Industry collaboration significantly improves CY 2026 final rule, but long-term stability remains uncertain
dallas, December 10, 2025 /PRNewswire/ — Homecare HomebaseSM (HCHB), a leading home health software provider, today announced key insights and compliance preparations under the Centers for Medicare and Medicaid Services' (CMS) Calendar Year 2026 Home Health Prospective Payment System Final Rule. While this rule reflects the meaningful progress made by industry-wide advocacy efforts against the proposed rule, it will still result in net savings for agencies already operating under significant financial strain.
This year's final rule represents a hard-won advocacy result resulting from a coordinated industry response. Agencies would still face a total payment reduction of 1.3% in 2026, but CMS reversed course on some of the most stringent elements originally included in the proposed rule. These changes include an 80% reduction in proposed payment reductions and a recalculation of behavioral assumptions and represent a significant shift toward a fairer and more accurate methodology.
“This final rule shows that consistent, unified advocacy can have real impact,” said Luke Rutledge, president of HomeCare Homebase. “CMS's adjustments reflect a more realistic view of the challenges and costs needed to safely care for patients at home. The final rule demonstrates the progress that is possible when industry works together, but further improvements are still needed to ensure long-term stability and protect access.”
The CY 2026 final rule, effective January 1, 2026, includes several financial and operational updates that directly impact agency planning and reimbursement. Notable changes include:
Financial updates
Total Medicare home health payments are projected to decrease by $220 million, reflecting a net decrease of 1.3%. Home health payment 2.4% update. A permanent adjustment of 0.9% and a temporary adjustment of 2.7% will be applied to the entire payment. The national standard 30-day payment rate has been updated to $2,038.22. Updates to per visit payment amounts, low utilization payment adjustments, fixed dollar loss calculations, case mix weights, impairment levels for CBSA/wage index values, and comorbidity subgroups.
Latest operational information
Conditions of Participation: CMS has clarified that OASIS submission is required for all patients receiving skilled services, regardless of payer. Quality Reporting Program (QRP): We summarized comments on the proposal to shorten the data submission deadline window and revised the QRP course of action. HHCAHPS Survey: New questions, updated measurement weights, and changes to star rating methodology. Provider Registration: Expanded grounds for refusal, cancellation, and retroactive effective date. Extension of Review: If special circumstances prevent you from submitting your quality reporting program in a timely manner, your agency may request an extension.
HCHB emphasized that while the final rule is a significant improvement, significant challenges remain for agencies navigating the rapidly changing payer landscape driven by rising labor costs, increased administrative demands, and Medicare Advantage and value-based reimbursement models. HomeCare Homebase applauds the continued solidarity across the home health care industry and emphasizes the need for sustained advocacy momentum.
Hannah Pearson, chief revenue officer at HomeCare Homebase, added: “While this progress is encouraging, our work is not done yet.” “Home health care providers continue to face increasing financial burdens and sustained policy improvements are needed to maintain patient access across Medicare fee-for-service and Medicare Advantage. We are committed to supporting the industry's efforts toward long-term stability, fair reimbursement, and continued innovation in home health care.”
Upon publication of the rule, HCHB began implementing product updates to ensure compliance by the January 1st deadline. The company's analytics team also updated the Home Health Impact Model. This allows agencies to use their own claims data to assess how new policies will impact their operations.
With the largest market share in the home health care industry, HCHB provides unparalleled visibility into national trends, operational challenges and regulatory impacts. This wealth of data, combined with extensive regulatory expertise, enables HCHB to guide agencies through ongoing policy change and support the transition to a more complex, value-driven regulatory environment.
For more information about Homecare Homebase, visit hchb.com.
About Home Care Home Base LLC
Founded in 1999 by industry veterans, Homecare HomebaseSM (HCHB) is a Dallas-based software leader that enables superior home care through hosted, cloud-based technology solutions and managed services. HCHB's customized mobile solutions enable real-time wireless data exchange and communication between field clinicians, physicians, and office staff, resulting in better care, more accurate reporting, and improved revenue cycle management. HCHB's products and services streamline home health agency operations, simplify compliance, and improve clinical and financial outcomes. Each year, more than 300,000 HCHB users serve approximately 1 million patients each day, with more than 121 million annual visits. Home Care Homebase is a Hearst Health company. For more information, visit hchb.com or call toll-free 1-866-535-HCHB (4242).
About Hearst Health
Hearst Health's mission is to guide healthcare organizations by providing critical intelligence and software that improves the quality, safety and efficiency of healthcare. Hearst Health is committed to making a lasting positive impact on health and has been innovating with care for more than 40 years. Hearst Health companies (FDB, Homecare Homebase, MCG, MHK, QGenda, and Zynx Health) improve care by informing and empowering participants across their health journey. For more information, visit www.hearst.com/hearst-health and follow @Hearst Health on LinkedIn.
SOURCE Home Care Home Base
