A minimum wage increase to $16/hour in Nevada, which took effect in January 2024, has helped reduce turnover among home care workers, with the state’s home care workforce growing by 6.5% and 96% of workers being retained between December 2023 and April 2024. Additionally, Nevada raised its Medicaid reimbursement rate from $17.56 to $25 per hour to better support home care providers as the state’s aging population continues to grow.

The Center for Medicare & Medicaid Services (CMS) recently updated the Medicaid eligibility standards for 2025, which reflects a 2.9% price increase between 2023 and 2024.

The Connecticut Department of Social Services (DSS) reported that, due to staffing issues and the complexity of the technical requirements, it plans to delay until April 1, full implementation of the home care provider registry and data processing system.

A new study published in the JAMA Health Forum reveals that the Medicaid "unwinding" process, which resulted in the disenrollment of approximately 15% of beneficiaries since March 2023, has created significant barriers to accessing home care services for seniors. Researchers surveyed 843 community-dwelling seniors who lost or had to renew their Medicaid eligibility, finding that many reported cost-related delays or forgoing care, especially for dental and home health services. Additionally, about half of the respondents received no information about the unwinding process, and many faced difficulties navigating the renewal procedure. The study emphasizes the need for better outreach and support to help seniors retain Medicaid coverage and reduce care access barriers, particularly for those who lost coverage due to procedural issues.

The Connecticut Department of Social Services (DSS) issued the final report of a two-part study of Medicaid reimbursement rates. The report recommends that DSS examine the current process for assessing home and community-based services (HCBS) waiver members and consider adoption of standardized and validated tools that could provide a comprehensive assessment of functional needs, natural supports, and level of acuity.

Pennsylvania Medicaid Home & Community Based Services (HCBS) Rates have been updated and take effect January 1, 2025.

The Centers for Medicare & Medicaid Services (CMS) has finalized a home health prospective payment rule for 2025 that includes a 0.5% aggregate increase in Medicare home health reimbursement, translating to approximately $85 million. This adjustment marks a shift from the proposed 1.7% decrease, reflecting ongoing adjustments related to the Patient-Driven Groupings Model (PDGM). Despite this improvement, stakeholders in the home health sector expressed dissatisfaction, emphasizing that the overall trend has been toward significant cuts and insufficient recognition of inflationary pressures on costs.

HCAOA joined NAHC, LeadingAge, ANCOR, and other industry leaders for a quarterly meeting with the Centers for Medicare and Medicare Services (CMS) last week as CMS continues to seek feedback regarding the implementation of the Medicaid Access Rule. Throughout the meeting, our coalition of industry leaders continued to stress the potential impact of the 80/20 provision on providers and provided recommendations for sub-regulatory guidance that has yet to be articulated by CMS, such as reporting and audit requirements, to ensure state-by-state continuity in implementation and to mitigate unnecessary administrative burden on providers.

A recent report from the University of California San Francisco (UCSF) highlights significant barriers preventing seniors with cognitive impairment from accessing home care services. Approximately 4.3 million seniors in the U.S. live alone with cognitive challenges. Yet, nearly 80% cannot obtain home care aides through programs like Medicaid due to their ineligibility to qualify for Medicaid. Many of these seniors struggle with daily activities and receive little to no assistance from family or friends.

HCAOA Associate Member Paradigm has launched a new resource for home care agencies. The Medicaid Rate Lookup Tool is crafted to streamline access to Medicaid reimbursement rates and service details for home care agencies. It provides quick insights into service rates, claim filing periods, and state-specific Medicaid information.

The Centers for Medicare & Medicaid Services (CMS) is launching a training series focused on the home- and community-based services (HCBS) provisions of the Medicaid Access Rule. This final rule, aimed at improving access to care, quality of care, and health outcomes for Medicaid beneficiaries, introduces significant changes to strengthen safeguards, promote health equity, and enhance the consistency of Medicaid HCBS programs. The training sessions will cover key provisions of the rule, providing partners with the opportunity to understand the updates, ask questions, and give feedback on the rule's implementation.

​Thanks to aggressive advocacy by the HCAOA West Virginia Chapter, the state’s HCBS reimbursement rate has been raised from $18.92 to $25.44, a 34.5% increase! This increase makes West Virginia’s rates more competitive with surrounding state rates, such as Kentucky (soon to be $29), Ohio ($29), Maryland ($31), Pennsylvania ($23 regional average), and Virginia ($23 regional average).

​CMS has published a new fact sheet about the services available through the Guiding an Improved Dementia Experience (GUIDE) Model, along with guidance on how patients and families can work with their healthcare providers to access GUIDE services and supports. GUIDE focuses on dementia care management and aims to improve the quality of life for people living with dementia, reduce strain on their unpaid caregivers, and enable people living with dementia to remain in their homes and communities.

This webinar will help states by:
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• Highlighting the types of direct support professionals (DSPs) that deliver home and community-based services (HCBS);
• Discussing the causes and challenges contributing to HCBS workforce shortages; and
• Highlighting strategies states can use to address HCBS provider shortages.

All providers are invited to participate in CMS’ Open Door Forum on Tuesday, July 30 at 2:00 p.m. for an  overview of the home and community-based services (HCBS) provisions in the Ensuring Access to Medicaid Services Final Rule, including a deeper dive on what is commonly referred to as the “HCBS payment adequacy provision.”