Homecare Homebase Shares Insights from CMS CY 2026 Home Health Final Rule Updates and Ongoing Advocacy Efforts

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Dec 10, 2025, 10:00 ET

Industry collaboration leads to significant improvements in CY 2026 Final Rule but long-term stability remains uncertain

DALLAS, Dec. 10, 2025 /PRNewswire/ -- Homecare Homebase^SM (HCHB), a leading software provider for home-based care, today announced key insights and compliance preparations following the Centers for Medicare & Medicaid Services' (CMS) Calendar Year 2026 Home Health Prospective Payment System Final Rule. While the rule reflects meaningful progress driven by industry-wide advocacy in reaction to the proposed rule, it still results in a net reduction for agencies already operating under significant financial strain.

This year's final rule represents hard-won advocacy outcomes delivered by a coordinated industry response. While agencies will still face a 1.3% overall payment reduction in 2026, CMS reversed course on several of the most severe elements originally included in the proposed rule. These changes include an 80% reduction in proposed payment cuts and recalculated behavior assumptions, marking an important shift toward fairer, more accurate methodologies.

"This final rule shows that consistent, unified advocacy truly makes an impact," said Luke Rutledge, president of Homecare Homebase. "CMS's adjustments reflect a more realistic view of the challenges and costs required to care for patients safely at home. While the final rule demonstrates the progress possible when the industry collaborates, additional improvements are still needed to ensure long-term stability and protect access."

The CY 2026 final rule, which takes effect Jan. 1, 2026, includes several financial and operational updates that will directly affect agency planning and reimbursement. Notable changes include:

Financial updates

A projected $220 million decrease in overall Medicare home health payments, reflecting a 1.3% net reduction.
A 2.4% home health payment update.
A 0.9% permanent adjustment and 2.7% temporary adjustment applied across payments.
Updated national standardized 30-day payment rate of $2,038.22.
Updates to per-visit payment amounts, low utilization payment adjustments, fixed-dollar loss calculations, case-mix weights, CBSA/wage index values functionality impairment levels and comorbidity subgroups.

Operational updates

Conditions of Participation: CMS clarified that OASIS submission is required for all patients receiving skilled services, regardless of payer.
Quality Reporting Program (QRP): Summarized comments on a suggestion to shorten the data-submission deadline window and revised the set of measures for QRP.
HHCAHPS survey: New questions, updated measure weights and changes to the star rating methodology.
Provider enrollment: Expanded grounds for denials, revocations and retroactive effective dates.
Reconsideration extensions: Agencies may request extensions when extraordinary circumstances prevent timely Quality Reporting Program submissions.

HCHB emphasized that while the final rule is a marked improvement, significant challenges remain for agencies navigating rising labor costs, increasing administrative demands and a rapidly shifting payer landscape driven by Medicare Advantage and value-based reimbursement models. Homecare Homebase applauds the continued unity across the home health industry, while emphasizing that sustained advocacy momentum is necessary.

"This progress is encouraging but our work is far from finished," added Hannah Pearson, chief revenue officer at Homecare Homebase. "Home health providers continue to face mounting financial strain and sustained policy improvements are needed to preserve patient access across Medicare fee-for-service and Medicare Advantage. We are committed to supporting the industry's push toward long-term stability, fair reimbursement and continued innovation in home-based care."

With the publication of the rule, HCHB has begun implementing product updates to ensure compliance by the Jan. 1 deadline. The company's analytics team has also updated the Home Health Impact Model, which allows agencies to evaluate how the new policies will affect their operations using their own claims data.

With the largest market share in the home health industry, HCHB provides unmatched visibility into national trends, operational challenges and regulatory impacts. This depth of data, combined with extensive regulatory expertise, enables HCHB to guide agencies through ongoing policy changes and support their transition into a more complex, value-driven regulatory environment.

To learn more about Homecare Homebase, visit hchb.com.

About Homecare Homebase, LLC

Founded by industry veterans in 1999, Homecare Homebase^SM (HCHB) is a Dallas-based software leader empowering exceptional home-based care through hosted, cloud-based technology solutions and administrative services. HCHB's customized mobile solutions enable real-time, wireless data exchange and communication between field clinicians, physicians and office staff for better care, more accurate reporting and improved revenue cycle management. HCHB's products and services streamline operations, simplify compliance and boost clinical and financial outcomes for home-based care agencies. Each year, over 300,000 HCHB users serve approximately one million patients daily, resulting in over 121 million annual visits. Homecare Homebase is a Hearst Health company. For more information, visit hchb.com or call us toll-free at 1-866-535-HCHB (4242).

About Hearst Health

The mission of Hearst Health is to guide healthcare organizations by delivering essential intelligence and software that improve the quality, safety and efficiency of care. Hearst Health has been innovating with care for more than 40 years, with a commitment to making a lasting positive impact on health. The Hearst Health companies — FDB, Homecare Homebase, MCG, MHK, QGenda and Zynx Health — elevate care by informing and empowering participants across the health journey. To learn more, visit www.hearst.com/hearst-health and follow @Hearst Health on LinkedIn.