The CMS‑mandated moratorium has created understandable concern across the care at home industry, but for existing providers the moratorium creates a rare opportunity to strengthen their position in the market and prepare for accelerated growth once enrollment reopens. With very few new organizations entering the field, leaders can use this period to refine operations, elevate care quality, and invest in tools and strategies that will set them apart in a post moratorium landscape.

Evaluating Organizational Practices and Operational Readiness

One of the most valuable opportunities leaders can lean into during this period is by taking a comprehensive look at organizational operations. Raianne Melton, Senior Director of Clinical Services for Professional Services at Axxess, advised leaders to conduct a full assessment of where they excel and where improvement is needed.

Resources like the Home Health Moratorium ebook and the Hospice Moratorium ebook provide organizations with the necessary steps and strategies to evaluate their business in its current state and identify areas for operational growth. This kind of introspection enables organizations to emerge from the moratorium stronger, more efficient, and better prepared for the future.

Performance metrics also play a critical role in shaping growth strategies. While all metrics matter, organizations should take this time to take a deeper look at patient survey responses to understand how patients and families perceive their care.

“I think that focusing on the patient engagement survey, CAHPS, is going to direct organizations in the way they need to go in terms of evaluating the services they’re providing,” said Melton.

Strengthening Brand Reputation and Referral Relationships

Leaders should also use this period to improve their brand reputation and build referral relationships.

“This is a great time to work on building a strong brand and reputation,” said Melton.

With no new organizations entering the market, leaders can focus on showcasing what makes their care services stand out and reinforce their reputation with referral partners who value reliability, excellence in compliance, and consistency.

“You’ll really want to start thinking about what features or services you provide are outstanding,” said Melton. “That will really help you build your brand reputation. For instance, a hospice or home health provider that practices Age-Friendly Care.”

Pairing high-quality patient experiences and retention with unique, innovative care services will be a powerful differentiator for organizations once the moratorium is lifted and competition resumes.

Using Technology to Enhance Compliance and Reduce Errors

Technology adoption, and more importantly, partnering with the right technology partner, plays a central role in helping organizations optimize operations during the moratorium. Leaders should look to technology partners that have designed their solutions to support compliance, streamline documentation and eliminate duplication. By adopting regulatory-compliant technology now, organizations can reduce risk and improve operational efficiency.

A technology partner that offers predictive analytics also offers organizations an advantage during this period of increased oversight. Axxess intelligence® capabilities like predicting symptom exacerbation, hospitalization risk and end-of-life risk help leaders anticipate patient needs and intervene earlier. These proactive insights strengthen care delivery, and support retention and reputation, turning this moratorium period into a solid foundation for long term growth.

“By increasing your care, you increase your reimbursement due to the service intensity add-on in hospice,” said Melton. “If you’re using these tools and you can predict who’s going to have a crisis and you’re ahead of that crisis, that’s building brand reputation.”

Axxess is committed to helping providers stay ahead of regulatory changes with timely insights, expert guidance, and the technology needed to navigate an evolving healthcare landscape.

Home health leaders ask a lot of questions every day. Are we fully staffed? Are clinicians completing documentation on time? Are we on track to meet productivity goals? Will we hit our financial targets this month?

All of those questions matter. But there is one question that often reveals more about the health of an organization than any dashboard metric or monthly report:

What happens if a visit falls through today?

The answer to this question is rarely about a single missed visit. It’s about whether an organization is connected to what is actually happening in the field.

The Test Most Organizations Never Think To Run

Imagine a clinician calls off unexpectedly. A patient visit is at risk and the organization could be at more immediate risk for a LUPA. What happens next? Can the visit be reassigned immediately? Does a scheduler receive an alert? Is a manager notified? Will the patient experience a delay in care that will impact their plan of care? Could documentation, reimbursement, or compliance be affected?

For many organizations, answering those questions requires a series of phone calls, emails, text messages, and manual checks across multiple systems. By the time everyone understands what happened, the opportunity to prevent downstream disruption may already be gone.

“The issue is not the missed visit itself; unexpected changes happen every day,” explained Axxess Senior Vice President of Solution Delivery Shradha Aiyer. “The real issue is how quickly the organization can identify and respond to them.”

Visibility Is the Difference

Top-performing organizations are not necessarily the ones with the fewest disruptions. They are the ones with the most visibility.

They know when schedules change. They know when and why documentation is delayed. They know when staffing patterns create risk. Most importantly, they know about these issues while there is still time to take action.

That level of awareness becomes increasingly important as organizations grow. The more patients, clinicians, and service areas involved, the harder it becomes for managers to maintain a complete picture of what is happening through manual oversight alone.

What once felt manageable can quickly become reactive.

Where AI Changes the Equation

This is where AI begins to deliver real value. Not by replacing people. Not by making decisions for clinicians. By connecting the dots faster than humans can on their own.

“AI can continuously analyze operational data and identify patterns that might otherwise go unnoticed,” said Aiyer. “It can detect potential scheduling gaps, surface emerging risks, and highlight activities that require attention before they become larger problems.”

Instead of discovering issues after they affect patient care, organizations gain the ability to respond proactively. When a visit is at risk, leaders do not need to spend hours gathering information from multiple sources. They have visibility into what is happening and what needs attention.

“Once an issue is identified, teams need a fast and efficient way to coordinate a response,” Aiyer noted.

Secure communication tools like Axxess Connect help clinicians, schedulers, and managers stay connected in real time, making it easy to share information, communicate changes, and take action when disruptions occur.

This combination of AI-driven insights and connected communication helps organizations move from simply detecting problems to resolving them quickly.

Faster Responses Create Better Outcomes

When issues are identified earlier and teams can respond more effectively:

• Patients experience fewer disruptions in care and improved outcomes
• Clinicians spend less time navigating administrative obstacles
• Managers can intervene before small problems become significant challenges
• Revenue cycles remain more predictable
• Teams operate with greater confidence and efficiency 

In other words, organizations spend less time reacting and more time focusing on delivering high-quality care.

A Better Question for the Future

For years, the question was, “How do we find out what happened?”

Today, AI is helping organizations ask a different question: “Now that we know what is happening, what should we do next?”

That shift changes everything. Because the organizations that perform at the highest level are not the ones that avoid every disruption. They’re the ones that can see those disruptions clearly, understand their impact, communicate effectively, and respond before they affect patients, staff, or financial performance.

The Bottom Line

The question is simple: What happens if a visit falls through today?

If the answer takes time, multiple conversations, or significant investigation, there may be a visibility gap hiding beneath the surface. The good news is that AI can help close that gap, giving leaders the visibility they need to identify risks earlier and respond before they affect patient care and outcomes.

Axxess combines AI-powered insights with connected communication tools like Axxess Connect to help home-based care organizations improve visibility, strengthen care coordination, and respond more effectively to the challenges that arise every day.

Hospice providers are facing growing complexity in today’s care environment, shaped by tighter oversight and evolving requirements. With the current hospice enrollment moratorium in effect nationwide and increased audit scrutiny from CMS amid a broader fraud crackdown, providers must meet higher expectations for documentation accuracy, reporting, and billing integrity. For organizations committed to delivering high-quality care, these pressures can disrupt workflows, strain teams, and elevate the risk of compliance gaps.

A new case study highlights how one provider is using Axxess Hospice to stay ahead of these demands while maintaining a strong focus on patients and families.

Supporting Growth Without Compromising Care

Cardinal Hospice Care, a North Carolina-based provider with more than 25 years of experience, has sustained steady growth while navigating complex regulatory change. Serving a growing census of more than 300 patients, the organization has continued to deliver dependable, patient-centered care powered by strong processes and a highly trained team.

According to Tina Pell, Vice President of Hospice, consistency has been key to their success.

“In both 2025 and into 2026, we’ve experienced steady and continual growth in our average daily census while operating on Axxess Hospice,” said Pell. “That level of consistency is especially meaningful in hospice, where so much depends on the strength of our internal processes and the ability of our staff to work efficiently and confidently.”

Turning Complexity Into Clarity With Axxess Hospice

Regulatory changes can introduce risk, especially when requirements shift across reporting, licensure, and billing. Cardinal Hospice Care took a structured, collaborative approach to these challenges, combining internal education with a close partnership with Axxess.

“Rather than simply trying to ‘make it work’ on our own, we partnered closely with Axxess to build a process that not only ensured compliance but gave us a repeatable workflow,” Pell said.

Axxess worked alongside Cardinal Hospice Care to establish clear workflows, provide process documentation, and support data collection while automated reporting capabilities were developed. This approach helped the organization maintain accuracy and continuity, even during periods of regulatory transition.

Reducing Administrative Burden and Improving Efficiency

One of the most immediate impacts that Axxess Hospice had for Cardinal Hospice Care was a reduction in administrative strain. With structured workflows and advanced reporting capabilities, teams were able to shift their focus back to patient care.

“Pairing Axxess best practices with our internal training efforts has paid off in smoother workflows, fewer administrative burdens, and more time focused on patients and families,” said Pell.

Before these enhancements, pulling required data could be time-consuming and prone to error. With Axxess support and automation, those challenges were resolved, creating a more reliable and efficient operational model.

A True Partnership That Drives Better Outcomes

What sets Axxess apart is its partnership approach. From biweekly working sessions to ongoing stakeholder alignment, Axxess collaborates closely with providers to ensure solutions are practical, scalable, and sustainable.

“They don’t just give us software; they work alongside us to understand what we need and then help build the processes and tools that make compliance and reporting manageable,” said Pell.

In a care environment that continues to evolve, adaptability is essential. Axxess Hospice enables providers to respond to change with confidence, supported by technology, expertise, and a partner invested in long-term success.

“Axxess plays an important role in helping us stay adaptable in an increasingly complex care environment,” said Pell.

Read the full case study to see how Cardinal Hospice Care is strengthening operations, maintaining compliance, and enhancing patient experiences with Axxess Hospice.

Contact Axxess to learn how Axxess Hospice can support your organization.

In hospice care, there’s little margin for missed signals. When a patient’s condition changes, timely intervention can mean the difference between comfort and crisis.

That challenge is compounded by increasing regulatory complexity. With the introduction of Hospice Outcomes and Patient Evaluation (HOPE) requirements, clinicians must consistently assess and document eight key symptoms, including pain, shortness of breath, anxiety, and gastrointestinal issues. When symptoms escalate, follow-up visits are required, adding pressure to already limited clinical resources.

The challenge is clear: How do you know which patients are most likely to need immediate attention?

A new Axxess white paper examines how predictive analytics can help clinicians identify patients at risk for symptom exacerbation before it occurs.

“Identifying when symptoms are worsening and require fast action is critical,” explained Axxess Senior Data Scientist Phil Gigliotti, PhD. “The goal is to help clinicians focus their attention where it matters most.”

Moving From Reactive to Predictive Care

Traditionally, hospice providers rely on broad monitoring strategies to identify symptom changes. While effective in some cases, this approach can lead to inefficiencies, especially when patient symptom burden increases gradually in any given week.

To address this, Axxess developed a predictive model powered by Axxess intelligence designed to identify patients at high risk for severe symptom exacerbation in the next seven days.

Using hundreds of patient-specific data points, the model analyzes historical patterns to generate a forward-looking risk score. These predictions are updated nightly, giving care teams a continuously refreshed view of where intervention may be needed next.

“We’re not just looking at what’s happening right now,” Gigliotti said. “We’re leveraging patterns across time to anticipate what’s likely to happen next. That’s what enables earlier, more proactive care.”

What the Data Reveals

To evaluate performance, the model was tested across rolling seven-day windows throughout May 2026.

The results highlight just how difficult symptom exacerbation is to predict. These events occur in a small group of patients each week, yet the model is able to concentrate risk into an even smaller, more actionable subset.

That means clinicians aren’t spreading attention across the entire population; they’re focusing on a narrow group where the likelihood of a flare is meaningfully higher.

“When we concentrate risk into a select group, the probability shifts in a meaningful way,” Gigliotti explained. “Instead of guessing across the entire patient population, clinicians can focus on a subset where the likelihood of an event is significantly higher.”

That improvement is reflected in the model’s 11x lift, increasing the likelihood of identifying a true case of symptom exacerbation more than elevenfold compared to random selection.

Why Performance Transparency Matters

Predictive accuracy is only part of the equation. Equally important is helping clinicians understand how much confidence to place in those predictions.

Axxess intelligence addresses this with built-in transparency, surfacing key performance metrics (including recall, precision, and lift) directly within the dashboard.

“Trust is critical when you’re introducing predictive analytics into clinical workflows,” Gigliotti noted. “By showing exactly how the model is performing, we’re giving clinicians the context they need to make informed decisions.”

This transparency enables providers to:

• Quantify uncertainty in real time
• Better interpret risk scores
• Integrate predictions into clinical judgment with greater confidence

Rather than relying on “black box” outputs, clinicians gain clear, measurable insight into how the model is performing and where it adds value.

What This Means for Hospice Providers

Even small gains in early identification can have a significant impact, especially when dealing with high-stakes events.

By narrowing the focus to less than 4% of patients, the model enables:

• More proactive symptom management
• Better prioritization of follow-up visits
• Improved allocation of clinician time and resources
• Stronger alignment with HOPE compliance requirements

“The real value isn’t just in predicting events,” Gigliotti said. “It’s in enabling earlier, more targeted intervention that improves both patient experience and operational efficiency.”

A Smarter Approach to Symptom Management

As hospice providers face increasing demands, the ability to anticipate patient needs, rather than react to them, is essential.

Predicting symptom exacerbation helps hospice teams move beyond reactive care, prioritizing high-risk patients, staying ahead of HOPE requirements, and intervening before crises occur.

With Axxess intelligence, hospice providers can shift from broad, reactive workflows to precise, data-driven strategies, improving outcomes while optimizing operations.

The Centers for Medicare and Medicaid Services (CMS) has announced a new nationwide six-month moratorium on the enrollment of certain hospice and home health providers, signaling a significant shift in federal oversight strategy aimed at protecting patients and safeguarding the integrity of Medicare and Medicaid programs.

This move comes amid growing concerns about fraud, abuse, and rapid provider proliferation in certain markets. While targeted moratoria have been implemented in the past at the regional level, this expanded action underscores CMS’ commitment to addressing vulnerabilities at a national scale, and carries important implications for providers, health systems, and technology partners across post-acute care.

What the Moratorium Means

An enrollment moratorium temporarily pauses the ability of new providers or suppliers to enroll in Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). Under this directive, CMS will not accept new applications for hospice and home health organizations in designated categories during the moratorium period, except in limited circumstances such as demonstrated access-to-care needs.

For existing providers, operations will continue uninterrupted. However, heightened scrutiny is expected across the board, including increased audits, enforcement actions, and compliance expectations.

Why CMS Is Taking Action

CMS has cited persistent program integrity concerns as the primary driver of this decision. In recent years, certain geographic regions have experienced a surge in hospice and home health enrollments, some of which have been linked to questionable billing practices, inappropriate patient eligibility determinations, and fraudulent activity.

Fraud schemes in these sectors can include billing for services not rendered, enrolling ineligible patients, or cycling patients through multiple providers to maximize reimbursement. These practices not only strain federal healthcare programs; they can also compromise patient safety and erode trust in care delivery.

By pausing new enrollments, CMS is creating space to strengthen oversight, improve screening processes, and investigate existing providers more thoroughly.

Implications for Providers

Operationally, the moratorium may create both opportunities and challenges for established organizations. Because no new competitors can enter the Medicare market during the freeze, current providers may temporarily experience reduced market competition and increased referral opportunities. Hospitals, physicians, and discharge planners may rely more heavily on established organizations that already have Medicare certification and proven compliance histories.

At the same time, the moratorium raises concerns about access to care, workforce expansion, and future growth. Industry leaders warn that blocking new organizations could reduce care availability in rural and underserved communities where provider shortages already exist. Existing organizations may experience higher patient volumes, staffing pressures, and increased demand for services.

Most importantly, the moratorium sends a clear message that compliance has become a strategic priority for survival and growth in hospice care. Organizations must strengthen internal auditing, documentation accuracy, eligibility verification, coding integrity, and staff education. Organizations with strong compliance cultures, transparent operations, and effective leadership will likely be better positioned to withstand increased federal scrutiny.

Overall, while the moratorium does not shut down existing hospice organizations, it fundamentally changes the regulatory environment. Current providers must prepare for more aggressive oversight, stricter enforcement, and a healthcare landscape where operational integrity and compliance readiness are more important than ever.

For home health and hospice organizations, this announcement reinforces the importance of maintaining rigorous compliance standards and operational transparency.

Organizations should expect:

• Increased scrutiny of documentation, eligibility criteria, and billing practices
• Heightened audit activity, including pre- and post-payment reviews
• Stronger emphasis on data accuracy and reporting integrity

Providers operating in growth mode may need to adjust expansion plans, particularly if they were considering new branch locations or entering new markets. Concurrently, organizations with strong compliance track records may find opportunities to differentiate themselves in a more controlled and quality-focused environment.

Technology’s Role in Compliance and Visibility

As regulatory oversight intensifies, the role of technology becomes even more critical. Advanced solutions that support real-time documentation, predictive analytics, and audit readiness can help organizations stay ahead of compliance risks.

For example:

• Clinical decision support tools can help ensure patients meet eligibility criteria
• Automated workflows can reduce documentation errors and inconsistencies
• Data analytics platforms can flag unusual patterns before they trigger audits

In a landscape where transparency and accountability are paramount, organizations equipped with integrated, intelligent systems are better positioned to navigate regulatory change with confidence.

A Broader Signal for the Industry

Beyond the immediate operational impact, CMS’ announcement sends a clear message: growth in hospice and home health must be matched by accountability, quality, and ethical practices.

For industry stakeholders, including providers, associations, and technology partners, this is a moment to reinforce best practices, invest in staff education, and align more closely with evolving regulatory expectations.

It also highlights the ongoing need for collaboration between public and private sectors to ensure vulnerable patient populations receive high-quality, appropriate care.

What Comes Next

CMS has not indicated an exact timeline for lifting the moratorium, noting that the duration will depend on ongoing program integrity assessments and enforcement outcomes. While the moratorium is currently set for six months, CMS retains the authority to extend it for an indefinite period if program integrity concerns persist.

In the meantime, providers should:

• Conduct internal compliance audits and risk assessments
• Review documentation and billing workflows for consistency and accuracy
• Stay informed about CMS updates and guidance
• Engage with trusted partners to strengthen operational resilience

Final Thoughts

While enrollment moratoria can introduce uncertainty, they also create an opportunity for the industry to recalibrate and reinforce its commitment to excellence.

For organizations that prioritize compliance, transparency, and patient-centered care, this is a chance to lead by example, and help shape a stronger, more trustworthy future for hospice and home health services.

Axxess is committed to helping providers stay ahead of regulatory changes with timely insights, expert guidance, and the technology needed to navigate an evolving healthcare landscape.