Thriving Is Still Possible in the Year Ahead
How home health reimbursement cuts will shape 2026
By Tim Ashe
The 2026 Home Health Final Rule offers a mixed picture for our industry. On one hand, we’re encouraged that the Centers for Medicare & Medicaid Services (CMS) listened to the concerns of home health providers, revisited aspects of its methodology and made adjustments that better account for the real cost of delivering care in the home. That responsiveness is important and reflects the effort so many agencies, associations and advocates have made to help CMS understand what it takes to sustain high-quality care in today’s environment.
Yet even with those improvements, this marks the fourth consecutive year of payment cuts. For an industry already navigating rising staffing costs, increasing patient complexity and heightened regulatory expectations, the cumulative impact cannot be underestimated. Home health agencies have been absorbing year-over-year reductions while trying to expand access, innovate care models and build a workforce equipped for the future. Continued cuts make that work increasingly difficult.
Efficiency Is Essential
As we look ahead to 2026, many in the field are facing decisions they hoped they would never have to make. Some agencies may delay launching new service lines, even when community need is clear. Others may slow down expansion plans or decline referrals from areas requiring additional travel time and cost. A few may consider pulling back from communities they have proudly served for decades. These are not choices rooted in unwillingness. They are the result of economic realities that put providers in a position where sustaining operations becomes more challenging each year.
We have the privilege of working alongside many exceptional home health agencies, and we know their commitment to delivering high-quality care has never wavered. This is an industry defined by mission-driven leaders and clinicians who believe deeply in the value of home-based care. But commitment alone cannot offset the operational strain created by repeated payment reductions. As reimbursement tightens, agencies must find new ways to operate efficiently while maintaining the care standards their patients and communities depend on.
Across the country, we hear a consistent message from our partners: Efficiency is no longer optional—it is essential for survival. Home health has always operated on thin margins, but today those margins are being compressed even further. The agencies that will weather this period successfully are those positioned to optimize every part of their operation.
"But commitment alone cannot offset the operational strain created by repeated payment reductions."
Technology & Advocacy Together
Technology has a critical role to play. While it cannot replace the hands-on work of clinicians, it can remove friction from their day-to-day responsibilities. In my own career, I’ve witnessed how even small reductions in administrative burden can give clinicians the space to be more present with the people they serve. Smart scheduling, route optimization, revenue cycle automation and real-time performance insights can help agencies protect margins, improve productivity and expand access.
But technology alone is not enough. Advocacy remains essential. Our industry’s advocacy is working. We’re seeing growing bipartisan engagement and meaningful conversations in Washington. But now is not the time to let up. Continued advocacy is critical to protecting access to home-based care and preventing further destabilizing cuts.
At WellSky, we are actively advocating alongside our provider partners in support of the Home Health Stabilization Act of 2025, legislation that would pause additional home health cuts in 2026 and 2027 while the industry collaborates with CMS to determine a more sustainable long-term approach. Agencies need stability to continue providing high-quality care, and this legislation offers vital relief at a pivotal moment.
We are meeting with members of Congress, sharing data and elevating the perspectives of home health providers to ensure policymakers understand what’s at stake. Our commitment is to ensure that policy decisions reflect the realities of delivering care in the home, rather than being based on assumptions that overlook the true costs and complexities of that work.
A Collective Voice
This is a pivotal moment for home health, and the collective voice of our sector has never mattered more. We encourage providers to stay engaged: Reach out to your lawmakers, participate in advocacy campaigns and share your stories. Policymakers need to hear directly from the organizations and clinicians who are serving patients every day. Your voice is powerful, and together, we are already making a difference.
As we approach 2026, it is clear that the future of home health will be defined by adaptability and collective action. Payment models will continue to evolve, care demands will grow more complex and agencies will need to remain nimble to thrive. Those who combine mission with operational excellence will lead the way in shaping a more sustainable and effective home-based care system.
We are committed to ensuring home health agencies are not only able to survive the coming years but also emerge stronger and more capable of meeting the needs of an aging population. With continued advocacy, smarter workflows and a shared determination to protect access to care, we can drive meaningful change. And together, we can secure the future of home-based care for the patients and communities who depend on it most.
"Those who combine mission with operational excellence will lead the way in shaping a more sustainable and effective home-based care system."
Tim Ashe is chief clinical officer at WellSky and leads the WellSky Home division, overseeing applications and services for home health, hospice and personal care. His career has included a blend of clinical, operational, fiscal and academic roles. Before joining WellSky, Ashe was president of Fazzi Associates. He also served as vice president of clinical operations for Visiting Nurse Services of Rochester and Monroe County in New York and was assistant professor at the University of Rochester School of Nursing. Ashe is a frequent presenter at national and state conferences and is often asked to contribute to industry forums. Visit wellsky.com.
