CMS estimates that the final rule will increase aggregate Medicare payments to home health agencies by 2.4% compared to calendar year 2026, in line with the increase that CMS proposed in July. The rate bump is estimated to increase home health payments by $415 million year-over-year.

The increase consists of a payment update of 2.1% and an estimated 0.3% increase reflecting the updated fixed dollar loss (FDL) amount.

The final rule also includes a -3% temporary adjustment to the 2027 national, standardized payment rate.

Additionally, the rule allows CMS to make Medicare enrollment revocations effective as of the date that noncompliance began.

CMS estimated that the final rule would save taxpayers approximately $82 million annually by strengthening the agency’s ability to recover Medicare payments from noncompliant providers and prevent high-risk providers from entering or remaining in the Medicare program.

“The Trump Administration is taking action to hold noncompliant providers accountable and ensure Medicare works with legitimate, qualified providers,” CMS Administrator Dr. Mehmet Oz said in a statement. “These changes will help protect seniors, safeguard taxpayer dollars, and preserve access to the care beneficiaries need.”

The final rule continues CMS’ implementation of a 30-day unit of payment and of the Patient-Driven Groupings Model (PDGM) case-mix adjustment methodology. CMS did not propose an additional permanent adjustment to the 30-day base payment rate, but the agency said it will continue to analyze CY2026 claims to determine if additional permanent adjustments are necessary to account for Patient-Driven Groupings Model (PDGM).

The rule finalized the recalibrated PDGM Case-mix weights, updated the FDL for outlier payments and updated the low utilization payment adjustment (LUPA) thresholds, functional impairment levels and comorbidity adjustment subgroups.

The full fact sheet on the final rule can be viewed here.

Fraud focus

The final rule includes several fraud-focused measures, most of which will apply to all provider types enrolled in Medicare, not just home health, according to CMS’ fact sheet.

The rule finalizes a policy making all Medicare enrollment revocations retroactive to the date that noncompliance began. This is a change from current regulations, which make certain Medicare enrollment revocations go into effect 30 days after CMS or its contractor mails the revocation notice.

CMS also added new grounds for revocation or denial of enrollment and expanded some of the existing grounds.

These new grounds include changes in majority ownership. This requires home health agencies, hospices and durable medical equipment suppliers undergoing certain changes in majority ownership must reenroll in Medicare as new providers and undergo a survey or accreditation. The final rule gives CMS authority to deny or revoke enrollment if a provider fails to comply with those requirements.

CMS also expanded existing enrollment denial and revocation grounds involving license or healthcare program suspensions and revocations to include a provider’s owners and managing employees or organizations.

“The final revocation/denial authorities address situations noted by CMS as involving provider noncompliance and actual and potential fraud, waste and abuse,” CMS’ fact sheet read. “They also would allow the agency to target improper activity by those who own or operate Medicare providers.”

Other final changes

The final rule responded to comments regarding how best the agency can promote access to community-based palliative care services through the Medicare home health benefit.

“This final rule acknowledges the role of home health in palliative care services and confirms that CMS will provide examples of such services through future sub-regulatory guidance,” CMS’ fact sheet read.

The final rule also responds to comments to its request for information (RFI) regarding the development of a home health-specific wage index from an alternate data source, such as the Bureau of Labor Statistics. The final rule did not announce an implementation plan or finalized methodology for a new home health-specific wage index.

Additionally, the rule amended the definition of durable medical equipment (DME) to certain external infusion pumps and associated home infusion drugs.

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The post [Updated] CMS Finalizes 2027 Home Health Medicare Payment Rule With 2.4% Rate Increase appeared first on Home Health Care News.

Addus is rolling out its caregiver app in more states to help it serve more authorized hours, while being selective about the cases it can staff effectively, CEO Dirk Allison said during the company’s Q3 earnings call on Wednesday. 

“The slight decline in our personal care census over the prior year has primarily been in our lower hour cases, as our higher hour cases have increased year over year,” Allison said on the call. “This, along with the continued improvement in our service percentage, has contributed to our year-over-year increase in same-store personal care hours.”

Frisco, Texas-based Addus HomeCare provides home care, home health and hospice services. The company serves about 62,500 individuals throughout 263 locations within 24 states.

Allison attributed the decline in personal home care census to caregivers’ increasing desire for a 40-hour work week. Caring for clients who require few hours therefore becomes increasingly difficult to staff, he said.

Addus has two strategies to address this issue, Allison said. The first is the company’s technology, particularly its caregiver app Addus Connect. The app allows caregivers to access their schedule, modify their work hours and availability and view patient information.

Allison said the app performed well in Illinois. The company is currently rolling it out in Texas and plans to do so in New Mexico next.

“We should continue to see some positive improvements in in that metric, allowing us to serve more of the authorized hours that have been granted by the state,” Allison said.

The second strategy to increase census is to heighten selectivity. Allison said the company aims to be cautious when accepting patients to ensure they are a fit.

“What we’re trying to do is make sure we’re looking at the patients that give us more hours,” Allison said. “We’re trying to balance that with our referral sources to make sure that we’re doing all things that are necessary.”

However, Allison emphasized that Addus will still serve lower-hour patients. The company is looking to optimize its methodology to staff such patients most effectively with the hours that caregivers are looking for. That strategy has been a focus for the company for the past several quarters, Allison said.

Broader growth

On Sept. 14, Addus agreed to acquire AccentCare’s personal care assets, which spanned 10 states and served 13,700 clients in an average daily census, for about $275 million. Expected to close in Q1 2027, the deal would help Addus enter Colorado, Georgia, Minnesota, Pennsylvania, Tennessee and Washington. Allison estimated that the deal would increase Addus’ revenue base by approximately 19%.

The company’s PCS unit brought in $301 million in revenue in Q3, a 9% year-over-year increase.

Across its entire business,Addus reported third-quarter net revenue of $387.7 million, a 7% increase year-over-year. Its adjusted EBITDA rang in at $51.2 million, a 13.5% year-over-year increase.

Addus’ smallest segment is its home health service line, which comprised 4.6% of the revenue in Q3. Home health brought in $17.7 million for the quarter, a 0.36% increase year-over-year. Home health same-store revenue increased 2.5% and same-store admissions rise 13.8% year-over-year, Allison said.

Q3 2026 is the first positive year-over-year revenue quarter for Addus’ home health segment in years, driven by the company’s new leadership team, Allison added.

Allison also said that the Medicare home health enrollment moratorium has not affected the company’s growth strategy.

“Obviously, just like in PCS, we are not a de novo-based business, so most of the moratoriums that are out there do not really affect our growth profile or how we operate,” Allison said. “As long as we can continue to look at certain acquisitions in the state, and as if they’re not covered by the moratorium, then we should be fine.”

Moving forward, the company plans to grow its home health arm as opportunities arise.

“We are not a home health company per se today,” Allison said. “We are a company that has a segment of home health, and we want to continue to grow that appropriately as we have opportunities.”

The post Caregiver Desires For 40-Hour Weeks Shape Addus’ Personal Care Census Strategy  appeared first on Home Health Care News.

That combination is putting pressure on home health providers as MA accounts for a growing share of their patients, according to speakers at the National Alliance for Care at Home’s Annual Meeting & Expo.

The average revenue per visit for traditional Medicare is $266, compared with $206 for MA, according to Homecare Homebase data. At the same time, the weekly office workflow for MA patients is approximately 13% higher than traditional Medicare patients, Hannah Pearson, chief revenue officer of Homecare Homebase, said.  

Statistics including weekly visits per patient and rehospitalization rates are approximately the same across the two populations, Pearson said.

“So doing the same clinical work, a quarter less revenue with more paperwork, [and the] hospitalization risk is effectively the same,” Pearson said on a panel at the Alliance’s Annual Meeting & Expo.

MA now accounts for 49.5% of patients in Homecare Homebase’s dataset, a 31% increase since 2016. Pearson described that growth as a structural change requiring providers to reconsider how they operate.

“Most organizations built their staffing, their workflows, and their contracts when traditional Medicare was two thirds of their business,” she said.

Homecare Homebase provides technology and administrative services to the home-based care sector.

Traditional Medicare margins have remained relatively steady since the implementation of the Patient-Driven Groupings Model (PDGM), while the cost-report category that includes MA has consistently operated at a loss, according to Nick Seabrook, executive vice president of SimiTree.

That category also includes other payers, meaning its results do not isolate MA performance.

“Medicare is really our only payer source in home health that’s making any kind of a positive margin,” Seabrook said on the panel.

When PDGM was first implemented, overall margins were around 7%, he said, referencing CMS data through 2024. Over the last three years, margins have hovered around 3%.

SimiTree offers consulting, technology and billing services for home healthcare, hospice and behavioral health providers.

Rising visit costs add another challenge. Seabrook reported that total RN visit costs approached $230, approximately $60 higher than at PDGM’s inception.

Still, opportunities exist for providers to negotiate episodic, Medicare-like MA contracts rather than accept per-visit reimbursement. Seabrook said plans have become more receptive to those arrangements.

“I would encourage you to reach out to your Medicare Advantage plans now to start that negotiation process to see if they would be receptive to a Medicare-like reimbursement rather than that per-visit model,” Seabrook said.  

As providers negotiate, they should be ready to provide payers with clinical outcomes.  

The post Home Health Agencies Face 13% More Paperwork For $60 Less Per Visit Under Medicare Advantage appeared first on Home Health Care News.

Providers of home- and community-based services (HCBS) face ever-mounting challenges, including shifting regulations and Medicaid funding cuts.

As the operating landscape grows more complex, HCBS providers must balance providing quality care with the wages and hours caregivers requires, industry experts told Home Health Care News.

“I think success is ultimately going to be: Are you still delivering high-quality care? Are you still maintaining a healthy employment practice with good retention? Those are the outcomes that we have to look for at the end of this game,” President and CEO of Home Assist Health Sara Wilson told HHCN.

Phoenix-based Home Assist Health is a nonprofit provider of home health, home care and community health services in Maricopa County.

HCBS address an individual’s daily living needs and functional limitations, with care delivered in the home or community. HCBS can include home health care, personal care, adult day care, home assessments and other services.

About 8.4 million people receive Medicaid HCBS, according to an April report from the Brandeis University Community Living Policy Center.

Medicaid paid for more than half of the $286.5 billion spent on HCBS in the United States, according to data from 2024.

Over the past few years, several major policy shifts have altered how providers can deliver HCBS services. Notable changes include the 80/20 rule, which the Centers for Medicare & Medicaid Services (CMS) finalized in 2024. The rule requires HCBS providers to direct 80% of Medicaid reimbursements to caregiver wages, with the remaining 20% designated for overhead and profit.

The One Big Beautiful Bill Act, signed into law in 2025, also cut $1 trillion from the Medicaid budget. At the time, Katie Smith Sloan, president and CEO of LeadingAge, called the cut a “death knell” for many agencies.

More changes occurred in 2026, such as the Olmstead reversal. In July, the Department of Justice shifted away from requiring providers to care for individuals with disabilities within the home or community as opposed to institutions. Without federal enforcement to prevent unnecessary institutionalization, HCBS advocates voiced concern about providers’ ability to deliver care.

Contending with workforce shortages, breakneck regulations

When Medicaid budgets are cut, one of the first services to go is HCBS, Gal Wettstein, associate director of health and insurance at the Center for Retirement Research at Boston College, told HHCN.

“Where they can cut back is in these discretionary things they aren’t required to cover, the biggest of those is HCBS,” Wettstein said.

A workforce shortage is exacerbating the funding cuts. Though the 80/20 rule aimed to improve home-based caregiver workforce by improving wages, HCBS providers told HHCN that the limited labor pool is the main hindrance to delivering HCBS.

Caregiving is not only low-paying but also physically and emotionally demanding, Wettstein said.

“There are only so many people willing to do this job,” Wettstein said.

Retaining caregivers hinges on wages as well as the hours available to them, which depend on the amount of care authorized for clients.

“When you see things like authorization hours drop, that also means your employees are going to have fewer hours to work,” Wilson said. “You have to balance not only the quality of the care being received, but the work of your staff and maintaining their needed work schedules.”

This year, the HCBS caregiving labor pool was dealt additional blows from immigration enforcement actions, especially those targeting Haitian immigrants. In June, the Supreme Court allowed for the ending of Haiti’s Temporary Protected Status designation along with the work authorization tied to it.

Providers also must compete with large health systems for registered nurses, licensed nurses and other workers, said Flournoy Health Systems CEO Faris Flournoy told HHCN.  

“Right now, attracting individuals to a workforce for an industry that’s underpaid, that’s been our biggest struggle,” Flournoy said. “These are our certified nursing assistants, our personal care aides.”

Flournoy Health Systems, based in Milledgeville, Georgia, is a home care management company operating in Georgia and Indiana through a portfolio of brands, including Primecare Home Care and Just Care Home Care.

Beyond recruiting staff to deliver care, providers must keep up with changing regulations as well, Wilson noted.

“I do see [some of them being] very helpful and an improvement, but keeping up with it is strenuous,” Wilson said. “And you’ve got your staff — just as they interpret and understand one rule, there’s another one coming down.”

Other changes can drain the capacity of the nurses already employed. Flournoy said nursing requirements can add costs and place additional demands on clinical staff.

“Now the mandates are requiring the nurses to be a part of some of those visits, which becomes costly,” Flournoy said.

Looking to the future

While HCBS providers feel squeezed by morphing regulations, the future offers glimpses of hope.

For instance, in August, Democratic senators from Virginia and New Mexico introduced the Home and Community-Based Services Access Act. The bill aims to make HCBS mandatory under Medicaid, giving older adults and people with disabilities more robust choices in receiving care in the home, community or at an institution.

While HCBS have often been beleaguered, their value will become increasingly clear in the coming years, said Wilson. There have historically been few measurable metrics to demonstrate the value of HCBS, especially for older adults and individuals with disabilities, she added.

“You didn’t have a lot of data to show the value, and I do believe that as we go into maybe the later part of 2027 and into 2028, we’re going to start being able to prove more of that,” Wilson said. “There is a lot of work going into demonstrating outcomes and proving the value of home and community-based care.”

Technology can also help, Wilson said. For instance, improvements to electronic storage can enable providers to run more comprehensive reports and track trends more accurately and affordably.

For states, the question is how to preserve access to home- and community-based services while navigating competing demands on Medicaid funding, Wettstein said.

But despite the upfront costs to providing HCBS, the services can help states and taxpayers save money in the long run. HCBS not only cost less on average than a year in a nursing home, but can further reduce costs over time, according to Brandeis University.

“Working with a very small minimum reimbursement, it really constrains the opportunity to go through and support our community,” Flournoy said. “I do believe that investment in home and community-based services is a trickle-down effect.”

The post The State Of HCBS In 2026: Policy Upheaval, Staffing Shortages Squeeze Providers  appeared first on Home Health Care News.

To differentiate themselves from fraudulent operators, home-based care providers are placing greater emphasis on documentation, audit readiness, accurate enrollment records and policy reviews to highlight their regulatory compliance, industry leaders said during a FUTURE panel in August.

“It used to be that there was a finding of fraud, and then you were charged, and then they took action on that enforcement,” said Katie Wehri, vice president of regulatory affairs, quality and compliance for the National Alliance for Care at Home (the Alliance). “What’s happening now is they’re going after folks without a finding of fraud.”

The Alliance, based in Alexandria, Virginia, is a member network of more than 2 million home health, hospice, Medicaid home- and community-based care and other professionals in the home-based care space.  

Providers are contending with increased oversight, enrollment restrictions and proposed changes to affiliation disclosures. Wehri said home-based care operators could also face suspensions or revocations based on location or business ties.

That approach can make it difficult to distinguish compliant providers that make mistakes from entities engaged in intentional fraud, said Gayle Devin, CEO of Home Care Delivered.

“We’ve been in business for 30 years. Do we make mistakes? We do,” Devin said. “But there’s a difference between a mistake and patterns.”

The Centers for Medicare & Medicaid Services (CMS) should ideally look at the data showing where fraud occurs and take actions to correct patterns of intentional scams, Devin said. Compliant providers who have made a mistake and might need only re-education should be treated differently from bad actors purposely enacting illicit activity.

Richmond, Virginia-based Home Care Delivered is a specialty medical supplier that partners with home healthcare companies, physicians and other healthcare providers to deliver medical products to patients’ homes.

However, the current climate of aggressive fraud enforcement will likely not go away any time soon, said Brian Holzer, CEO of Freedom Senior Services. As a result, companies must always be prepared for compliance checks.

For instance, Freedom Senior Services plans to implement unannounced internal audits to ensure the company is always ready, Holzer said.  

“If you cannot prepare your company for increased scrutiny and regulatory oversight, it might be a good time to sell to someone who can,” Holzer added.

Louisville, Kentucky-based Freedom Senior Services provides home care, adult day healthcare and other services across Kentucky, Ohio, Pennsylvania, Tennessee and Indiana.

Welcoming differentiation

Despite the higher intensity and stakes of the fraud crackdown, the enforcement environment offers an opportunity for compliant providers to differentiate themselves, Wehri said.

“This broad brush has been placed upon all of us, and all these providers are now doing the wrong thing, assumed to be fraudulent,” Wehri said. “Now is an opportunity to show how you’re different, and you are not falling into this bucket that CMS and others have created.”

Providers can differentiate themselves by explaining to CMS why they may be an outlier, Wehri said. For example, an agency could show that it is filling a gap in care and demonstrate the value of its approach. Providers can also differentiate themselves with customers by showing that they have not faced revocations or suspensions.

Some providers may also welcome the opportunity for scrutiny, Holzer said.

“I would think any operator that aspires to run a platform company in the space would say that we welcome the increased scrutiny,” Holzer said. “There is an enormous amount of fraud, waste and abuse, and any good operator would say, ‘We want to be rewarded for doing it the right way, for the investments we make and for the culture we create.’”

Other providers, such as Home Care Delivered, are using this opportunity to become more proactive than reactive, according to Devin.

For instance, the number of unannounced surveys and volume of audits have increased, Devin said. So the company responded with more vigilance for verification eligibility, ensuring that the company meets all policy guidelines and scrubbing all claims.

Overall, home-based care companies should keep their employees informed of all regulatory changes and how they can remain compliant, Devin said. Companies can leverage technology to assist with compliance and policy reviews, but human oversight remains essential

“My advice for companies is: Compliance is key, and it has to be embedded in every aspect of the organization,” Devin said. “It’s important that your employees not only know their role and their function, but understand the regulated environment that they’re operating in.”

The post Amid Fraud Crackdown, Home-Based Care Operators Look To Differentiate  appeared first on Home Health Care News.

Executives also believe that pairing primary care with home health will help deepen relationships with Medicare Advantage plans and other partners, they said during BrightSpring’s Q3 2026 earnings call on Oct. 30.

“We see our model of primary care in the community and inpatient residences as key to driving more integrated and coordinated care across our service lines, better care transitions, optimal outcomes and growth from value-based care models and new payer opportunities,” BrightSpring CEO Jon Rousseau said in the call.

Louisville, Kentucky-based BrightSpring Health Services provides home health, personal home care, hospice, infusion and other services. It operates across all 50 states, working with about 500,000 customers, clients and patients.

BrightSpring’s primary care offerings involve in-home care for individuals with complex health issues, chronic conditions or limited mobility. One of the advantages of the program is a reduced hospitalization rate, according to Rousseau.

In-home primary care is a key pillar to BrightSpring’s long-term growth strategy, leaders emphasized during the Oct. 30 call. This would entail augmenting virtual visits for higher-risk, rural and home bound patients, such as individuals discharged from hospitals and nursing homes, since primary care complements other services and sits between pharmacies and other provider services, Rousseau said.

“We view primary care as the tip of the spear and the linchpin for ‘integrated care’ within our company,” Rousseau said.

In terms of financial results, BrightSpring’s home healthcare revenue increased 50% year-over-year to reach $288 million in Q3.

The home healthcare growth largely stemmed from BrightSpring’s acquisitions of Amedisys and LHC Group assets, deals which closed toward the end of 2025. BrightSpring acquired 107 home health and hospice assets from UnitedHealth Group (NYSE: UNH) and Amedisys in a nearly $239 million deal.

The assets from Amedisys and LHC Group contributed $76 million of the company’s total revenue. Excluding those branches, BrightSpring’s home healthcare revenue increased 12% year over year.

BrightSpring’s home healthcare census grew approximately 58% year over year in Q3, driven by the acquired branches, new locations, business development and expanding preferred Medicare Advantage relationships, Rousseau said.

In addition, BrightSpring’s provider services segment brought in $79 million in EBITDA in Q3 — up 30% year –over year, BrightSpring Executive Vice President and Chief Financial Officer Jennifer Phipps saidon the call. EBITDA for the provider services segment also increased 16%, excluding the acquired Amedisys and LHC Group units.

“Profitability growth reflected strong revenue performance across our businesses, disciplined execution, and continued investment in technology, processes and people across the company,” Phipps said.

Total Q3 2026 revenue checked in at $4.21 billion (up 24.6% compared to the same period a year ago), with the majority of that attributed to BrightSpring’s pharmacy solutions business.

BrightSpring Health Services BrightSpring Health Services

BrightSpring sees further opportunities to deepen its Medicare Advantage relationships by incorporating medication management and virtual primary care into its home healthcare service line. These new offerings can strengthen partnerships with hospitals and accountable care organizations (ACOs), Rousseau said.

BrightSpring was also selected for a new Long-term Enhanced ACO Design (LEAD) Medicare program beginning in January 2027, Rousseau said, adding that the company could see “impactful economics from that” by 2028.

Meanwhile, the company has also invested in AI and other technology solutions, Phipps said. BrightSpring has begun to implement its technology solutions in Q3 and will continue to do so in Q4, expecting to see opportunities for return on investment.

The post BrightSpring Home Health Revenue Jumps 50% As Company Sets Sights On Primary Care, New ACO Model  appeared first on Home Health Care News.

The HHCN POY Awards recognize innovative, evidence-informed products, solutions and technologies that deliver real-world impact by improving quality of life, care, safety and operational effectiveness across home health and home care providers.

Earlier this year, vendors serving the home health and home care industry submitted their products, solutions and technologies for nomination. Once finalized, HHCN subscribers were asked to vote for their favorites in each category.

Based on the voting results, each category has a Gold, Silver, and/or Bronze winner. There is also a Most Valuable Product (MVP) winner, which is for the product that received the most votes overall from HHCN subscribers.

“The inaugural HHCN Product of the Year Awards highlight the innovative, evidence-informed solutions helping home health and home care organizations elevate care, improve safety and operate more effectively,” said Robert Holly, Arrowfly VP and Editorial Director. “With winners chosen directly by HHCN subscribers, these awards give our readers a meaningful platform to recognize the tools and technologies that make a real difference in daily care and operations.”

To view this year’s winners in greater detail, visit the HHCN POY Awards website and download our Winner eBook. Below are the winners and nominees for each of the 12 categories submitted this year:

Most Valuable Product (MVP)

• MVP – Company Name: Caribou, Product Name: Caribou Engagement and Shift Booking Platform

Category: Capital, M&A, Financial & Advisory Services

• Gold – Company Name: Montauk AI, Product Name: Operate. Optimize. Exit. Platform

• Silver – Company Name: WOTC.com, Product Name: WOTC.com Business Portal

Category: Clinical Documentation, EHR & Care Coordination Platforms

• Gold – Company Name: IO Health Technologies LLC, Product Name: IO Health Platform

• Silver – Company Name: IntellaTriage, Product Name: IntellaHub 2.0

• Bronze – Company Name: AxisCare, Product Name: AxisCare’s Skilled Care Solutions

• Nominee – Company Name: WellSky, Product Name: WellSky Extract for Home Health

• Nominee – Company Name: WellSky, Product Name: WellSky Home Health Intelligent Health Record Platform

• Nominee – Company Name: WellSky, Product Name: WellSky Scribe for Home Health

Category: Clinical Quality, Outcomes & Risk Management Technology

• Gold – Company Name: POM Safe, Product Name: Intake Risk Assessment

• Silver – Company Name: Ruby Health, Product Name: Ruby Health

• Bronze – Company Name: AxisCare, Product Name: AxisCare’s Skilled Care Solutions

Category: Data Analytics & Business Intelligence Solutions

• Gold – Company Name: Zingage, Product Name: Zingage Operator

Category: Durable Medical Equipment (DME) & Home-Based Care Solutions

• Gold – Company Name: WellSky, Product Name: Bonafide, Powered by WellSky

Category: Facilities, Safety, Infection Control & Home Environment Solutions

• Gold – Company Name: POM Safe, Product Name: POM Safe Workforce Safety Platform 

Category: Home Health & Home Care Operations Management Software

• Gold – Company Name: Aegle Technologies, Product Name: SwyftOps

• Silver – Company Name: Commure, Product Name: Orchestrator for Home Health Referral Management

• Bronze – Company Name: AxisCare, Product Name: AxisCare Home Care Operations Management Software

• Nominee – Company Name: eRSP, Product Name: eRSP

• Nominee – Company Name: WellSky, Product Name: WellSky Orders & Consents Exchange

• Nominee – Company Name: WellSky, Product Name: WellSky Summarize for Personal Care

Category: Marketing, Growth & Referral Management Platforms

• Gold – Company Name: AutomationEdge, Product Name: Referral Intake CareFlo AI

Category: Patient Engagement, Experience & Communication Technology

• Gold – Company Name: Nevvon, Product Name: Family Caregiver Training Hub

• Silver – Company Name: CareBestie, Product Name: CareBestie

• Bronze – Company Name: Zingage, Product Name: Zingage Operator

• Nominee – Company Name: Maxwell TEC, Product Name: nanaCONNECT

• Nominee – Company Name: NewDays, Product Name: NewDays AI

• Nominee – Company Name: Skyscape, Product Name: Buzz

• Nominee – Company Name: WellSky, Product Name: WellSky S3 Resupply, Powered by WellSky

Category: Remote Patient Monitoring & Virtual Care Technology

• Gold – Company Name: Cognitive Systems Corp, Product Name: Caregiver by Cognitive

Category: Revenue Cycle Management, Billing & Compliance Solutions

• Gold – Company Name: Advanced RevCycle, Product Name: ACE

• Silver (TIE) – Company Name: AxisCare, Product Name: AxisCare RCM

• Silver (TIE) – Company Name: Inovalon, Product Name: Claims Management Starter

• Bronze – Company Name: WellSky, Product Name: WellSky Resource Manager

• Nominee – Company Name: Inovalon, Product Name: Claims Management Medicare Starter

Category: Workforce Management, Staffing & Scheduling Solutions

• Gold – Company Name: Caribou, Product Name: Caribou Engagement and Shift Booking Platform

• Silver – Company Name: Homecare Homebase, Product Name: HCHB Smart Scheduling

• Bronze – Company Name: Palm Care, Product Name: Care Hero

• Nominee – Company Name: Arya Health, Product Name: Talent Agent

• Nominee – Company Name: AxisCare, Product Name: AxisCare Home Care Operations Management Software

To learn more about the HHCN POY Awards, visit https://poyawards.homehealthcarenews.com/.

The post Announcing the Winners of the Inaugural Product of the Year Awards appeared first on Home Health Care News.

CMS’ fraud crackdown was a recurring topic at the National Alliance for Care at Home’s Annual Meeting & Expo this week in Washington, from the main stage to breakout sessions to hallway conversations.

I left the event thinking the home health enrollment moratorium’s next chapter might not be a simple choice between extending the nationwide freeze and letting it expire. CMS has options, including a potential gold card approach that would give established providers with strong compliance records a path to expand. Geographic limits are on the table, too. My bet is that CMS finds a middle path — though whether that offers meaningful relief will depend on the details.

Meanwhile, providers were awaiting the home health final rule, with payment rates and broader enrollment proposals still hanging in the balance. Even if CMS opens a door for expansion, it could tighten scrutiny elsewhere.

In this week’s exclusive, members-only HHCN+ Update, I’m writing from the airport to share key takeaways from the Alliance’s annual event, including:

• Why a “gold card” option could become the moratorium’s middle path 

• The potential for a smaller freeze, but a wider compliance net 

• The relationship between the moratorium and the payment rule 

Creative moratorium solutions

In the opening mainstage panel, Brandt said that the home health industry has shared a slew of creative solutions to limiting the number of compliant providers caught in the program integrity net. One that she mentioned was a gold card approach.

Denis Fleming Jr., the Alliance’s chief government affairs officer, described the gold card system as a potential program in which CMS would provide exceptions to the moratorium for existing providers with strong compliance track records. 

Costco’s gold star-level membership seems to be popular, and a potential CMS gold card model would likely be popular too, based on my conversations at the event.

The benefit here wouldn’t be access to bulk groceries, but a path for established, compliant providers to open new locations. Brandt acknowledged that CMS has heard concerns from existing operators that want to expand, particularly into rural areas, but are running into the enrollment restrictions.

That’s what makes the gold card idea worth watching. CMS could keep a barrier in place for new entrants while giving providers with demonstrated compliance records a way to keep growing. For communities where access is already strained, that could be more than a perk for the provider.

Of course, the details would make or break it. Neither Brandt nor Fleming laid out potential criteria for such a program, and CMS has not announced a gold card program. Brandt said the agency was working with its counsel’s office on potential solutions. Still, hearing a CMS leader openly consider the idea struck me as a meaningful opening.

A gold card also wouldn’t solve every problem. An exception for established operators would not necessarily help a legitimate new provider trying to enter the market. And the roughly 250 home health agencies blocked from enrollment during the moratorium should not be confused with 250 proven fraudsters. That number tells us how many agencies were not approved, not how many were doing something wrong.

Gold cards aren’t the only option on the table. Brandt also raised geographic limitations, which could allow CMS to focus its enrollment restrictions on certain markets rather than keeping a nationwide freeze in place.

CMS could also allow the moratorium to expire and instead apply other tools, including those used for hospice. That would not necessarily mean easing up on fraud. As Hillary Loeffler, BrightSpring Health Services’ (Nasdaq: BTSG) new vice president of federal government relations, pointed out during a separate panel, a moratorium stops new entrants; it does not, by itself, remove fraudulent providers already in the program.

On the flip side, a narrower moratorium would not necessarily mean a lighter compliance load. In that same session, Katie Wehri, the Alliance’s vice president for regulatory affairs, quality and compliance, warned about broader proposed enrollment requirements and the staffing and financial resources providers need to respond to mounting scrutiny. Relief on expansion could coexist with more oversight elsewhere.

After hearing the options discussed at the event, my bet is that CMS moves toward a modified moratorium rather than a blanket extension or expiration. I’ll be watching whether that middle path gives compliant providers a usable route forward.

Final home health rule loading

The Alliance’s event took place as providers awaited the Medicare home health final rule, which typically drops around Halloween. Panelists and attendees discussed possible timing and contents of the final rule. CMS’ July proposal included an aggregate payment increase of 2.4% and a temporary 3% reduction to the 2027 national, standardized payment rate.

It also included other measures, such as fraud-fighting tools, an RFI to develop a home health-specific wage index and a discussion of expanding access to palliative care. 

Kim Brandt, CMS’ deputy administrator and chief operating officer, linked CMS’ anti-fraud efforts to more favorable payment rates, arguing that money going to bad actors was money taken away from compliant providers. But with a proposed 3% temporary adjustment still in the mix, I’m watching for how that anti-fraud progress translates into meaningful payment relief for legitimate operators.

I avoided going too in depth into the conversations surrounding the rulemaking process in this Update because, well, anything I write now could be moot in a matter of minutes. But the Alliance staff assured attendees they were closely watching for the final rule’s publication and would share their thoughts on what it means for the home health industry.

HHCN is watching too and will ensure readers know the details as soon as possible.

The post Gold Cards, Geographic Limits: Potential Paths For The Home Health Enrollment Freeze appeared first on Home Health Care News.

RCD is currently in place in Illinois, Ohio, Oklahoma, North Carolina, Florida and Texas. CMS filed a notice on Friday requesting expedited approval from the Office of Management and Budget to revise the demonstration’s information collection requirements. This process would be a step toward allowing CMS to expand RCD to California. 

The notice is scheduled for publication on Nov. 2, but the unpublished text is available on the Federal Register website.

In the notice, CMS said emergency is necessary to prevent public harm.

“A delay in the expansion means an extended time the public will be harmed through the continuation of significant fraud found in the traditional Medicare home health benefit in California through the waste of taxpayer money, a loss of funds from the Medicare Trust Funds that could have been used for truly needed care, paying for care that is never delivered and beneficiaries potentially receiving non-medically necessary care,” the notice read.

California has been repeatedly identified as a hot spot for home health and Medicare fraud.

The notice does not specify when California agencies would begin participating in RCD. It provides for a 14-day public comment period following publication in the Federal Register.

RCD involves more rigorous claims review procedures meant to combat improper billing.

Under current CMS guidance, agencies meeting a 90% target full provisional affirmation rate, based on at least 10 requests or claims during a six-month review period, become eligible for additional review choices, including relief from most reviews except for spot checks.

Some providers have previously advocated for expanding RCD to California. Stacey Smith, vice president of public affairs at AccentCare, told Home Health Care News in 2025 that the company supported expansion to California and nationwide.

Supporters say RCD’s pre-claim review option provides greater payment certainty by allowing agencies to address documentation issues before submitting final claims, reducing the risk of denials months later.

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A new Mertz Taggart report recorded 11 completed home health, home care and hospice transactions in Q3 2026 — down from 23 counted in the previous quarter. However, buyers remain willing to pay premiums for quality agencies that fit their strategies, even as longer closing timelines and other variables depress quarterly deal counts, according to M&A experts.  

“Our report counts completed transactions, so the timing of closings affects the quarterly numbers,” Cory Mertz, managing partner at Mertz Taggart, told Home Health Care News. “I would not interpret a light quarter as evidence that buyers have lost interest. We continue to expect a strong Q4.”

Fort Myers, Florida-based Mertz Taggart is a sell-side M&A advisory firm focusing on healthcare services.

Of the 11 deals closed in Q3, six were sponsor-backed strategic add-ons, two were new sponsor platform investments, two were completed by other buyers, including independent operators and one came from a strategic buyer, according to the report.

The third-quarter figures mark a 52.2% decrease compared to 23 transactions in Q2 2026. By sector, six home health deals closed, along with four in home care and six in hospice.

Some deals announced in Q3 did not cross the finish line this quarter, including Addus HomeCare Corp.’s (Nasdaq: ADUS) planned acquisition of AccentCare’s personal care division for roughly $275 million. Deaconess Associations Incorporated’s (DAI) also closed its acquisition of 31 home health and hospice agencies from HCA Healthcare (NYSE: HCA) after the quarter ended.

The total number of deals could be higher than reported, according to Les Levinson, partner and co-chair of the transactional health law group at Robinson+Cole.  

“Sometimes statistical reports are based upon publicly available information and if that is the case here, there may be some deals which were not accounted for various reasons,” Levinson told HHCN. “Therefore, the number of completed deals may be higher.”

Hartford-based Robinson+Cole is a law firm specializing in business transactions, health law, real estate, development and other sectors.

The report described a more selective buying environment. Buyers are taking a closer look at agencies’ compliance histories, documentation and leadership depth during due diligence — factors that are increasingly important to buyers in 2026.

“I can say with certainty that buyers are paying premiums for quality agencies that have strategic value to them,” Mertz said. “For an owner, the important distinction is that buyer demand is selective — not absent.”

Mertz added that agencies do not need national reach for the right buyer to find them strategically important.

“Reliable financials, sound compliance and a strong team help establish the quality of the business. How that agency fits a particular buyer’s strategy is a separate part of the value equation,” Mertz said.

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