The Scale of the Proposed Cuts

The U.S. Centers for Medicare and Medicaid Services (CMS) has proposed what many are calling the largest payment cut in the history of the home health industry. This substantial reduction stems from concerns over the methodologies CMS employs to determine reimbursement rates, a point of contention fiercely debated by industry advocates. Dr. Steven Landers, CEO of the National Alliance for Care at Home (the Alliance), articulated the gravity of the situation at the Alliance’s 2025 Annual Meeting and Exposition, stating that the Alliance has actively opposed the proposal but is simultaneously preparing for a potentially unfavorable outcome.

Landers expressed skepticism that CMS will fully address the identified flaws, citing pressure from groups like MedPAC to reduce spending and the presence of fiscal conservatives within the current administration. “They put out a proposal knowing some of these issues, and got it wrong,” he said. “So there’s a risk that this isn’t fixed.”

Potential Impacts on Patient Care

If implemented as proposed, these cuts could trigger a cascade of negative effects throughout the home health sector. Landers warned of potential delays in care, agency closures, and, most critically, reduced access to vital services, particularly in rural communities where home health is often the only available option. What level of disruption to patient care is acceptable in the pursuit of budgetary goals?

The Alliance is actively pursuing legislative solutions, including the Home Health Stabilization Act of 2025, introduced by Representatives Kevin Hern (R-Okla.) and Terri Sewell (D-Ala.). This bipartisan bill aims to temporarily pause the proposed cuts for 2026 and 2027, providing a crucial window for further review and negotiation. However, the recent government shutdown presents a significant obstacle, as Congress is currently unable to convene and address the issue.

Beyond Medicare: Additional Challenges

The Alliance’s advocacy efforts extend beyond the Medicare home health rule. The organization is also focused on combating the Medicare Advantage (MA) hospice carve-in, which poses a threat to integrated care delivery. Furthermore, the pause in telehealth flexibilities due to the government shutdown is creating uncertainty for home health agencies relying on these technologies to deliver remote care. Home Health Agencies on the Edge of a Telehealth Cliff as the shutdown continues.

Landers emphasized the paramount importance of unity within the home-based care industry. “We’ve got to work together to amplify our voice, find common ground so that we’re not contradicting one another and stepping over one another to make sure that message is heard,” he stated. “We’re in it to win it, but we’ve got to stick together, because we’re a small sector and if we’re contradicting one another, God save us.” How can the industry foster greater collaboration and a unified message to effectively advocate for its needs?

The Alliance is urging stakeholders to remain vigilant and prepared to mobilize quickly should the final rule mirror the proposed cuts. The coming weeks will be critical in determining the future of home health care access for millions of Americans.

CMS Proposed Home Health Payment Rule has shaken industry leaders.

Frequently Asked Questions About the Medicare Home Health Cuts

1. What is the primary concern regarding the proposed Medicare home health cuts? The primary concern is the significant reduction in reimbursement rates, which could lead to agency closures and reduced access to care, particularly in rural areas.
2. What is the Home Health Stabilization Act of 2025? This bipartisan bill aims to pause the proposed cuts to Medicare home health reimbursement rates for 2026 and 2027, providing time for further review and negotiation.
3. How does the government shutdown impact efforts to address the proposed cuts? The government shutdown has stalled Congressional action on the issue, delaying potential legislative solutions.
4. What other challenges is the home health industry facing alongside the Medicare cuts? The industry is also grappling with the Medicare Advantage hospice carve-in and the pause in telehealth flexibilities.
5. Why is unity within the home health industry so crucial right now? A unified voice is essential to effectively advocate for the industry’s needs and ensure that policymakers understand the potential consequences of the proposed cuts.
6. What is CMS’s role in the proposed cuts to home health? The U.S. Centers for Medicare and Medicaid Services (CMS) proposed the cuts, citing concerns over their current methodologies for determining reimbursement rates.
7. What can home health agencies do to prepare for potential cuts? Agencies should prepare for potential delays, agency closures and limited access to care in rural areas.