The home health industry is currently in limbo as providers and stakeholders await the release of the 2026 Medicare home health final rule. For industry advocates, it has become a “war room situation,” according to Dr. Steven Landers, CEO of the National Alliance for Care at Home (the Alliance).

The home health industry faces the largest proposed cut in its history – a threat driven by flawed methodologies used by the U.S. Centers for Medicare and Medicaid Services (CMS), Landers said at the Alliance’s 2025 Annual Meeting and Exposition. Landers emphasized that while the Alliance has “done everything it can” to oppose the proposal, the organization is also preparing its strategy should the final rule mirror the proposed one.

“It’s still possible they’re going to get this wrong,” he said on Sunday. “They’ve got MedPAC telling them to cut. This administration has a lot of fiscal hawks in it that are looking for line items to cut. They put out a proposal knowing some of these issues, and got it wrong. So there’s a risk that this isn’t fixed.”

If the “dramatically erroneous and misguided” proposed rule is not corrected, Landers said, the industry could be hit with delays, agency closures and limited access to care in rural areas.

One of the Alliance’s lines of defense involves the Home Health Stabilization Act of 2025, a bill introduced in September by representatives Kevin Hern (R-Okla.) and Terri Sewell (D-Ala.) that would pause cuts to the Medicare home health reimbursement rate for 2026 and 2027.

In case the final rule resembles the proposed rule, the bipartisan bill and Congress’ involvement will be critical to pausing the implementation of major cuts to the home health reimbursement rate, Landers said. The problem with this approach, he said, is that with the government shutdown, Congress is not in session.

“So please stay on, stay alert,” he said. “If we don’t get what we need here, we’re going to have to rally fast and make sure the message gets through to Congress to try and fix things.”

In addition to its advocacy on the home health rule front, the Alliance is also narrowing in on other critical problems. The organization is working to “stamp out” the Medicare Advantage (MA) hospice carve-in. Also top of Landers’ mind are telehealth flexibilities that were paused by the government shutdown. 

The crucial element for the home-based care industry, Landers said, is unity.

“We’ve got to work together to amplify our voice, find common ground so that we’re not contradicting one another and stepping over one another to make sure that message is heard,” Landers said. “We’re in it to win it, but we’ve got to stick together, because we’re a small sector and if we’re contradicting one another, God save us.”