Home Health, Hospice Leadership Lays Out 2025 Priorities

Home Care Magazine | By Hannah Wolfson
 
Stopping Medicare cuts, ensuring Medicare Advantage beneficiaries have good access to care, passing groundbreaking hospice legislation and bringing homecare into the forefront are all priorities for the newly-formed National Alliance for Care at Home, said CEO Steve Landers.

“We’ve got to start improving access to home health care, and the way that we do that is we end this march of payment cuts that are being set forward by Medicare,” Landers said at the Alliance’s Homecare and Hospice Conference and Expo, which was held in October in Tampa, Florida.

The event was originally organized by the National Association for Homecare and Hospice (NAHC), which merged this summer with the National Hospice and Palliative Care Organization (NHPCO) to form the new group. The expo included a handoff from NAHC President Bill Dombi to Landers. 

The new organization plans to highlight the patient and family perspective to advocate for home health in Washington and beyond, which Landers called a “life or death issue.”
Landers said the new alliance has the opportunity to have a stronger voice, and that he will add his own clinical perspective to his leadership and conversations with regulators and legislators.

“I'm also a family caregiver and have my own personal experiences with homecare and hospice that have instructed how I think about these things,” Landers said. “There is every opportunity here to get stronger, to try to make a bigger impact. … We need to find another way to tell these stories, to somehow get somebody to listen.” 

This will require getting frontline workers, patients and their families into the offices of decision-makers to tell their stories, Landers said. It may entail additional partnerships with state associations to focus on local advocacy, as well as sharing data from studies that show the positive outcomes in-home care has on patients’ lives. 

The alliance has automatically enrolled members of both legacy organizations, but Landers said that for renewals or new members, participants will be required to sign an attestation that says they have a program in place for quality and compliance, that they monitor the Office of Inspector General’s expulsion list and don’t take referrals or staff from organizations on that list and that they strive to participate in Medicare’s quality reporting programs.

“In order to make a difference on behalf of our members and make a difference on behalf of the people that need care at home, we have to have as credible and high integrity of a voice as possible,” Landers said.

Landers spoke before the results of the election were known or the final rule on home health payments was released by the Centers for Medicare and Medicaid Services. But even then, he said it would be important for advocates and providers to work for the long haul.

“We've got to wake ourselves up … and just keep our energy up, keep our voices up," he said. "So many people are depending on us, and they're hidden. The people that depend on home health and hospice care programs—they're hidden. They're sick, they're in their homes, mostly. Their families are stressed. … We’ve got to keep the volume up and keep telling the story.”…

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CMS Approves Revised Home Health Change of Care Notice

Alliance Daily

The Office of Management and Budget (OMB) has approved the Home Health Change of Care Notice (HHCCN) for 3 years. There were no substantive changes made to the HHCCN form or the form instructions. CMS did make plain language and information design changes to the form and form instructions according to our Office of Communications (OC) recommendations. OC’s recommendations in plain language and information design are research-based best practices. The OC worked to apply the same research-based standards across all products and channels to make sure our language, messaging and branding are consistent.

CMS has also provided the HHCCN in 3 additional languages with this package approval.  Those languages, along with English and Spanish, include Chinese, Vietnamese and Korean.  

Since the current HHCCN does not expire until 12/31/2024, you may continue to use the HHCCN (OMB expiration date of 12/31/2024) until 1/31/2025 however, you will be required to use the newly approved HHCCN (OMB expiration date of 11/30/2027) on 2/1/2025.  The newly OMB approved HHCCN form (expiration date of 11/30/2027) may be found in the downloads section.  FFS HHCCN | CMS

Hidden Changes: What Home Health Providers May Have Missed In The Final Rule

Home Health Care News / By Audrie Martin

On Nov. 1, the Centers for Medicare & Medicaid Services (CMS) issued the final home health payment rule for 2025, updating Medicare policies and rates for home health agencies. 

But while the payment-related information grabbed headlines, there are plenty of other changes to home health care within the rule that providers should be paying attention to. 
CMS estimated that Medicare payments to agencies in 2025 would increase by 0.5%, or $85 million, compared to 2024. In addition to the slight payment increase, the rule introduced other changes for HHAs that may impact their business practices.

“This is not where we want to be,” William A. Dombi, president emeritus of the National Alliance for Care at Home, said during a recent webinar. “We are on a slippery slope toward potential disaster. We projected this would happen when we examined CMS’ methodology for budget neutrality. All CMS has done is mitigate the situation, rather than create a foundation for restoring the home health benefit to its intended state.”

Elara Caring CEO Scott Powers echoed this sentiment and urged CMS to reevaluate its payment model. 

“While CMS’ 2025 payment adjustments attempt to address some challenges faced by home health providers, the current approach remains inadequate,” Powers told Home Health Care News. “The budget neutrality methodology continues to undermine the fundamental purpose of home health care, limiting access for the seniors who rely on these services the most. We urge CMS to prioritize a payment model that genuinely reflects the value of home health care.”

With a presence in 18 states, Elara Caring provides an array of home-based care services across more than 200 locations, serving more than 60,000 patients. 

“CMS’ decision to implement a -1.975% permanent projected adjustment to home health payments is deeply concerning,” Compassus CEO Mike Asselta told HHCN. “This is particularly troubling as the demand for these services continues to rise. Concurrently, new conditions of participation increase the administrative burdens on home health agencies without adequately addressing critical issues like access to care.”

Based in Brentwood, Tennessee, Compassus also offers a wide range of home-based care services including home health care, home infusion, palliative care, hospice care and home-based high-acuity care, with more than 270 locations across 30 states.

Bud Langham, the executive vice president of clinical excellence and strategy for Enhabit Inc. (NYSE: EHAB) , expressed significant concern about the 2025 home health final rule. 
“The most pressing issue is yet another cut to home health reimbursement,” he said. “This marks the third consecutive implementation of negative permanent adjustments, along with planned temporary adjustments that are still pending. Congress needs to take action; over 60 million Medicare-eligible Americans are counting on it.”

In addition to the disappointing annual payment update, CMS has finalized several other changes that will affect home health providers starting in 2025 and beyond…

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CMS Floats Five Home Health CAHPS Changes

McKnights Home Care / By Adam Healy
 
The Centers for Medicare & Medicaid Services is weighing five changes to the Home Health Consumer Assessment of Healthcare Providers and Systems (CAHPS). The proposed measures could affect home health providers’ Medicare star ratings and scores under Home Health Value-Based Purchasing (HHVPB).

CMS disclosed last week the five new CAHPS additions in its Measures Under Consideration (MUC) list for 2024. They include: Care of Patients; Communications Between Providers and Patients; Talk About Home Safety; Review Medicines; and Talk About Medicine Side Effects. 

“Providers should be aware that the existing multiquestion measure around ‘specific care issues’ is being changed to create three, new single-question measures on home safety, review of medicines (for prescriptions and over the counter medications), and talking about medicine side effects,” Katy Barnett, director of home care and hospice operations and policy at LeadingAge, told McKnight’s Home Care Daily Pulse Thursday in an email. “These changes will require agencies to really focus on medication reconciliation and side effect reviews as well as occupational visits to create a safe home environment.”

Barnett noted that CMS’ proposed changes suggest that the agency aims to remove repetitive and confusing questions that are currently in the Home Health CAHPS survey. Two of the measures under consideration, Care of Patients and Communication Between Providers and Patients, will affect HHVBP and providers’ Star Ratings, she said. 

CMS is soliciting feedback on the proposed measures through Dec. 30, and the agency will likely provide an update on their status in next year’s home health rule.

“CMS is required to go through formal notice and comment rulemaking to implement any changes,” Barnett explained. “As we’ve often seen with the MUC list process, CMS will often move forward with proposing and finalizing measures despite concerns from members of the consensus-building body’s advisory groups. We’ll know more about CMS’ intent with these changes in the summer when the CY2026 Home Health Proposed Rule is issued.”

She added, “We can also hope that CMS takes steps to change the administration of the survey as they did in hospice by extending the time the survey is in the field or creating a web mode. We’ll know more in future rulemaking.”