The home health care industry is currently in limbo as health care providers and stakeholders await the release of the 2026 Medicare Home Health Final Rule. It has become a “war room situation” for industry advocates, according to Dr. Stephen Landers, CEO of the National Home Care Alliance (Alliance).
Landers said at the alliance's 2025 Annual Meeting and Exhibition that the home health care industry faces the largest proposed cuts in history, a threat posed by flawed methodology used by the U.S. Centers for Medicare and Medicaid Services (CMS). Landers emphasized that while the Alliance “did everything we could” to oppose the proposal, it is also preparing a strategy if the final rule reflects the proposed rule.
“There's still a chance they'll get it wrong,” he said Sunday. “They've been told by MedPAC to make cuts. There's a lot of fiscal hawks in this administration who are looking for items to cut. They put forward a proposal knowing some of these problems, and they got it wrong. So there's a risk that this problem won't get fixed.”
Landers said if the proposed “drastically flawed and misguided” rules are not fixed, the industry could face delays, agency closures and limited access to care in rural areas.
One of the alliance's lines of defense concerns the Home Health Care Stabilization Act of 2025. The bill, introduced in September by Rep. Kevin Hahn (R-Okla.) and Rep. Terry Sewell (D-Alabama), would suspend Medicare home health reimbursement rate reductions in 2026 and 2027.
Landers said that if the final rule is similar to the proposed rule, bipartisan legislation and Congressional engagement will be critical to pausing the implementation of significant reductions in home health reimbursement rates. The problem with this approach, he said, is that Congress is not in session due to the government shutdown.
“So leave it alone, stay vigilant,” he said. “If we don't get what we need here, we need to come together quickly and make sure the message gets through to Congress to fix things.”
In addition to defending the Family Medicine Rule, the Alliance is focused on other important issues. The organization is working to “eradicate” Medicare Advantage (MA) hospice carve-ins. Also top of mind for Landers is the flexibility of telemedicine, which was put on hold due to the government shutdown.
Landers said a key element for the home care industry is unity.
“We must work together to elevate our voices and find common ground to ensure our messages are heard and not contradict or overstep each other,” Landers said. “We are trying our best to win, but we have to stick together because we are a small sector and if we contradict each other, God help us.”
