their peers. The candidate must be a high-performing employee who is 40 years of age or younger, a passionate worker who knows how to put vision into action, and an advocate for seniors, and the committed professionals who ensure their well-being.

Broney sat down with Home Health Care News to share what drew her to the home health & home care industry, the biggest leadership lessons she has learned, her thoughts on the future of home health & home care, and much more. To learn more about the Future Leaders Awards program, visit https://futureleaders.wtwhmedia.com/.

HHCN: What drew you to the home health & home care industry?

Broney: What drew me to the home care industry was my personal experience with my grandparents and their need for home care toward the end of their lives. I truly value the opportunity to help individuals remain in the comfort of their own homes for as long as possible while also supporting and guiding families and loved ones through what can often be a very emotional and challenging journey.

HHCN: How would you describe your leadership style, and how has it changed over time?

Broney: I would describe my leadership style as productive, results-driven, and team-oriented. I’ve always been focused on setting clear goals, maintaining accountability, and ensuring strong outcomes. Over time, I’ve learned that effective leadership is not just about driving results — it’s also about patience, communication, and consistent follow-up.

HHCN: What is the biggest leadership lesson you’ve learned while serving the home health & home care industry?

Broney: One of the biggest leadership lessons I’ve learned while serving the home care industry is the importance of adaptability and resilience through change.

This industry is constantly evolving, and I’ve learned that effective leaders must be able to remain flexible, stay solution-oriented, and guide their teams confidently through uncertainty. I’ve also learned that how a leader responds during challenging times sets the tone for the entire team. Staying calm, communicating clearly, and maintaining a positive mindset helps build trust and keep teams focused even during difficult transitions.

HHCN: In one word, how would you describe the home health & home care industry and why?

Broney: Meaningful.

HHCN: What do you see as the biggest opportunities and challenges currently facing the home health & home care industry?

Broney: One of the biggest opportunities is the aging population and the demand for home-based care. Patients and families increasingly value the comfort, independence, and cost-effectiveness of receiving care at home.

At the same time, the industry faces several significant challenges. Workforce shortages are probably the most pressing issue. Recruiting and retaining qualified caregivers remains difficult due to caregiver burnout, rising competition for caregivers, and wage pressures. Maintaining consistent staffing while ensuring quality care is a constant balancing act for agencies.

HHCN: If you had a crystal ball, what do you think will impact the home health & home care industry over the next 5-10 years?

Broney: The biggest long-term driver will continue to be the aging population. As the number of older adults grows, demand for home-based services will continue to increase.

More consumers are choosing to receive care at home rather than in hospitals or skilled nursing facilities, making the home a central site of care delivery.

Technology will also have a major impact. While it’s hard to predict exactly how quickly it will evolve, I believe technology will improve patient outcomes, help reduce hospitalizations, and allow agencies to operate more efficiently.

HHCN: In your opinion, what qualities must all Future Leaders possess?

Broney: In my opinion, Future Leaders will need a combination of adaptability, emotional intelligence, and strategic thinking to succeed in an increasingly fast-changing environment.

The post Future Leader: Melody Broney, Market Leader – Delaware, Help at Home appeared first on Home Health Care News.

CMS announced the moratorium as a six-month freeze on home health and hospice, but specified that the pause could be extended in six-month increments if CMS deems it necessary. In a recent webinar co-hosted by Home Health Care News, Hospice News and HME Business, experts warned that the moratorium is at risk of being extended beyond the initial time frame.  

“My sense is that they will probably extend it at least once for home health and hospice,” Hillary Loeffler, vice president of policy and regulatory affairs at the National Alliance for Care at Home, said during the webinar. “Don’t hold me to that. Don’t go to Vegas and place bets on that. That’s what I think at the moment.”

Several pieces of evidence point to the relative likelihood of an extension, Loeffler said. For one, the timing of the moratorium coincides unfortunately with the timing of the midterm elections. The moratorium took effect in May, meaning the initial six-month period expires in October, just weeks before the Nov. 3 midterm elections.

This timing is bad news for providers, Loeffler said.

“CMS very much takes specific actions around the time of midterms,” she said. “They’re very careful about what they announce, what they release. There are a lot of timing considerations around midterm and presidential election years, so the agency is already going to [have] heightened awareness of things that are coming out of the agency. … I think they might sneak in at least one extension, get them past the midterms, and then reevaluate.”

CMS might announce the extension earlier than the six-month expiration date, Loeffler added.

Home health providers may get an indication in August, when CMS’ enrollment moratorium on durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) is set to expire. If CMS extends the DMEPOS moratorium, it could signal that an extension to the home health moratorium is imminent, Loeffler said.

While there are some tells regarding the possibility of an extension, CMS has failed to release sufficient information to make a clear guess, Loeffler said. When announcing the moratoria on home health, hospice or DMEPOS, CMS did not provide insight into what metrics needed to be achieved for the enrollment moratoria for home health. The same was true for the moratorium on new Medicare home health agencies introduced in 2013, Loeffler said. CMS continually expanded and extended the moratorium, which ultimately lasted five years. 

Dan Fedor, the director of reimbursement and education for U.S. Rehab, a division of the VGM Group, predicted that the DMEPOS moratorium would indeed be extended. 

“Even though… there are other methods to look at the waste, fraud, and abuse … I do believe it will be extended,” Fedor said on the webinar. “Given the current environment we’re in, I see at least another six-month extension.”

The VGM Group provides services and solutions for home medical equipment (HME) and complex rehab technology (CRT) companies.

While predicting that CMS is likely to extend the moratorium past the six-month mark, Loeffler emphasized that the Alliance would advocate against such sweeping responses to fraud.

“We really think there are definite actions that CMS can take to target fraudulent actors without using this blunt tool,” she said.

The post Why Midterms, CMS Precedent Signal Extension To Home Health Enrollment Moratorium appeared first on Home Health Care News.

The company’s care coordinators – called Heroes – manage the non-clinical but often complicated work of caring for an older adult, which often falls to family caregivers, such as scheduling appointments, ensuring medication accuracy and navigating Medicare and Medicaid programs.

Hera’s model is complementary to traditional home care, Jenny Lee, co-founder and CEO of Hera, told Home Health Care News.

“We’re not competing with home-based care; we’re the coordination layer that’s been missing upstream,” Lee said in an email. “The ecosystem already has the players. What no one owns is the whole picture for the family, so by default it falls on a family member who is least equipped: a working daughter with kids or an aging spouse trying to get educated and navigate all the calls. Hera owns that role to coordinate across all the doctors, pharmacies, DME suppliers, Medicaid, hospital discharge planners and agencies.”

New York City-based Hera employs hundreds of Heroes and serves thousands of families, Lee told HHCN. The company currently operates in New York, California, Florida, Massachusetts, Pennsylvania, Maryland and New Jersey. Its leadership aims to expand into over 25 states by the end of 2026 – and eventually operate in all 50, utilizing its new cash fund to do so.

Company leadership also plans to use the newly raised funds to build out its AI platform called Juno. The platform learns which types of care are available and makes recommendations to families based on a backlog of outcome data. For instance, the platform could share information about which cardiologists have openings next week or how to get additional home care approved through Medicaid.

“Healthcare navigation for aging families has remained painfully analog because the most valuable context outside the four walls of the hospital has never been captured in systems,” Alysaa Co, partner at Bain Capital Ventures, said in a statement. “Hera’s AI platform doesn’t just surface options – it learns what actually helps families.”

San Francisco-based Bain Capital Ventures is a venture capital firm that invests in B2B software startups. Its health care portfolio includes AI chart review platform Charta and primary-care-centered health plan administrator Centivo.

Hera clients who are eligible, original Medicare beneficiaries, can receive Hera’s services, including the AI platform and assistance from Heroes, with no out-of-pocket cost.

Lee described Hera’s Heroes as dedicated senior care managers, comparing them to having a social worker or nurse as part of the family. These workers are mostly nurses and licensed social workers with “deep geriatric experience.”

Heroes work in alignment with referring physicians at major health care systems, including Weill Cornell, NYU Langone, Mount Sinai, the University of Southern California and the University of California, San Francisco.

Heroes complete tasks such as starting a Medicaid application months before a family anticipates running out of funds, setting up a pooled trust to protect assets or calling the managed long-term care (MLTC) plan to advocate for more aide hours if a client’s needs increase. Heroes can also vet a client’s health care providers and pass information along to home care agencies.

“Heroes are not the aide who comes to the house,” Lee said. “They coordinate all of the care after a patient leaves the doctor’s office, including facilitating home-based care.”

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To become a Future Leader, an individual is nominated by their peers. The candidate must be a high-performing employee who is 40 years of age or younger, a passionate worker who knows how to put vision into action, and an advocate for seniors, and the committed professionals who ensure their well-being.

Lerner-Greenstein sat down with Home Health Care News to share what drew her to the home health & home care industry, the biggest leadership lessons she has learned, her thoughts on the future of home health & home care, and much more. To learn more about the Future Leaders Awards program, visit https://futureleaders.wtwhmedia.com/.

HHCN: What drew you to the home health & home care industry?

Lerner-Greenstein: When I was 15 years old, my grandfather was diagnosed with stage 4 lung cancer. In a short period of time, he went from being fully mobile to needing around-the-clock care at home. During those months, I saw firsthand how important compassionate, reliable caregivers are — and how difficult it can be for families when that support is missing.

That experience inspired me to enter the home care industry because I wanted to help create the kind of care every family deserves: relationship-based, person-centered, and rooted in dignity and respect. At Help at Home, we believe every client should feel seen, supported, and cared for as an individual — not just another name on a schedule. Helping people remain safe, comfortable, and independent at home is what makes this work so meaningful to me.

HHCN: How would you describe your leadership style, and how has it changed over time?

Lerner-Greenstein: My leadership style is goal-oriented, collaborative, and grounded in a care-first approach. I focus on achieving strong outcomes while ensuring every decision supports safe, high-quality, compassionate care for our clients.

I lead with empathy by listening actively, supporting team members, and creating a culture of accountability, respect, and teamwork. Over time, I’ve learned that when caregivers and employees feel valued and supported, they are better equipped to provide exceptional care and build meaningful relationships with the people we serve.

HHCN: What is the biggest leadership lesson you’ve learned while serving the home health & home care industry?

Lerner-Greenstein: The biggest lesson I learned is that in this field you always have to be prepared to be humbled and you need to be able to learn as you go. Home Care is not something that is just a black-and-white process and you have to follow it and be structured. You always have to be able to change on the go and adapt to the healthcare industry. The home care industry your patience needs.

HHCN: In one word, how would you describe the home health & home care industry and why?

Lerner-Greenstein: Essential.

Home care provides critical support that allows seniors, veterans, and individuals with disabilities to remain safe, independent, and connected to their communities. At Help at Home, we know home-based care is about more than completing tasks — it’s about improving quality of life, preserving dignity, and helping people live where they feel most comfortable: at home.

HHCN: What do you see as the biggest opportunities and challenges currently facing the home health & home care industry?

Lerner-Greenstein: One of the biggest challenges is how long it can take for individuals to access the home care services they need. Many clients require support immediately, but the process can involve multiple evaluations, approvals, and administrative barriers.

At the same time, the growing demand for home-based care presents a major opportunity for the industry. More individuals want to age in place and receive care in their homes and communities. That creates an opportunity for organizations like Help at Home to continue advancing high-quality, person-centered care while improving access, strengthening caregiver support, and helping more people live safely and independently at home.

HHCN: If you had a crystal ball, what do you think will impact the home health & home care industry over the next 5-10 years?

Lerner-Greenstein: Over the next 5–10 years, I believe the biggest impacts on the home care industry will be technology, workforce challenges, and the growing demand for aging-in-place care. As the population ages, more individuals will prefer receiving care at home rather than in institutional settings, increasing the need for accessible, reliable, high-quality home-based services.

The industry will need to balance innovation and efficiency while continuing to deliver compassionate, relationship-based care. Organizations that invest in caregivers, quality, safety, and strong operational support will be best positioned to meet the growing needs of clients and families.

HHCN: In your opinion, what qualities must all Future Leaders possess?

Lerner-Greenstein: Future Leaders must possess adaptability, integrity, empathy, and strong communication skills. They must be able to make difficult decisions while always keeping clients and caregivers at the center of those decisions.

I also believe Future Leaders need resilience and a strong sense of purpose. In home care, leadership is about more than operations — it’s about improving lives, supporting communities, and helping people live with greater independence, dignity, and support in their homes.

The post Future Leader: Raquel Lerner-Greenstein, Market Leader – New York, Help at Home appeared first on Home Health Care News.

Medicare pre-claim reviews for home health services cut spending in Illinois by 13% and reduced an estimated $1.2 billion in traditional Medicare home health expenditure during the study period, according to a new study published in Health Affairs. 

Pre-claim reviews did not lead to statistically significant declines in Medicare spending in three other states included in the study: Florida, North Carolina and Ohio. The findings suggest pre-claim review could benefit areas with higher cases of suspected fraud, such as in Chicago, rather than acting as a general policy guideline.

“Evidence from Illinois suggests that reductions in spending were driven by reductions in services that were more susceptible to fraud and reductions in spending in a geographic area with a history of home health fraud,” the study’s authors wrote. “Our results from Illinois add to a growing body of research that suggests that prior authorization (and prior authorization–like) programs can reduce health care spending and use.”

https://www.healthaffairs.org/ https://www.healthaffairs.org/

Illinois, particularly the Chicago area, has been linked with home health fraud over the last decade. 

Researchers examined whether a pre-claim review program affected unnecessary or fraudulent home health spending. The program required home health agencies to file the necessary documentation after services began but before payment was made. Medicare approves the claim if the home health agency provides sufficient evidence that the patient is homebound and under a physician’s approved care plan, which is required to satisfy Medicare’s coverage requirements.

To test the efficacy of pre-claim review, the researchers used 100% traditional Medicare claims, the Medicare Master Beneficiary Summary File and the Medicare Provider Analysis and Review file. They analyzed nationwide Medicare claims from 2014 through 2023, comparing four states that implemented pre-claim review — Illinois, Florida, North Carolina and Ohio — against a group of states that never implemented the pre-claim review process.

They looked at hospitalizations as an unintended consequence of pre-claim reviews, as hospitalizations are more likely to occur if pre-claim reviews deny or discourage quality health care, the authors explained.

When examining Illinois’s pre-claim review period from 2014 to 2023, the authors found a decline of $8.89 per Illinois beneficiary, representing a 13% decrease compared to the period before pre-claim reviews began. They then calculated that pre-claim reviews cut traditional Medicare home health spending in Illinois by about $1.2 billion during the study period.

A sharp decline in community-initiated home health care after the initiation of pre-claim review largely drove the spending reduction. Home health spending per user did not change considerably under pre-claim review. Additionally, the study authors found no notable increase in hospitalizations following the implementation of pre-claim review.

As for why other states showed statistically insignificant findings, the authors noted that this could have been due to state-level variation in home health services that may not have met Medicare’s coverage requirements. The onset of the COVID-19 pandemic lockdowns in early 2020 may have also influenced the results of pre-claim review implementation.

The study authors noted certain limitations. First, focusing on hospitalizations as an unintended consequence fails to measure other patient-centered outcomes, such as beneficiary satisfaction or caregiver burden, that come from applying a pre-claim review. The findings might also not apply to other states or services outside of home health, they added.

“Our results emphasize that prior authorization-like programs do not uniformly decrease spending. Home health pre-claim review reduced spending in some areas, such as Cook County, but did not have statistically significant effects in other states,” the authors wrote. “Policy makers should be cognizant of this potential heterogeneity in designing future prior authorization programs.”

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To become a Future Leader, an individual is nominated by their peers. The candidate must be a high-performing employee who is 40 years of age or younger, a passionate worker who knows how to put vision into action, and an advocate for seniors, and the committed professionals who ensure their well-being.

Greenberg sat down with Home Health Care News to share what drew her to the home health & home care industry, the biggest leadership lessons she has learned, her thoughts on the future of home health & home care, and much more. To learn more about the Future Leaders Awards program, visit https://futureleaders.wtwhmedia.com/.

HHCN: What drew you to the home health & home care industry?

Greenberg: I was drawn to the home health industry because it allows therapists to treat patients in their natural environments. In a hospital setting, therapists try to simulate what the patient’s home environment looks like to ensure they are preparing the patient to return home safely. However, in the home environment you truly understand the patient’s day-to-day routines and how their physical environment affects them. Being in the home allows therapists to make a concrete difference in patients’ lives by addressing their occupations in the natural environments in which they occur.

HHCN: How would you describe your leadership style, and how has it changed over time?

Greenberg: I learn something new from the therapists that I manage each day.

Every therapist has their unique style and brings their own background/training to home health. From this, I have developed an empowering leadership style. I ask my therapists what they need from me to support their work, rather than simply telling them what to do or how to approach problems. This collaborative dynamic fosters a sense of trust and creates a culture where therapists feel comfortable speaking with me regarding issues, big and small. It also helps the therapists feel confident in their work and in their decision making. 

HHCN: What is the biggest leadership lesson you’ve learned while serving the home health & home care industry?

Greenberg: The biggest leadership lesson I’ve learned while serving the home health industry is the importance of community partners.

The complex behavioral health patients we serve at Innovive Health have often fallen through the cracks of traditional healthcare systems due to barriers related to their mental and physical health. These challenges are compounded when patients are struggling to pay their rent or electric bills each month. Social determinants of health, such as economic instability, unsafe environments, and food insecurity, affect the health and quality of life for our patients.

We cannot solve all of these challenges as a home health agency. However, by partnering with state agencies and community partners, we can ensure that we address these factors to improve our patients’ lives and quality of life. Collaboration with other leaders is key in this setting. 

HHCN: In one word, how would you describe the home health & home care industry and why?

Greenberg: I would describe the home health and home care industry as the “future.”

The average length of stay in hospitals has steadily declined over the past decade, with patients returning home with significant healthcare support needs. In addition, patients naturally want to age in place rather than move to an institutional setting. Home health can fill these gaps by helping patients recover from recent illness/injury as well as remain in their homes as they age. Based on this, I believe that home health will continue to grow as a major sector for healthcare services. 

HHCN: What do you see as the biggest opportunities and challenges currently facing the home health & home care industry?

Greenberg: In my opinion, the biggest opportunities in home health involve value-based care for patients with complex healthcare needs. At Innovive Health, we are expanding across states to provide healthcare services for behavioral health patients through partnerships with various insurance entities. We have demonstrated that by integrating nursing, occupational therapy, and physical therapy services, we can significantly reduce hospitalization rates. For therapy, this often involves creating a fall prevention plan and helping patients engage in healthy daily routines. Demonstrating the value of these services and their potential for cost-savings is essential as healthcare expenses continue to rise.

One of the biggest challenges in home health is the workforce shortage, which impacts the ability to expand and offer this valuable care. At Innovive Health, we are working to expand our therapy department as we recognize the value of occupational therapy and physical therapy for our patients. However, the demand for clinicians continues to grow across all healthcare sectors. The workforce shortage can be addressed by offering a work setting with significant clinician autonomy, collaborative support, realistic caseload expectations, and competitive salaries, all of which are offered at Innovive Health.

HHCN: If you had a crystal ball, what do you think will impact the home health & home care industry over the next 5-10 years?

Greenberg: I believe that artificial intelligence (AI) will have the most impact in the home health and home care industry over the next 5-10 years. It is already being used across many healthcare systems for electronic medical record review and generating medical records/notes.

In the future, I envision how AI could ensure patients are completing their home exercise programs, engaging in hygiene routines, and following fall risk precautions outside of therapy visits through remote monitoring.

A challenge that occupational therapists and physical therapists face is helping patients engage in their plans of care and follow safety precautions outside of their skilled sessions and after discharge. AI may bridge this gap and improve the safety and quality of life of home health patients long-term.

HHCN: In your opinion, what qualities must all Future Leaders possess?

Greenberg: Future Leaders must have a curiosity and hunger for continued learning. Home health care is never stagnant; it is always changing based on patient needs and the stakeholders involved. That curiosity fuels me every day working at Innovive Health.

Each day brings new challenges and new successes. I am passionate about diving into these learning experiences to support patients’ rights to live and thrive in their homes and communities.

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