Medicaid Reforms 2025 - Home Care Guide

The Home Health Care Wire 

Your source for CareVoyant and industry news. June 5, 2025

Medicaid Changes in 2025: A Survival Guide for Home Care Agencies

Significant changes to Medicaid will impact home care agencies across the US in 2025. Although these reforms aim to improve transparency and service delivery, they do present new challenges for providers of home-based services, especially those reliant on Medicaid reimbursements.

Home care agencies should proactively seek solutions to challenges regulatory upheaval could pose. Investing in an all-in-one home care software can help agencies tighten up operations and prevent excess revenue leakage. The right home care software will also help agencies meet their compliance metrics efficiently and effectively.

The impact of unbilled services is significant for home care agencies. Agencies pay employees for unbilled services even while they are not reimbursed, doubling the impact on cash flow and bottom line.

Home Care Agencies must develop metrics and processes to manage unbilled services. Home Care Software that provides the tools to monitor and reduce or eliminate unbilled services can go a long way. Reducing unbilled services will increase revenue, improve cash flow and the agency's bottom line to help them provide quality care and improve patient and employee satisfaction.

When a scheduled caregiver fails to arrive without prior notice, that can shake client trust. In home care, where consistency and reliability are essential, no-shows are more than just a scheduling hiccup—they increase liability and damage an agency’s reputation. Worse, now-shows often lead to revenue loss, missed compliance benchmarks, and poor client retention.

Scheduling challenges are not insurmountable. By identifying root causes and investing in an integrated home care software, agencies can build a more reliable caregiving workforce—and restore confidence in every scheduled visit.


Home Healthcare Industry News

MA denials cut payouts to providers by 7 percent, study finds
Medicare Advantage denials are eroding healthcare providers’ reimbursement — even when they are successfully appealed and overturned.

CMS Rolls Out Strategy to Accelerate Medicare Advantage Audits
Beginning immediately, CMS will audit all eligible MA contracts for each payment year in all newly initiated audits and invest additional resources to expedite the completion of audits for payment years 2018 through 2024.


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