In response to proposed payment cuts to home health provider reimbursement, the National Alliance for Care at Home hosted a webinar sponsored by Axxess, to discuss the 2026 home health proposed rule from the Centers for Medicare and Medicaid Services (CMS) and delivered a call to action for all providers.
Alliance staffers Hillary Loeffler, Vice President of Policy and Regulatory Affairs, and Patrick Harrison, Senior Director of Regulatory and Compliance, provided a detailed overview of the proposed payment reductions, their potential impact and strategies for submitting effective public comment letters to CMS.
Understanding the 9% Cut
The proposed rule includes a significant 9% cut to the 30-day payment rate for home health organizations, made up of a 4% permanent and a 5% temporary reduction.
“This [cut] is the largest we’ve seen in any single year in recent memory,” Harrison said. “This is pervasive, this is challenging, this is unique, and it’s going to have horrific impacts for the home health industry and the beneficiaries who depend on this important benefit.”
If finalized, this proposal could lead to reduced service areas, staffing cuts and potentially organization closures.
Financial Strain on Home Health Organizations
Loeffler emphasized that proposed cuts would have a devastating impact on the financial stability of home health organizations.
“If they were to finalize the 2026 proposed 4% permanent reduction, CMS would have reduced our payments by nearly 13% over the past four years, taking over $2 billion out of the home health baseline,” Loeffler said.
Loeffler highlighted that by 2040, 60% of home health organizations are projected to have negative total margins, further emphasizing the need for careful consideration of the proposed rule.
Behind the Numbers
CMS says the current payment rate is 33% higher than the cost of delivering care, but according to Loeffler, the number doesn’t reflect the reality we are living in.
“We are highlighting CMS’ own data back to them saying the picture of home health isn’t that great,” said Loeffler. “We are under financial strain, and our agencies can’t really absorb a 9% cut this year.”
Value of Home Health Organizations
Both presenters emphasized the vital role that home health organizations play in healthcare.
“It’s a saver that can [generate] positive outcomes for patients as well as the Medicare program itself,” Harrison said.
Loeffler added, “Home health is the setting of care where people want to receive services. It prevents costly hospitalizations, costly ER visits, and institutional stays, like in a nursing home or inpatient rehab.”
Your Voice Matters
It is important to submit personalized and evidence-based comments to CMS to influence their decision-making process.
The Alliance provides resources online to help the home health community respond to the proposed cuts. The resources include tools to engage media and policymakers on how to protect home health services.
CMS is accepting public comments on the proposed rule until August 29, 2025.
“CMS actually reads every single comment that’s submitted on the rule,” said Loeffler. “The ones that are impactful are the ones that tell your own personal story.”
By sharing personal stories, providing concrete examples, and citing relevant data, providers can help demonstrate the value of home health care and the potential consequences of the proposed cuts.
Anyone in the care at home industry can share their story with the Alliance here.
Axxess is committed to public policy advocacy to ensure the future of healthcare is in the home.