News From the National Alliance for Care at Home Annual Meeting & Expo

In the face of almost overwhelming hurdles—including a threatened 9% payment cut—in-home care providers met in New Orleans in November to learn about how to keep their businesses going and better serve their patients.

“The work that you all are doing—that we are doing—needs to be top priority,” Steve Landers, CEO of the Alliance for Care at Home, told those gathered for the group’s Annual Meeting and Exposition, the first meeting since the Alliance was created with the merger of the National Association for Homecare and Hospice and the National Hospice and Palliative Care Organization. “It’s not something to cut, to cast aside, to inappropriately audit and inconvenience and disadvantage. It’s something to invest in; it’s something to build up. It’s something to make more vibrant. It’s something to celebrate, and that’s why we’ve got to make sure we stick together to tell that story.”

Louisiana Gov. Jeff Landry kicked off the three-day event, telling attendees that broad access to care in the home would help solve the nation’s health care problems.

“I believe that people getting home health are actually getting a better product,” Landry said in his opening keynote address. “I just think health care is strongest when it meets people where they are,” he added.

Landry said in-home care provides the innovation and efficiency the health system needs in order to improve, because homecare provides high-volume care with better outcomes and has helped pioneer value-based care, telehealth and remote monitoring, along with other cutting-edge technologies.

The governor also said homecare is central for managing chronic diseases such as diabetes, and he praised care providers for serving a broad population that includes veterans, seniors and people with disabilities.

A Fight in Washington

Landers said that it was important for the governor to attend because leaders need to hear and see the story of the industry and recognize the critical work that’s being done.

Much of the talk at the conference was the Centers for Medicare & Medicaid Services’ (CMS’) proposed rule, which would reduce home health payment rates by 4% in 2026 and add a temporary 5% clawback. Landers called the proposal “dramatically erroneous and misguided.”

Industry experts had expected to see a final rule around Oct. 31 but it had not been released yet by the show (or by press time), likely because of the extended shutdown of the federal government, which ended Nov. 12. The same rule also includes significant changes for durable medical equipment providers, including the possible return of competitive bidding. If the final rule includes significant cuts, Landers said, the industry will need to act fast to make sure its message can get through to Congress.

“There’s a risk that this isn’t fixed,” Landers told attendees. “And one of the things we’ve been doing to mitigate that risk as an alliance—and many of you have been at the forefront of this—is trying to make sure that Congress has some model to come in and stop the cuts if CMS doesn’t.”

Throughout the event, attendees heard similar messages at educational sessions about the importance of advocacy as well as other ways to move the industry forward. Some of the highlights included:

• How Medicaid cuts could impact the future of care and the fact that many professional caregivers are Medicaid-eligible themselves, requiring agencies to provide documentation so their staff can receive benefits
• A look at ways to engage and support family caregivers to alleviate their stress and improve patient outcomes
• Efforts and obstacles to promoting field staff into management and, ultimately, leadership roles
• Ways the growing and changing aging population—including a more diverse collection of seniors—will impact the future of care needs
• The effect of Medicare Advantage Plans and a prediction that MA growth may have plateaued.

Actress Shares & Tackles Challenges of Caregiving

Actress and podcast host Yvette Nicole Brown sat down with Elyssa Katz, senior director of marketing for the National Alliance for Care at Home, and Carla Davis, hospice and homecare advocate and executive leader, at the Alliance’s annual meeting to share her personal experience as a caregiver.

Brown, who acted in the hit show “Community,” has been caring for her father, who has Alzheimer’s disease, even passing up the final season of the show to take care of him. She also hosts a podcast, “Squeezed,” that works to raise awareness of care-at-home issues and to highlight people carrying the weight of family caregiving.

Brown discussed how leaders in home health and in-home care can encourage their teams to do their best work in the field, and she urged them to use their platforms to advocate for things like pay, staffing and proper care for patients.

She got emotional as she shared the way many guests on the podcast say the caregiver role weighs heavily on their lives. Many say it’s been a long time since someone asked them, “How are you doing?”

“We’ll either be a caregiver or a caregivee before we leave this Earth, and the more of us that accept that and learn that early the better off we’re all going to be,” Brown said. “So what I tell people all the time is that caregiving is just love. It’s just showing love for another person … I just needed to understand that I don’t have to have all the answers. I just need to show up every day and make sure he’s fed, he’s comfortable, he’s housed and he’s loved. I can do that, and you can do that.”

Reasons for Optimism

Despite noting that some things feel like they are moving backward, Landers said the industry has every reason to be optimistic, as the signing of Medicare and Medicaid into law marked its 60th anniversary this year.

“President Johnson told the country that the law reminds us never to ignore untended suffering in a land bursting with abundance,” Landers said. “If that’s what Medicare is about, then the work that you all are doing, that we are doing, needs to be top priority.”

The Alliance gave out four awards over the course of the show:

Advocate of the Year: 
Jonathan Fleece, president and CEO of Empath Health
The award goes to someone who has elevated the field through persistent advocacy. Fleece has worked with the Florida Hospice and Palliative Care Association and testified before Congress this year.

Lifetime Achievement Award: 
Richard MacMillan, retired senior counsel of regulatory and legislative affairs at LHC Group 
An attorney and registered nurse, MacMillan helped found LHC in rural Louisiana. He has served as general counsel for the Home Care Association of Louisiana, president of the Louisiana Rural Health Association and as a member of other national organizations.

Lifetime Achievement Award: 
David Totaro, chief government affairs officer for BAYADA Home Health 
Totaro founded Hearts for Home Care, a national advocacy group with more than 13,000 members. Totaro recently announced his planned retirement from BAYADA and is also rolling off of the Alliance’s board.

Care at Home Partner Award: 
Axxess 
The technology company was honored for its commitment to empowering the workforce, expanding access to care and advancing innovation.

New Board Members

Retiring members of the Alliance board were thanked, including Susan Lloyd, Mary Myers, David Totaro, Sarah Radcliffe and Mark Morris. It was announced that these new members of the board will join in January:

• Kristen Yntema, president and CEO of of AuthoraCare Collective
• Jenn Ofelt, president of UnityPoint at Home at UnityPoint Health
• David Baiada, CEO of BAYADA Home Health Care
• Tim Rogers, president and CEO of the Association for Home and Hospice Care of North Carolina and the South Carolina Home Care and Hospice Association

“Hopefully, our friends in Washington will bring a fun and easy year to all of our new board members,” Landers said. “But otherwise, we’ve got a lot of work to do, and it’s going to be hard work. … Come January, the work we have to do is incredible.”