Federal Home Health and Hospice Updates
(Aug. 12, 2025) Please see the following updates from LeadingAge national on home health and hospice:
Home Health October 2025 Preview Reports Available: On August 6, the home health Provider Preview Reports were updated and posted to iQIES. These reports contain provider performance scores for quality measures, which will be published on Care Compare during the October 2025 refresh. Data contained within the Provider Preview Reports are based on quality assessment data submitted by HHAs from Quarter 1, 2024 through Quarter 4, 2024. The data for the claims-based measures will display data from Quarter 1, 2023 through Quarter 4, 2024 for the Discharge to Community and Medicare Spending Per Beneficiary measures, Quarter 1, 2022 through Quarter 4, 2024 for the Potentially Preventable 30-Day Post-Discharge Readmission measure, and Quarter 1, 2024 through Quarter 4, 2024 for the Home Health Within-Stay Potentially Preventable Hospitalization measure. Additionally, the data for the HHCAHPS measures will display data from Quarter 2, 2024 through Quarter 1, 2025. Providers have until August 8, 2025, to review their performance data.
LeadingAge Reinforces Need for MA Reforms in U.S. House Ways & Means Testimony: The U.S. House Ways & Means subcommittees on Health and Oversight held a joint hearing on July 22 entitled “Medicare Advantage: Past Lessons, Present Insights, Future Opportunities.” The hearing included five in person witnesses, including Avera Health who represented a rural and system provider perspective, as well as a health plan. LeadingAge submitted written testimony to the committee on August 5 seeking to supplement what the committee heard with the experiences of our skilled nursing facility and home health agency provider members when they participate in Medicare Advantage (MA) plans. Our remarks continued to hammer home the need for MA reforms that address both the inadequate provider payments from MA plans as well as the excessive administrative burden of participating in the program. During the hearing, committee members referenced several pieces of legislation that have been introduced to address needed MA reforms. LeadingAge reiterated our support for the Improving Seniors’ Timely Access to Care Act (H.R. 3513/S.1816), which seeks to standardize and modernize MA prior authorization practices and enjoys broad bipartisan support from more than 200 senators and representatives; and the more recently-introduced, bipartisan Prompt and Fair Pay Act (H.R. 4559), which would require MA plans to pay providers at least Medicare fee-for-service rates and establishes timelines by which they need to pay providers’ clean claims. We also detailed our concerns about aspects of Congressman David Schweikert’s (R-AZ) MA reform bill, H.R. 3467 that would seek to automatically enroll all Medicare A and B eligible beneficiaries into an MA plan and lock them into that specific plan for 3 years. Should such an MA auto-enrollment provision pass Congress, it could lead to a rapid shift of the remaining Medicare beneficiaries into MA and could be financially perilous for providers. Members can read our written testimony as we submitted here.
New Study Suggests Foreign-Born Workers Drive Growth in Direct Care Workforce: A new study by Britainy Barnes and David C. Grabowski, published in Health Affairs in August 2025, examined the evolving composition of the long-term services and supports (LTSS) workforce. Using data from the American Community Survey (2012–2022), the authors found that foreign-born workers accounted for half of the increase in the direct care workforce in home and community-based services (HCBS) over the past decade. For purposes of the study, “direct care workers” were defined as paraprofessionals who provide hands-on support with activities of daily living, including nursing assistants, home health aides, and personal care assistants (and excluding licensed professionals such as registered nurses). “Foreign-born workers” included both naturalized U.S. citizens and non-citizens born outside the U.S., encompassing lawful residents and undocumented individuals. The study found that while the overall LTSS workforce remained relatively stable, institutional settings saw a 23.2% decline in direct care workers, largely due to native-born worker attrition. In contrast, the HCBS workforce grew by 24.3%, with foreign-born workers contributing nearly half of that growth. By 2022, foreign-born individuals made up 31.9% of the HCBS workforce, compared to 22.4% in institutional settings. States with higher shares of foreign-born workers—such as New York, New Jersey, and California—also had larger HCBS workforces. The study’s results affirm LeadingAge’s view that immigration reform is essential to sustaining and strengthening our workforce. We will continue to pursue related policy priorities—such as creating and expanding visa pathways for direct care workers— which we believe are vital to ensuring access to quality care for older adults.
CMS Launches Hospice Provider Security Official Enrollment: The Centers for Medicare and Medicaid Services (CMS) is now accepting enrollment for hospices in the iQIES system. This new system is required for submitting information on the Hospice Outcomes and Patient Evaluation (HOPE) tool starting on October 1, 2025. CMS states for a hospice organization to receive access to iQIES, the organization must complete the steps in the announcement no later than September 10, 2025.
HOPE Validation Utility Tool Now Available: The Centers for Medicare and Medicaid Services (CMS) announced the availability of the Hospice Outcomes and Patient Evaluation (HOPE) tool validation utility tool (VUT) on July 31. This tool is used by hospice vendors to test their current products and validate assessment upload compatibility. This is one of the final steps before implementing new quality requirements for assessment submissions.
HOPE Training - Is Your Hospice Agency Prepared for HOPE? Starting October 1, 2025, the Hospice Outcomes and Patient Evaluation (HOPE) Tool will replace the Hospice Item Set (HIS) collection process, introducing a more comprehensive approach to patient assessments and quality reporting. This webinar is designed to provide you with the latest updates ahead of the submission deadline, along with actionable strategies to help your agency prepare for implementation.
LeadingAge Training on August 20th - https://learninghub.leadingage.org/courses/is-your-hospice-agency-prepared-for-hope
Also, please see HPCANYS's HOPE training, Preparing for The Implementation of HOPE~ What can you do NOW to be ready? This is also on August 20th , see registration link here.
Contact: Meg Everett, meverett@leadingageny.org.