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How Build Back Better and Workforce Shortages Affect Home Health and Hospice

HCHB News - October

To keep you informed on news, innovation, education and advocacy issues around home-based care, we’ve pulled together these important headlines.

Build Back Better

The Build Back Better plan has been scaled down drastically, but it still includes improved Medicaid coverage for home care services for seniors and the disabled population. $150 billion has been allocated to help reduce waiting lists and improve pay for low-wage care jobs. The plan has also set aside $1 billion for direct care workforce competitive grants and additional funding for hospice and palliative care workforce and education. Read the full article here.

Palliative Care

Senators Jacy Rosen and Lisa Murkowski are pushing support for palliative care by re-introducing The Provider Training in Palliative Care Act. The bill would allow National Health Service Corps members to defer service for a year to pursue palliative care training. The National Health Service Corps offers scholarships and loan repayment to primary care providers. Including palliative care in the program would encourage an influx of providers capable of offering palliative care. The Palliative Care and Hospice Education and Training Act (PCHETA) has also been introduced to help address this problem. Read the full article here.

Vaccination Deadlines

More than 30,000 caregivers failed to meet the vaccination deadline set by the state of New York. These caregivers have not started the vaccination process and are unable to continue working in the state. Providers are pushing for a phase-up approach, rather than a hard deadline moving forward to avoid drastic workforce shortages. Read the rest of the article here.

Workforce Shortages

A report from PHI and the Health Workforce Research Center on Long-Term Care (HWRC) illuminated that of the over 160,000 direct care workers displaced by COVID, close to 0% have returned to caregiving. In fact, the majority of these workers have not returned to the workforce at all. Read the full article here.

A New report from ShiftMed indicates that almost half of U.S. nurses are ​“somewhat likely” to leave the profession within the next two years. Some may leave the workforce entirely. 38% plan to switch to non-patient-facing roles and 31% would like to leave the healthcare industry entirely. Higher pay, better shifts and more flexible schedules are the top three items that may keep nurses in the field. Read the rest of the article here.


The Centers for Medicare & Medicaid Services is collaborating with the Occupational Safety and Health Administration on the rules for a federal vaccine mandate. The agency will likely release the details at the end of October. The release will be followed by a 60-day comment period. NAHC President, William A. Dombi weighed in on his expectations for the upcoming rule. Read the full article here.

CMS announced the completion of a ​“strategy refresh” calling for greater payment and regulatory flexibilities supporting the provision of home and community-based care. A webinar and whitepaper were provided to share the direction that the organization envisions as they work towards more accountable care. read the rest of the article here.

CMS has launched a new online hub to share details on how each of the states plans to use the additional HCBS funding provided by the American Rescue Plan. The hub is designed to provide transparency and encourage states to share their strategies and results with one another. Read the full article here.


Despite challenges during the pandemic, PACE programs are growing in popularity. The program’s inherently value-based setup is appealing because it is in line with the vision that many providers have for the future of healthcare in the U.S. In addition, PACE programs have shown impressive outcomes and savings. The PACE Plus Act was introduced to the Senate in April as well, showing expanded support in the Capitol. Read the rest of the article here.


Choose Home

The Choose Home Care Act has been officially introduced to both the U.S. House of Representatives and the Senate. The bill is designed to give Medicare beneficiaries more choices on where they would like to recover after a hospital stay. The next step for the law to move forward is scoring by the Congressional Budget Office (CBO). This scoring will likely take place in November. Read the rest of the article here.

Workplace Violence

The increased interest in home-based care has also come with increased scrutiny. OSHA in particular is taking a closer look at workplace violence in home health care. Home health care workers are vulnerable because they often work alone in their clients’ homes and many have reported experiencing abuse from clients. Providers must have systems in place to take action when these events occur. Read the full article here.


LHC Group and VNHS

During the 2021 Future Conference, hosted by Home Health Care News, the CEOs of the LHC Group and Visiting Nurse Health System opened up about the expansion of HHVBP and Choose Home. Find out what they had to say by reading the full article here.

Visiting Nurse Association Health Group

Dr. Steve Landers president and CEO of Visiting Nurse Association Health Group connected with Home Health Care News to discuss the trends and challenges that are forming the future of the home health industry, as well as VNA’s plans for technological advancement. Read the rest of the article here.


Megan Ambers, VP of Workforce Strategy and HR Innovations for Amedisys, Inc. has been named one of Home Health Care News’ Future Leaders. She highlights the importance of combining data with careful listening to caregivers to understand their needs without bringing preconceived notions to the table. She seeks to cultivate a culture of caregiving. Read the full article here.

Shannon Becher, Area Vice President of Clinical Operations was named a Future Leader by Hospice News. Becher discussed her vision for the future of hospice including the need for more connection and education within the medical community and the drive to set up inpatient unit styled care in the home. Read the rest of the article here.

Addus Homecare Corporation

Addus is seeking to ramp up acquisitions in 2022. The company is looking closely at home health, personal care and hospice opportunities to see which organizations would fit with Addus’ current service areas and culture. The company has also received a shift in referral sources from facility to non-facility-based referrals. Read the rest of the article here.


UCare, an independent, nonprofit health plan has committed to a strategic investment in Lifespark citing the company as a care innovator. UCare and Lifespark previously collaborated in a partnership with North Memorial Health and Ridgeview Medical Center on value-based care agreements with impressive results. Read the full article here.

Sutter Health

Chris Waugh, chief design and innovation officer at Sutter Health expressed his thoughts regarding chronic care at home. ​“I don’t know that there’s a chronic disease that doesn’t benefit from home care,” Waugh said. ​“It’s being the eyes and ears of the home to me, and it raises the empathy quotient on the care team side because you can see the context of what you’re dealing with.” Read the rest of the article here.

Kindred at Home

Alan Wheatley, the retail segment president at Humana discussed the future of homecare at Better Medicare Alliance’s Medicare Advantage Conference. Purchasing Kindred at Home is along Humana to put ​“its MA members in a position to have care delivered in their home”. Read the full article here.

Encompass Health

Encompass Health is preparing to set up the organization’s hospice and home health spin off company as a publicly trading entity in 2022. The goal is to optimize the new company for long-term value creation. Read the rest of the article here.

Bayada Home Health Care

Carla Martinoff, division director at Bayada Home Health Care has been named a 2021 Future Leader by Home Health Care News. In an interview with the publication, Martinoff discussed the importance of increasing wages for workers and always remembering to provide compassionate, person-centered care. Read the full article here.

Jessica DeGrenchie, division director-hospice for Bayada Home Health Care received a future leaders award from Hospice News. DeGrenchie discussed the evolution of hospice and how her background as a social worker affects her predictions and hopes for the industry. Read the rest of the article here.


California Legislation

The state of California is seeking an increase in hospice oversight through two laws that were recently signed by Governor Gavin Newsom. The laws instated a moratorium on new hospice provider licenses and triggered an audit of the licensing and oversight process. Read the full article here.

Primary Care

Home-based primary care is a key component of establishing value-based care and reducing hospitalization rates. Many hospices are weighing the benefits of creating their own primary care service lines to aid MA relationships vs. partnerships with existing primary care providers. Read the rest of the article here.


Value-based care is here to stay, but some industry advocates see major gaps that need to be addressed to improve the results from the demonstration. As a result, organizations including NHPCO, Families USA and Medicare Rights have sent a letter to CMS to delay the second year of the model. Read the full article here.


St. Croix Hospice

St. Croix is expanding its presence in Missouri with the acquisition of three companies from LifeCare Collective. The three companies, HomeCare of Mid Missouri, Nurses & Company and Transitions Hospice will add a total of four locations to St. Croix’s current Missouri branches. Read the full article here.

Founder and CEO, Health Bartness and President and Chief Financial Officer, Stephen Phenneger sat down with Hospice News to discuss what makes St. Croix’s growth strategy unique. St. Croix Hospice is focused particularly on the mid-west. Unlike many other organizations, the provider serves more rural than urban communities. The organization expects to continue to grow through de novo locations and acquisitions in 2022. Read the rest of the article here.

Heart to Heart Hospice

Heart to Heart Hospice is opening a de novo location in Temple, Texas in order to bridge the cap in care between Auston and Waco. Texas has the third largest elderly population in the nation. Read the rest of the article here.

Transitions Hospice

Transitions Hospice is expanding into the Pennsylvania market with the acquisition of Pittsburgh-based Pilgrimage Hospice. The company has aims to increase its footprint into three additional states by quarter 1 of 2022. Read the rest of the article here.