Major deals hit snags. Home health cuts continued. Regulatory noise came in from all sides, in Medicare and in Medicaid.

All of those realities made their way into Home Health Care News’ most popular stories for the year.

In order to summarize the 2024 that providers had, HHCN is revisiting 10 of its most widely read stories.

1. Home Care Industry Slams Finalized 80-20 Rule, Warns Agency Closures Are Coming (April 22)

When the “Ensuring Access to Medicaid Services” rule was finalized in April, after first being proposed in 2023, all eyes were on the 80-20 provision.

The provision requires 80% of Medicaid payments for home- and community-based services (HCBS) to be reserved for caregiver wages, with some caveats. The provision became the most controversial aspect of the rule, with providers and industry advocates speaking out against it during the public comment period and beyond.

Many providers believe that improved rates are the best way to ensure that caregivers are compensated well.

“Access to care is a shared goal, and so is increasing compensation for our caregivers,” Care Advantage CEO Tim Hanold told Home Health Care News in April. “I think we’re all aligned around that. The CMS rule started with good intentions, but certainly there’s going to be some unintended consequences if it comes out as written. Rate adequacy really continues to be the main driver for providing appropriate wages, and that is what I believe the administration should focus on to improve access to care.”

Currently, the provision is six years away from implementation. There is also a belief that the Trump administration could do away with it entirely.

2. Court Orders VitalCaring to Share 43% of Profits With Encompass Health, Enhabit (December 3)

A recent story making waves across the home health industry is the news that a federal judge in Delaware ordered VitalCaring to share future profits with Encompass Health (NYSE: EHC) and Enhabit Inc. (NYSE: EHAB). The company will have to put 43% of its earnings in trust for Encompass and Enhabit, if the order holds.

“A sizable 43% portion of the proceeds will flow to Encompass due to the willful misconduct that produced VitalCaring,” the court’s opinion stated.

Over the years, Encompass Health has been vocal about its allegation that VitalCaring CEO employed unethical practices to launch the company.

Both companies view the decision as a major win.

“Encompass Health and Enhabit launched the litigation to protect the interests of their stockholders in the wake of the illegal and outrageous conduct of Anthony and the other former officers,” the company said in a statement. “Encompass Health and Enhabit believe the broader investing public will also benefit from the Delaware Court of Chancery’s clear message that intentional breaches of fiduciary duty and self-dealing by corporate officers will have severe consequences.”

VitalCaring’s PE backers are currently considering an appeal.

3. How The Supreme Court’s Chevron Decision Could Help Stop Home Health Cuts (June 28)

Industry insiders believe that a 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. Generally, this precedent meant that if federal legislation is ambiguous, or leaves an administrative gap, the courts must defer to regulatory agencies’ interpretation.

For home health providers, upending the precedent could lead to a less powerful Centers for Medicare & Medicaid Services (CMS) in the future. That, in turn, could mean an end to significant rate cuts.

4. DOJ Sues To Block ‘Anticompetitive and Illegal’ UnitedHealth Group-Amedisys Deal (November 12) 

One of the biggest stories of 2023 was the sale of Amedisys Inc. (Nasdaq: AMED) to UnitedHealth Group (NYSE: UNH.

Last month, the Department of Justice (DOJ) — along with the Attorneys General for the states of Illinois, Maryland, New Jersey and New York — filed an antitrust lawsuit attempting to block the deal.

“We are challenging this merger because home health and hospice patients and their families experiencing some of the most difficult moments of their lives deserve affordable, high quality care options,” U.S. Attorney General Merrick B. Garland said in a statement. “The Justice Department will not hesitate to check unlawful consolidation and monopolization in the health care market that threatens to harm vulnerable patients, their families, and health care workers.”

On its end, UnitedHealth Group has not backed away from the Amedisys deal. Plus, a new Trump administration set to take over next month could mean changes at the DOJ.

5. Home Care’s Industry-Wide Turnover Rate Reaches Nearly 80% (July 3)

High turnover has remained the consistent thorn on the side of the home care industry at large.

In July, Activated Insights’ 2024 Benchmarking Report confirmed that home care turnover has increased over the past two years. Currently, the industry-wide turnover rate is 79.2%.

On the home health side, the report found that only 16.4% of home health and hospice nurses applicants were hired last year.

6. The Looming Home Care Disaster In New York State (March 18) 

Already a bustling market for home care, New York state dealt with even more shakeups this year.

Gov. Kathy Hochul’s executive budget for 2025 included more than $1 billion in cuts to the state’s home care programs. It also meant changes for New York’s Consumer Directed Personal Assistance Program (CDPAP), which enabled home care consumers to hire the caregiver of their choice. These caregivers received compensation through the program.

The budget passed in April, and designated one statewide fiscal intermediary to oversee CDPAP. Prior to the budget passing, the program had hundreds of fiscal intermediaries.

In November, Public Partnerships LLC (PPL) was awarded the fiscal intermediary contract in New York.

7. ‘We Need A Break, Please!’: Home Health Providers Sound Off On CMS Over Rate Cuts (October 11)

When CMS opened up the comment period on the 2025 home health proposed payment rule, it led to many incisive responses from the industry, including from Henry Ford Health and Primary Home Health.

However, one comment managed to capture how most of the industry felt in one word — “opposed.”

8. Enhabit Walks Away From UnitedHealthcare After ‘9 Months Of Unsuccessful Negotiations’ (August 7) 

After a whopping 9 months of months of unsuccessful negotiations with UnitedHealthcare, Enhabit Inc. (NYSE: EHAB) submitted a termination notice on August 1.

Less than a week later, Enhabit President and CEO Barb Jacobsmeyer explained why during the company’s Q2 earnings call.

“We will dedicate our clinical resources to fee-for-service Medicare patients, and those that are members of the 68 favorable contracts,” she said. “We remain committed to providing our strong quality of care to United Healthcare members, if at some point they decide to contract with acceptable rates.”

Since then, Enhabit has been able to work out a new deal with UnitedHealthcare.

9. 6 Home Care Leaders To Watch, According To Other Home Care Leaders (January 29)

In this piece, home care leaders took the time to express their admiration for industry peers. Leaders such as Qiana James, Ryan Iwamoto, Kevin Smith and others explained which executives they felt were moving the industry forward overall.

10. Pinnacle Home Care CEO: Home Health Margins Will Increase ‘Significantly’ With AI (October 22)

In October, Pinnacle Home Care CEO Shane Donaldson sat down with HHCN to discuss being acquired by New York-based HCS-Girling, and how emerging technologies would be a key tool for home health providers going forward.

“We are on the precipice of a technological revolution,” Donaldson said. “I know that for some people it is exciting, and for other people it is alarming and concerning. But you’re either on the train, or you better jump on soon, because it’s leaving the station. That’s the reality of it.”