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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Alliance to Congress: Pass the Credit for Caring Act

Alliance Daily

The National Alliance for Care at Home has joined with a group of likeminded organizations to urge Congress to enact financial relief for family caregivers by including the bipartisan, bicameral Credit for Caring Act (S. 3702/H.R. 7165) in any tax legislation you advance in the 119th Congress. This legislation would create a new, non-refundable federal tax credit for eligible working family caregivers to help address the financial challenges of caregiving.

Family caregivers are the backbone of services and supports in this country. They help make it possible for older adults, people with disabilities, and veterans to live independently in their homes and communities. The physical, emotional, and financial challenges they face in their caregiving roles cannot be overstated. Family caregivers are of all ages, races, and ethnicities and cut across all segments of our population. This is an ageless and nonpartisan issue.

Family caregivers provide about $600 billion annually in unpaid labor to their loved ones. They face out-of-pocket expenses to assist their loved ones as well as potential income and retirement savings foregone. An AARP report found that family caregivers spend, on average, 26 percent of their income on caregiving expenses or over $7,200 annually. Their assistance helps save taxpayers billions of dollars by helping to delay or prevent expensive nursing home care and unnecessary hospital stays. Family and others who provide care for veterans spend on average $11,500 of their personal income on out-of-pocket costs related to caregiving each year.

The Credit for Caring Act would create a new, non-refundable federal tax credit of up to $5,000 for eligible working family caregivers to help address the significant financial impact of caregiving. Eligible caregivers caring for loved ones of all ages could receive the credit if the care recipient meets certain functional or cognitive limitations or other requirements. This tax credit would help working family caregivers regardless of whether they live with their loved one or if their loved one is a dependent.

Family caregivers need support as they take on the costs and responsibilities associated with caregiving. Therefore, we urge Congress to enact the Credit for Caring Act.