Amid an uncertain reimbursement environment and sea of recent policy updates, Aveanna Healthcare Holdings Inc. (Nasdaq: AVAH) remains focused on the strategies that have been helping the company achieve success.

That doesn’t mean Aveanna is resting easy. Instead, the company is being proactive and getting ahead of the potential roadblocks that may arise as a result of the current home-based care climate.

This means ramping up the company’s efforts around advocacy, as well as actively working with various state Medicaid programs.

Home Health Care News caught up with Jim Melancon at last month’s National Alliance for Care at Home Financial Summit to learn more. Melancon serves as senior vice president of government affairs at Aveanna.

Aveanna is an Atlanta-based company that delivers a range of pediatric and adult health care services, including nursing, rehabilitation, occupational nursing in schools, therapy services, day treatment centers for medically fragile and chronically ill children and adults and home health and hospice services. The company has 327 locations across 34 states.

The transcript below has been edited for length and clarity.

HHCN: What are some of Aveanna’s main strategic priorities for the rest of 2025?

Melancon: For the rest of 2025, it’s continuing what we’ve been saying on our quarterly and annual calls, which is to have our preferred payer and government affairs strategy. I think the government affairs are even more important now than it maybe was, simply because Aveanna does Medicare services as well as Medicaid services. We have to keep our eyes open on both.

What was your response to the 2026 home health proposed payment rule?

The word I think of is disappointing. I think that is industry wide. It’s especially disappointing when put in context of other proposed rules for other industries, not that the increases have been large, but just the fact that there have been increases across the board. For home health to be singled out, with the amount of the decrease, really doesn’t make for a sustainable industry.

We’ve seen providers who are struggling to make ends meet now, and it doesn’t really help. This is a benefit that people have paid for, and they’re not going to be able to access it at the end of the day. If these cuts continue to be made, it’s going to be harder. It becomes a real access issue. I think there’s also the impact that it will have on inpatient care, when patients aren’t able to be discharged from a hospital, from a facility.

What regulatory or policy changes are a top concern for Aveanna right now?

When you’ve seen one Medicaid program, you’ve seen one Medicaid program. One of the things we’re going to be working on is with our partners in the Medicaid agencies to ensure, how can we be a partner with them? We’re in the home with these families every day. It’s making sure we’re being proactive on eligibility enrollment questions that come up, and those are going to differ between expansion states and non-expansion states under the bill.

We’re going to be able to be proactive in ensuring that eligibility is continued for our families, because quite often a lot of people on Medicaid don’t know they’re on Medicaid. If you ask them, they may say, ‘I don’t have Medicaid. I have fill-in-the blank — a Centene plan, a Molina plan, Aetna Better Health.’

Someone recently said, we’ve done such a good job of de-stigmatizing Medicaid that a lot of people don’t realize they’re on Medicaid. Now, that we have so many people who are covered, how do we help continue that coverage? On our private-duty services side, we take care of so many children and adults with complex conditions. We are very cost effective, and overall cost-effective for the health care continuum.

How active is Aveanna on the advocacy front?

We’re very active in the sense that we partner quite extensively with a lot of state associations, and with the Alliance as well. We also participate with the Partnership for Medicaid Home-Based Care.

We’re very active in that advocacy front, and we are really increasing our grassroots advocacy efforts. Internally, we just hired a director, and that will be her responsibility to help us. We have an advocacy connect network. It’s our internal platform that we use for grassroots efforts. We’ve really stepped up over the last few years.

The Trump administration has pursued aggressive immigration policies. To what extent will these policies impact the caregiver workforce?

I think it varies by market, and I think it may impact more of the home care market versus the skilled care market. It’s definitely something we see, and I know that our peers are seeing and there’s concern about those issues. There’s concern about the caregivers and the people who are employing the caregivers. “Will I have this same caregiver next week?’ I think that consistency is really important for families and for clients.

What are some of the biggest operational and financial challenges impacting home-based care right now? How is the company navigating these challenges?

Consistently, you’re going to hear workforce. We don’t have a demand problem for services. There’s a huge demand. It’s the supply side of caregivers that’s causing issues. When you’re talking about Medicaid, even Medicare, when the rates are not sufficient to pay caregivers what they’re expecting, demanding and what they deserve, it’s very challenging. I would say workforce and rates, those two things that go hand in hand is what you’ll hear from not only Aveanna, but also our peers. That’s why we advocate so hard to make sure we have adequate funding, so the service can be provided. It’s not a benefit if you can’t provide it because you can’t pay workers what they deserve to be paid.