Large-scale transactions will be difficult. Reductions in home medical care also continued. Regulatory noise is coming in from every aspect of Medicare and Medicaid.
All of these realities were featured in Home Health Care News' most popular stories of the year.
To summarize the year providers experienced in 2024, HHCN reviews the 10 most widely read articles.
1. Home care industry slams finalized 80/20 rule, warns of impending government shutdown (April 22)
When the “Ensuring Access to Medicaid Services” rule was finalized in April after first being proposed in 2023, all attention focused on the 80-20 provision.
The provision requires that 80% of Medicaid payments for home and community-based services (HCBS) go toward caregiver wages, but there are some caveats. This provision became the most controversial aspect of the rule, with providers and industry advocates speaking out against it during and after the public comment period.
Many health care providers believe that improving rates is the best way to ensure that care workers are adequately compensated.
“Access to care is a common goal and we are also increasing compensation for caregivers,” CareAdvantage CEO Tim Hannold told Home Health Care News in April. “I think we all agree on that. The CMS rule started with good intentions, but it certainly has unintended consequences when implemented as written. Wages continue to be the main driver for decent wages, and I believe this is what the administration should focus on to improve access to care.”
There are currently six years left until this provision comes into force. Some believe the Trump administration may abolish it completely.
2. Court orders Vital Caring to share 43% of profits with Encompass Health and Enhabit (December 3)
In recent news that is making waves throughout the home health industry, a federal judge in Delaware has ordered Vital Caring to split future profits with Encompass Health (NYSE: EHC) and Enhabit, Inc. (NYSE: EHAB). This is the news that I have been ordered to do so. If the order is upheld, the company would have to trust 43% of its profits to Encompass and Enhabit.
“The willful misconduct that created Vital Caring results in a significant portion of its revenues flowing to Encompass,” the court's opinion said.
For years, Encompass Health has been vocal in its claims that Vital Caring's CEO acted unethically to start the company.
Both companies see this decision as a major victory.
“In response to the illegal and outrageous conduct of Mr. Anthony and other former executives, Encompass Health and EnHabit filed this lawsuit to protect the interests of our shareholders,” the company said in a statement. “Encompass Health and Enhabit believe that the broader public investor community will also benefit from the Delaware Court of Chancery's clear message that willful breaches of fiduciary duty and self-dealing by corporate officers have serious consequences. ”
VitalCaring's PE backers are currently considering an appeal.
3. How the Supreme Court's Chevron decision will help stop home health cuts (June 28)
Industry insiders believe the summer Supreme Court decision could have a future impact on home health care.
In June, the U.S. Supreme Court struck down the Chevron doctrine precedent. In general, this precedent meant that courts must defer to regulators' interpretations when federal law is ambiguous or administrative gaps remain.
For home health providers, overturning precedent could lead to less power for the Centers for Medicare and Medicaid Services (CMS) in the future. If that happens, it could mean the end of deep interest rate cuts.
4. The Department of Justice files a lawsuit seeking to block the “anti-competitive and illegal” transaction between UnitedHealth Group and Amedisys (November 12)
One of the biggest news stories of 2023 is Amedisys, Inc.'s (NASDAQ: AMED) UnitedHealth Group (NYSE: UNH.
Last month, the Department of Justice (DOJ), along with the attorneys general of Illinois, Maryland, New Jersey, and New York, filed an antitrust lawsuit in an attempt to block the deal.
“Home health and hospice patients and their families who are going through some of the most difficult times in their lives deserve access to affordable, high-quality care options,” U.S. Attorney General Merrick B. Garland said in a statement. We are therefore objecting to this merger.” “The Department of Justice will not hesitate to crack down on illegal consolidation and monopolization in health care markets that can harm vulnerable patients, their families, and health care providers.”
As it turns out, UnitedHealth Group isn't walking away from its deal with Amedisys. Additionally, the new Trump administration, scheduled to take office next month, could bring changes to the Justice Department.
5. Turnover rate in the home care industry as a whole reaches nearly 80% (July 3rd)
High employee turnover continues to be a consistent problem for the home care industry as a whole.
Activated Insights' 2024 Benchmark Report released in July confirmed that home care turnover rates have increased over the past two years. The industry-wide attrition rate is currently 79.2%.
On the home health side, the report found that only 16.4% of home health and hospice nurse applicants were hired last year.
6. Home care disaster looming in New York state (March 18)
Already a booming market for home care, New York faced even bigger changes this year.
Gov. Kathy Hochul's 2025 executive budget included more than $1 billion in cuts to the state's home health program. It also means changes to New York State's Consumer Directed Personal Assistance Program (CDPAP), which allows home care consumers to hire the caregiver of their choice. These caregivers received compensation through the program.
The budget, passed in April, named a statewide fiscal intermediary agency to oversee CDPAP. Before the budget was passed, the program had hundreds of financial intermediaries.
In November, Public Partnership LLC (PPL) entered into a financial brokerage agreement in New York.
7. “I need a break, please!”: Home health care providers slam CMS for excessive rate reductions (October 11)
When CMS opened a comment period on the 2025 Home Health Proposal Payment Rules, there were many sharp responses from the industry, including Henry Ford Health and Primary Home Health.
But one comment was able to capture the sentiment of much of the industry in one word: “against.”
8. Ehabbit withdraws from United Healthcare after “9 months of unsuccessful negotiations” (August 7)
After months of unsuccessful negotiations with UnitedHealthcare, EnHavit (NYSE: EHAB) filed a notice of termination on August 1st.
Less than a week later, EnHabit President and CEO Barb Jacobsmeyer explained why during the company's second-quarter earnings call.
“We will dedicate our clinical resources to our fee-paying Medicare patients and our 68 advantageous contract members,” she said. “We remain committed to providing strong quality care to United Healthcare members should they decide to contract at an acceptable rate at some point.”
Since then, Enhave has been able to secure a new agreement with UnitedHealthcare.
9. 6 home care leaders to watch from other home care leaders (January 29)
In this article, home health leaders took the time to express their admiration for their peers. Leaders like Kiana James, Ryan Iwamoto, and Kevin Smith explained which executives they feel are moving the industry as a whole forward.
10. Pinnacle Home Care CEO: AI will “significantly” increase home care profits (October 22)
In October, Pinnacle Home Care CEO Shane Donaldson spoke with HHCN about the acquisition by New York-based HCS-Girling and how emerging technology will become an important tool for home health care providers in the future. He talked about what would happen.
“We are on the brink of a technological revolution,” Donaldson said. “I know it's exciting for some people and alarming and alarming for others, but you're on a train or you're leaving a station. So you better jump right in. That's the reality.
