By Paul Joiner, CEO, HHAeXchange
LinkedIn: Paul Joiner
LinkedIn:Â HHAeXchange
Homecare is undergoing rapid change as shifting demographics, new technologies, and evolving regulations reshape the industry. For home- and community-based services (HCBS) providers, these trends present both significant challenges and new opportunities to deliver care more effectively. To better understand how providers are navigating this landscape, a recent survey collected insights from 145 agency leaders about current industry trends and developments, focusing on possible future impacts.
The findings align with a growing national awareness of caregiving issues. For example, PBS’s documentary, Caregiving, highlights the increased pressures faced by providers, caregivers, and members nationwide, including rising administrative demands and efforts to deliver compassionate care. The survey results support the film’s message and closely examine how providers are seeking more support to improve the overall system.
Compliance is Top of Mind for the Majority of Providers
Regulatory complexity is influencing how HCBS providers are shaping their operational priorities. According to the survey, compliance is the top business concern for providers in 2025, with 70% ranking it as their No. 1 or No. 2 focus. This marks a shift from previous years, when cost reduction and operational efficiency were the main priorities.
The increased focus on compliance stems from several factors, including the surge in audit activity by the Office of the Inspector General and other oversight entities. Providers are also navigating more complex Medicaid guidelines and policy changes, which amplify non-compliance consequences and pose more financial and reputational risks — a possibility agencies are keenly aware of. Among those who use reporting tools, 52.3% said that ensuring compliance is their primary reason for adopting the technology.
Maneuvering around these challenges requires proactive investment in specialized tools built to track, report, and adapt to changing regulatory frameworks. Besides reducing compliance burdens, these solutions underscore broader trends, such as providers’ growing reliance on technology for operational support.
Interest in Operational Technology Rising As Resource Shortages Continue
To offset resource strains, staff shortages, and administrative bottlenecks, HCBS providers are more open to leveraging innovative tools that streamline workflows and automate tasks. According to survey data, technology delivers value in areas like staff scheduling and communication, as well as billing and payment processing. Ranked as the top tech need by 34.1% of respondents, scheduling tools assist providers in managing caregiver assignments and enhance communication between staff, caregivers, and clients. Billing solutions, identified as the second most in-demand digital resource, help address the complexities of claim submissions and payment reconciliation within the Medicaid system.
Using the latest innovative advancements to reduce administrative workloads offers many benefits, but providers may be cautious due to perceived barriers like cost and change management. To address these concerns, vendors need to show how their tools provide real-world improvements while addressing compliance concerns.
Research Presents Opportunities to Leverage Data’s Untapped Potential
Data collection in the homecare industry remains steady, but its application is often limited. The survey revealed that two-thirds of agencies that use reporting platforms are not utilizing the data collected by those tools to guide business decisions. This highlights a gap in the industry’s adoption of data-driven strategies. Agencies that use data more effectively can improve outcomes by:
- Optimizing resource allocation in response to real-time trends.
- Enhancing decision-making in value-based care models, where reimbursement is based on performance metrics.
- Identifying and addressing operational inefficiencies.
Providers that can connect actionable insights from data to the daily problems they struggle with will likely have an easier time adjusting as HCBS evolve and expand. That adaptability is advantageous, especially as the industry is expected to grow rapidly alongside the nation’s aging population, which has already shown interest in aging and receiving care at home.
Though the challenges providers face are numerous and complex, they remain dedicated to their mission. Most survey respondents cite delivering high-quality, compassionate care as their main source of motivation. This takeaway underscores the industry’s longstanding core principle — despite the pressures providers face and the obstacles still to come, they are deeply committed to the people they serve.