HHCN’s FUTURE Conference, held in Dallas from Sept. 15-17, is your opportunity to learn more about innovation in the home-based care industry, including topics discussed in this article. To learn more and reserve your ticket, click here.
The home-based care industry is undergoing a profound transformation in 2025 as providers grapple with persistent workforce shortages and ongoing reimbursement uncertainties that threaten operational stability. These pressures have led providers to reimagine their business models and service delivery approaches.
Providers are diversifying their service lines to expand into specialty and high-acuity markets and investing in workforce initiatives to address staffing gaps. The opportunity capturing the most attention, however, is the shift to value-based reimbursement models, according to a recent Home Health Care News survey. Over 35% of respondents saw partnering with payers and health systems to forge value-based reimbursement agreements as the current top opportunity for at-home care providers – surpassing all other innovative opportunities.
Value-based care offers home health providers potential upside, and providers have made payer innovation a key part of their strategies.
“There’s a tendency towards price suppression in our category, and so value-based care is a way to differentiate, and to be able to share the performance that we’re already creating for our patients in their homes,” Sue Chapman Moss, managing director of payer and provider contracting and strategy at Bayada Home Health Care, previously said at a HHCN event.
Other innovative techniques have caught providers’ attention equally. Respondents split evenly on the industry’s second-biggest opportunity, according to the survey, which included 11 home health and home care stakeholders. An equal number of providers, 18%, saw strengthening care transitions and hospital relationships, creating scalable workforce pipelines and expanding into speciality or high-acuity service lines as the second top opportunity for the industry.
Survey respondents were even more aligned when considering the greatest challenges facing the home-based care industry. For 46% of respondents, recruiting and retaining clinical staff or caregivers was the top challenge, while 27% saw navigating payment reform and reimbursement uncertainty as the most significant challenge.
Workforce shortages have beleaguered the home-based care industry, and recent legislative moves have worsened the outlook. Providers have lost workers due to the Trump administration’s immigration crackdown, creating significant problems for workers as well as home-based care companies and clients.
In July, John Sneath, CEO of Framingham, Massachusetts-based Tribute Home Care, told HHCN that his company had lost nine workers with several more in jeopardy.
“All of these caregivers were working with clients who had built relationships,” John Sneath, CEO of Tribute Home Care, previously told HHCN. “[Losing them] was tough for clients and, obviously, tough on everyone [who] works at Tribute to see that happen.”
Industry insiders do not report much optimism that the industry’s greatest challenge will improve. Fewer than 10% expected the recruitment landscape for home-based care workers to improve in the next six months, with 36% reporting that the hiring landscape would worsen.
Home-based care providers have turned to new techniques to build out their staff, including creating digital employee referral programs.
Respondents had a slightly sunnier view of retention, with 18% reporting that they expect retention to improve and only 18% forecasting that the retention landscape would get harder over the next six months. Workforce development was also a consideration for some respondents, with 18% stating that creating scalable workforce development pipelines was the current greatest opportunity for at-home care providers.
The changes providers are making
To adapt to the changing home-based care landscape, providers are turning to new service lines and overhauling their technology stacks.
Over a third of survey respondents reported that their organization planned to launch a new service line in 2025, and 27% responded that their organization would possibly do so. Respondents’ plans for new service lines included palliative care, wound care, pediatrics and dementia care offerings.
Diversified service lines have also become a way for home care providers to differentiate themselves from a “sea of sameness” within the industry.
Technology has become a significant beacon of hope. Outdated technology can result in security vulnerabilities, operational troubles and can even harm patients, putting pressure on providers to keep their technology stacks up to date.
Respondents expressed hope that a variety of technologies would improve at-home care operations, including remote patient monitoring, advanced electronic health records, workforce management platforms and telehealth technology.
Organizations are not just hopeful about new technologies; they are also taking steps to integrate new tech into their systems. Respondents reported that their organizations planned to invest in clinical documentation or voice technology, predictive analytics tools, telehealth or virtual care platforms and remote patient monitoring, among others.
Providers are pursuing these changes with clear goals in mind. Clinically, providers most often reported that they are prioritizing care coordination, while the most commonly reported business goal was to expand referral relationships – efforts ultimately serving care quality and patient access.
Editor’s note: A previous version of this article incorrectly stated that Sue Chapman Moss serves as the managing director of payer and provider contracting and strategy at Enhabit. Moss works at Bayada Home Health Care.
